免疫抑制宿主中的非结核分枝杆菌感染
Nontuberculous mycobacteria infections in immunosuppressed hosts.
作者信息
Henkle Emily, Winthrop Kevin L
机构信息
HIV, STD, and TB Section, Public Health Division, Oregon Health Authority, 800 NE Oregon Street, Suite 1105, Portland, OR 97232, USA.
Division of Infectious Diseases, Oregon Health and Science University, 3375 Southwest Terwilliger Boulevard, Mailstop CEI, Portland, OR 97239, USA; Division of Public Health and Preventative Medicine, Oregon Health and Science University, 3375 Southwest Terwilliger Boulevard, Mailstop CEI, Portland, OR 97239, USA.
出版信息
Clin Chest Med. 2015 Mar;36(1):91-9. doi: 10.1016/j.ccm.2014.11.002. Epub 2014 Dec 23.
Abstract
Diseases and therapies that reduce cell-mediated immunity increase the risk of nontuberculous mycobacterial (NTM) disease. Extrapulmonary NTM disease, including disseminated, skin, and catheter-related disease, is more common in immunosuppressed than immunocompetent patients. Mycobacterium avium complex remains the most common cause of NTM infection, but rapid growers including Mycobacterium abscessus, Mycobacterium chelonae, and Mycobacterium fortuitum play an important role in skin and catheter-related infections. With the exception of antibiotic prophylaxis for AIDS patients, the prevention of NTM remains difficult. Management is complicated, involving restoration of immune function and removal of catheters in addition to treatment with species-specific antibiotics per current guidelines.
摘要
降低细胞介导免疫的疾病和疗法会增加非结核分枝杆菌（NTM）病的风险。肺外NTM病，包括播散性、皮肤和导管相关疾病，在免疫抑制患者中比免疫功能正常的患者更常见。鸟分枝杆菌复合体仍然是NTM感染最常见的原因，但快速生长菌，包括脓肿分枝杆菌、龟分枝杆菌和偶然分枝杆菌，在皮肤和导管相关感染中起重要作用。除了对艾滋病患者进行抗生素预防外，NTM的预防仍然困难。管理很复杂，除了按照现行指南用针对特定菌种的抗生素治疗外，还涉及恢复免疫功能和拔除导管。
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