Mayo Medical School, Mayo Clinic, Rochester, MN 55905, USA.
Mayo Clin Proc. 2013 Jan;88(1):38-45. doi: 10.1016/j.mayocp.2012.06.029. Epub 2012 Dec 4.
To determine the incidence and clinical characteristics of cutaneous nontuberculous mycobacterial (NTM) infection during the past 30 years and whether the predominant species have changed.
Using Rochester Epidemiology Project data, we identified Olmsted County, Minnesota, residents with cutaneous NTM infections between January 1, 1980, and December 31, 2009, examining the incidence of infection, patient demographic and clinical features, the mycobacterium species, and therapy.
Forty patients (median age, 47 years; 58% female [23 of 40]) had positive NTM cultures plus 1 or more clinical signs. The overall age- and sex-adjusted incidence of cutaneous NTM infection was 1.3 per 100,000 person-years (95% CI, 0.9-1.7 per 100,000 person-years). The incidence increased with age at diagnosis (P=.003) and was higher in 2000 to 2009 (2.0 per 100,000 person-years; 95% CI, 1.3-2.8 per 100,000 person-years) than in 1980 to 1999 (0.7 per 100,000 person-years; 95% CI, 0.3-1.1 per 100,000 person-years) (P=.002). The distal extremities were the most common sites of infection (27 of 39 patients [69%]). No patient had human immunodeficiency virus infection, but 23% (9 of 39) were immunosuppressed. Of the identifiable causes, traumatic injuries were the most frequent (22 of 29 patients [76%]). The most common species were Mycobacterium marinum (17 of 38 patients [45%]) and Mycobacterium chelonae/Mycobacterium abscessus (12 of 38 patients [32%]). In the past decade (2000-2009), 15 of 24 species (63%) were rapidly growing mycobacteria compared with only 4 of 14 species (29%) earlier (1980-1999) (P=.04).
The incidence of cutaneous NTM infection increased nearly 3-fold during the study period. Rapidly growing mycobacteria were predominant during the past decade.
确定过去 30 年来皮肤非结核分枝杆菌（NTM）感染的发病率和临床特征，以及主要菌种是否发生了变化。
利用罗切斯特流行病学项目的数据，我们确定了明尼苏达州奥姆斯特德县在 1980 年 1 月 1 日至 2009 年 12 月 31 日期间患有皮肤 NTM 感染的居民，检查了感染的发病率、患者的人口统计学和临床特征、分枝杆菌种类和治疗方法。
40 名患者（中位年龄 47 岁；58%为女性[40 名中的 23 名]）的 NTM 培养物呈阳性且伴有 1 种或多种临床体征。皮肤 NTM 感染的总年龄和性别调整发病率为每 10 万人 1.3 例（95%可信区间，每 10 万人 0.9-1.7 例）。诊断时的发病率随年龄的增长而增加（P=.003），2000 年至 2009 年的发病率（每 10 万人 2.0 例；95%可信区间，每 10 万人 1.3-2.8 例）高于 1980 年至 1999 年（每 10 万人 0.7 例；95%可信区间，每 10 万人 0.3-1.1 例）（P=.002）。远端肢体是最常见的感染部位（39 例患者中的 27 例[69%]）。没有患者患有人类免疫缺陷病毒感染，但 23%（39 例中的 9 例）的患者存在免疫抑制。在可识别的病因中，创伤性损伤最为常见（29 例患者中的 22 例[76%]）。最常见的菌种是海分枝杆菌（38 例患者中的 17 例[45%]）和脓肿分枝杆菌/溃疡分枝杆菌（38 例患者中的 12 例[32%]）。在过去的十年（2000 年至 2009 年）中，24 种菌种中的 15 种（63%）是快速生长分枝杆菌，而在此前的十年（1980 年至 1999 年）中，只有 14 种菌种中的 4 种（29%）是快速生长分枝杆菌（P=.04）。
在研究期间，皮肤 NTM 感染的发病率增加了近 3 倍。在过去的十年中，快速生长分枝杆菌占主导地位。
