Iroh Tam P Y, Kline S, Ward G, Ferrieri P
Department of Pediatrics,University of Minnesota Masonic Children's Hospital,Minneapolis,MN,USA.
Department of Medicine,University of Minnesota,Minneapolis,MN,USA.
Epidemiol Infect. 2015 Nov;143(15):3173-81. doi: 10.1017/S0950268815000333. Epub 2015 Mar 12.
Non-tuberculous mycobacteria (NTM) illness is an emerging life-threatening infection, and paediatric features have not been well studied. The objective of our study was to review the NTM isolates of hospitalized paediatric patients identified at our institution and to describe the characteristics of these cases. Our retrospective chart review from 2010 to 2013 identified 45 patients with 46 positive NTM cultures. Fifteen (33%) patients had received haematopoietic cell transplant, 13 (29%) had cystic fibrosis, and six (13%) were previously healthy. Twenty-seven (59%) NTM isolates were Mycobacterium chelonae/abscessus, 14 (30%) were M. avium intracellulare, and four (9%) were M. immunogenum. The majority (65%) of cases were community-acquired, and 20 (43%) patients were treated as infection. This case series identified a predominance of M. chelonae/abscessus, and includes a substantial number of haematopoietic cell transplant patients, which reflects the changing spectrum of NTM disease as molecular diagnostics improve and quaternary care facilities provide for a larger immunocompromised population.
非结核分枝杆菌（NTM）病是一种新出现的危及生命的感染，其儿科特征尚未得到充分研究。我们研究的目的是回顾在我们机构确诊的住院儿科患者的NTM分离株，并描述这些病例的特征。我们对2010年至2013年的病历进行回顾性研究，确定了45例患者，其NTM培养结果为46例阳性。15例（33%）患者接受过造血细胞移植，13例（29%）患有囊性纤维化，6例（13%）此前身体健康。27例（59%）NTM分离株为龟分枝杆菌/脓肿分枝杆菌，14例（30%）为鸟分枝杆菌复合群，4例（9%）为免疫分枝杆菌。大多数病例（65%）为社区获得性，20例（43%）患者按感染进行治疗。该病例系列显示龟分枝杆菌/脓肿分枝杆菌占主导地位，且包括大量造血细胞移植患者，这反映了随着分子诊断技术的改进以及四级医疗设施为更多免疫功能低下人群提供服务，NTM疾病谱正在发生变化。
