Miguez-Burbano Maria Jose, Flores Monica, Ashkin David, Rodriguez Allan, Granada Ana Maria, Quintero Noaris, Pitchenik Arthur
Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences (D21), 6th Floor, University of Miami School of Medicine, 1400 N.W. 10th Ave., Miami, FL 33136, USA.
Int J Infect Dis. 2006 Jan;10(1):47-55. doi: 10.1016/j.ijid.2004.11.005. Epub 2005 Nov 14.
The present study characterized and determined the prevalence of mycobacterial diseases (tuberculosis (TB) and non-tuberculous mycobacteria (NTM)) as a cause of hospitalization among HIV-infected subjects consecutively admitted to a large metropolitan hospital during 2001/2002.
Hospital discharge diagnoses were established for 521 HIV-positive patients.
Respiratory disease accounted for 49% of the admissions. Community acquired pneumonia (CAP) was the main cause of respiratory disease (52%) followed by Pneumocystis carinii (PCP, 24%), non-tuberculous mycobacteria (NTM, 11%) and Mycobacterium tuberculosis (TB, 9%). Mycobacterium tuberculosis disease was established using bacteriological, clinical and radiographic criteria. NTM disease was defined following the American Thoracic Society criteria. NTM was disseminated in the majority of cases (19 Mycobacterium avium complex (MAC), one Mycobacterium kansasii). Nine patients had respiratory disease (seven MAC, one Mycobacterium fortuitum, one Mycobacterium kansasii) and one had gastrointestinal disease caused by MAC. Mortality was 10% for NTM disseminated cases; none of the TB patients died over the course of the study. The length of hospitalization for NTM patients was longer (15+/-13 days) than for other respiratory cases (10+/-10, p=0.04).
NTM disease along with its related mortality is a significant pathology as a cause of hospitalization among HIV-infected individuals.
本研究对2001/2002年期间连续入住一家大型都市医院的HIV感染患者中作为住院原因的分枝杆菌病（结核病（TB）和非结核分枝杆菌（NTM））进行了特征描述并确定了其患病率。
确定了521例HIV阳性患者的出院诊断。
呼吸系统疾病占入院病例的49%。社区获得性肺炎（CAP）是呼吸系统疾病的主要原因（52%），其次是卡氏肺孢子虫肺炎（PCP，24%）、非结核分枝杆菌（NTM，11%）和结核分枝杆菌（TB，9%）。结核分枝杆菌病根据细菌学、临床和影像学标准确诊。NTM病按照美国胸科学会标准定义。大多数NTM病例为播散性（19例鸟分枝杆菌复合群（MAC），1例堪萨斯分枝杆菌）。9例患者有呼吸系统疾病（7例MAC，1例偶然分枝杆菌，1例堪萨斯分枝杆菌），1例患者有由MAC引起的胃肠道疾病。NTM播散性病例的死亡率为10%；在研究过程中，没有TB患者死亡。NTM患者的住院时间（15±13天）比其他呼吸系统病例（10±10天）更长（p=0.04）。
NTM病及其相关死亡率是HIV感染者住院的一个重要病因。
