Guglielmetti Lorenzo, Mougari Faiza, Lopes Amanda, Raskine Laurent, Cambau Emmanuelle
AP-HP, Hôpital Lariboisière-Fernand Widal, Service de Bactériologie, F-75010 Paris, France.
Centre National de Référence des Mycobactéries et Résistance des Mycobactéries aux Antituberculeux (CNR-MyRMA), F-75010 Paris, France.
Future Microbiol. 2015;10(9):1467-83. doi: 10.2217/fmb.15.64. Epub 2015 Sep 7.
Nontuberculous mycobacteria (>150 species such as Mycobacterium avium, Mycobacterium kansasii, Mycobacterium chelonae and Mycobacterium abscessus) are opportunistic pathogens causing lung and extrarespiratory infections, beside M. ulcerans and M. marinum that are pathogens causing specific skin and soft tissue infections. Disseminated infections occur only in severe immunosuppressed conditions such as AIDS. The diagnosis is based on repeated isolations of the same mycobacterium associated with clinical and radiological signs, and the absence of tuberculosis. Precise species identification is obtained by molecular biology. Therapeutic antibiotic regimens differ with regard to the mycobacterial species that are involved. Prevention of iatrogenic infections relies on using sterile water in all injections, healthcare and cosmetic occupations. Future perspectives are to set effective antibiotic regimens tested in randomized therapeutic trials.
非结核分枝杆菌（超过150种，如鸟分枝杆菌、堪萨斯分枝杆菌、龟分枝杆菌和脓肿分枝杆菌）是引起肺部和肺外感染的机会性病原体，此外溃疡分枝杆菌和海分枝杆菌是引起特定皮肤和软组织感染的病原体。播散性感染仅发生在如艾滋病等严重免疫抑制的情况下。诊断基于同一分枝杆菌的反复分离，并伴有临床和放射学体征，且排除结核病。通过分子生物学可实现精确的菌种鉴定。治疗性抗生素方案因所涉及的分枝杆菌种类而异。预防医源性感染依赖于在所有注射、医疗保健和美容行业中使用无菌水。未来的前景是制定在随机治疗试验中经过测试的有效抗生素方案。
