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1997-2008 年台湾地区非结核分枝杆菌所致皮肤软组织感染。

Skin and soft-tissue infection caused by non-tuberculous mycobacteria in Taiwan, 1997-2008.

机构信息

Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.

出版信息

Epidemiol Infect. 2011 Jan;139(1):121-9. doi: 10.1017/S0950268810001603. Epub 2010 Jul 2.

Abstract

The aim of this study was to investigate the clinical, microbiological, and pathological characteristics and the outcomes of skin and soft-tissue infection (SSTI) caused by non-tuberculous mycobacteria (NTM). Medical records of 50 patients with SSTI caused by NTM identified from 2005 to 2008 and 63 patients previously reported in a medical centre from 1997 to 2004 were reviewed. The annual incidence (per 100,000 outpatients and in-patients) ranged from 0·57 in 2005, 0·38 in 2007, to 1·1 in 2008, with an average of 0·62/100,000. From 1997 to 2008, the average incidence was 1·39/100,000 patients. The average annual incidence of SSTI caused by NTM was 0·62/100,000 outpatients and in-patients during 2005 and 2008. Of the total of 113 patients identified during the 12-year period, patients infected with Mycobacterium fortuitum and M. marinum were younger than those infected with M. avium-intracellulare complex (MAC) (36 and 44 years vs. 55 years, P=0·004 and P=0·056, respectively), and were more likely to have previous invasive procedures than those infected with MAC and M. abscessus (81·8% and 72·0% vs. 27·8% and 54·8%, P=0·007), and less likely to have associated immunosuppression (9·1% and 24% vs. 66·7% and 45·2%, P=0·006). Granuloma was more often observed in immunocompetent patients (60·1% vs. 40%, P=0·019), and in M. marinum-infected specimens (78·3%). There were significant differences in the demographic and clinical features of patients with NTM SSTI, including immunosuppression, trauma experience, and depth of tissue infections.

摘要

本研究旨在探讨非结核分枝杆菌(NTM)引起的皮肤软组织感染(SSTI)的临床、微生物学和病理学特征及结局。对 2005 年至 2008 年间从 50 例 NTM 引起的 SSTI 患者的病历进行回顾性分析,并结合 1997 年至 2004 年某医学中心之前报道的 63 例患者的数据。每年(每 10 万门诊和住院患者)的发病率范围为 2005 年的 0.57,2007 年的 0.38,2008 年的 1.1,平均为 0.62/10 万。1997 年至 2008 年,平均发病率为 1.39/10 万患者。2005 年至 2008 年间,门诊和住院患者中 NTM 引起的 SSTI 年平均发病率为 0.62/10 万。在这 12 年期间共发现 113 例患者,其中感染偶发分枝杆菌和海分枝杆菌的患者比感染鸟分枝杆菌胞内复合体(MAC)的患者年轻(36 岁和 44 岁 vs. 55 岁,P=0.004 和 P=0.056),且与 MAC 和脓肿分枝杆菌感染相比,更有可能接受过侵袭性手术(81.8%和 72.0% vs. 27.8%和 54.8%,P=0.007),而与免疫抑制的关系更小(9.1%和 24% vs. 66.7%和 45.2%,P=0.006)。免疫功能正常的患者(60.1% vs. 40%,P=0.019)和感染海分枝杆菌的患者(78.3%)更常出现肉芽肿。NTM SSTI 患者的人口统计学和临床特征存在显著差异,包括免疫抑制、创伤经历和组织感染深度。

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