慢性脓肿分枝杆菌感染与囊性纤维化患者肺功能下降。
Chronic Mycobacterium abscessus infection and lung function decline in cystic fibrosis.
机构信息
Statistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
出版信息
J Cyst Fibros. 2010 Mar;9(2):117-23. doi: 10.1016/j.jcf.2009.12.001. Epub 2010 Jan 13.
BACKGROUND
Although nontuberculous mycobacteria (NTM) are recognized pathogens in cystic fibrosis (CF), associations with clinical outcomes remain unclear.
METHODS
Microbiological data was obtained from 1216 CF patients over 8years (481+/-55patients/year). Relationships to clinical outcomes were examined in the subset (n=271, 203+/-23 patients/year) with longitudinal data.
RESULTS
Five hundred thirty-six of 4862 (11%) acid-fast bacilli (AFB) cultures grew NTM, with Mycobacterium abscessus (n=298, 55.6%) and Mycobacterium avium complex (n=190, 35.4%) most common. Associated bacterial cultures grew Stenotrophomonas or Aspergillus species more often when NTM were isolated (18.2% vs. 8.4% and 13.9% vs. 7.2%, respectively, p<0.01). After controlling for confounders, patients with chronic M. abscessus infection had greater rates of lung function decline than those with no NTM infection (-2.52 vs. -1.64% predicted FEV(1)/year, p<0.05).
CONCLUSIONS
NTM infection is common in CF and associated with particular pathogens. Chronic M. abscessus infection is associated with increased lung function decline.
背景
虽然非结核分枝杆菌（NTM）被认为是囊性纤维化（CF）的病原体，但与临床结果的关系仍不清楚。
方法
从 8 年期间的 1216 例 CF 患者中获得微生物学数据（481+/-55 例/年）。在具有纵向数据的亚组（n=271，203+/-23 例/年）中检查与临床结果的关系。
结果
在 4862 例酸性快速分枝杆菌（AFB）培养物中，有 536 例（11%）生长了 NTM，其中最常见的是脓肿分枝杆菌（n=298，55.6%）和鸟分枝杆菌复合体（n=190，35.4%）。当分离出 NTM 时，相关细菌培养物更常生长 Stenotrophomonas 或曲霉菌种（分别为 18.2%比 8.4%和 13.9%比 7.2%，p<0.01）。在控制混杂因素后，慢性脓肿分枝杆菌感染的患者比没有 NTM 感染的患者肺功能下降速度更快（-2.52 比-1.64%预测 FEV1/年，p<0.05）。
结论
NTM 感染在 CF 中很常见，并与特定病原体有关。慢性脓肿分枝杆菌感染与肺功能下降增加有关。
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