Department of Immunology and Infectious Diseases, Sydney Children's Hospital, New South Wales, Australia.
Pediatr Infect Dis J. 2009 Sep;28(9):801-5. doi: 10.1097/INF.0b013e31819f7b3f.
The epidemiology and management of nontuberculous mycobacterial (NTM) infection in Australian children is unknown.
From July 2004 to June 2007, clinicians identified children with NTM infection as part of a nationwide active surveillance network. Following notification, detailed data were collected.
From 192 reports, data were received on 153 cases (response rate: 79.7%). Of these, 102 met inclusion criteria. The median age was 2.9 years. Predisposing conditions were infrequent and included chronic respiratory disease (n = 12) and immunosuppression (n = 6). Lymphadenitis was the most frequent presentation (n = 68) with pulmonary and disseminated disease infrequent (n = 14 and 3, respectively). NTM was isolated in 68 cases with Mycobacterium avium-intracellulare complex most frequently isolated (33/68; 48.5%). Surgery was performed in 78 cases and 42 children were treated with antimycobacterial therapy. Twenty-five subjects received surgery and antimycobacterial therapy. Follow-up data were available for 77 children with recurrence observed in 18 cases. Complete excision was associated with a higher rate of treatment success when compared with all other therapies (OR: 9.48 [95% CI: 2.00-44.97], P = 0.001). Mycobacterium lentiflavum infection accounted for 4.4% of culture confirmed cases and had a lower rate of treatment success than other species (0% vs. 78.2%; P = 0.016).
The incidence of NTM infection in Australian children is 0.84 of 100,000 (95% CI: 0.68-1.02). Infection occurs most often in young children without predisposing conditions. Despite therapy, there was recurrence in 23.4% of cases.
澳大利亚儿童中分枝杆菌（NTM）感染的流行病学和管理情况尚不清楚。
2004 年 7 月至 2007 年 6 月，临床医生将 NTM 感染的儿童作为全国性主动监测网络的一部分进行识别。接到通知后，收集了详细的数据。
在 192 份报告中，收到了 153 例病例的数据（应答率：79.7%）。其中 102 例符合纳入标准。中位年龄为 2.9 岁。常见的发病原因是慢性呼吸道疾病（12 例）和免疫抑制（6 例）。淋巴结炎是最常见的表现（68 例），肺部和播散性疾病罕见（分别为 14 例和 3 例）。68 例分离出 NTM，其中最常分离出鸟分枝杆菌复合体（33/68；48.5%）。78 例患儿行手术治疗，42 例患儿接受抗分枝杆菌治疗。25 例患儿同时接受手术和抗分枝杆菌治疗。77 例患儿有随访数据，18 例患儿复发。与所有其他治疗方法相比，完全切除与更高的治疗成功率相关（OR：9.48 [95%CI：2.00-44.97]，P = 0.001）。分枝杆菌 lentiflavum 感染占培养确诊病例的 4.4%，其治疗成功率低于其他菌种（0% vs. 78.2%；P = 0.016）。
澳大利亚儿童 NTM 感染的发病率为每 10 万人中有 0.84 例（95%CI：0.68-1.02）。感染最常发生在没有发病原因的幼儿中。尽管进行了治疗，但仍有 23.4%的病例复发。
