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2008 - 2013年免疫功能低下患者的黏液产色分枝杆菌菌血症

Mycobacterium mucogenicum bacteremia in immune-compromised patients, 2008-2013.

作者信息

Abidi M Z, Ledeboer N, Banerjee A, Hari P

机构信息

Division of Infectious Disease, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.

Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

Diagn Microbiol Infect Dis. 2016 Jun;85(2):182-5. doi: 10.1016/j.diagmicrobio.2016.02.012. Epub 2016 Feb 17.

Abstract

Mycobacterium mucogenicum (MM) is a rapidly growing nontuberculous mycobacterium that may rarely cause bacteremia in immune-compromised hosts. All MM cases from 2008 to 2013 were analyzed across 4 risk groups: stem cell transplantation (SCT), hematologic malignancy, solid tumors, and others. Descriptive analysis was performed, as well as comparative analysis of neutropenic patients (absolute neutrophil count ≤1000/μL) with nonneutropenic patients. Of 39 MM cases, 27 patients had undergone SCT. Neutropenia was present in 12 patients. There was a significant difference in the presence of fever at the time of MM bacteremia between neutropenic and nonneutropenic groups (92% versus 42%; P=0.005). Central venous catheter (CVC) was present in 33 cases. All patients were treated with >1 antibiotic. Most frequently used combination antibiotic regimen involved clarithromycin and amikacin. Median duration of antibiotic treatment was 42days. Bacteremia resolved in all cases with CVC removal and combination antibiotic treatment.

摘要

黏液产生分枝杆菌(MM)是一种快速生长的非结核分枝杆菌,在免疫功能低下的宿主中可能很少引起菌血症。对2008年至2013年期间的所有MM病例按4个风险组进行了分析:干细胞移植(SCT)、血液系统恶性肿瘤、实体瘤和其他。进行了描述性分析,以及中性粒细胞减少患者(绝对中性粒细胞计数≤1000/μL)与非中性粒细胞减少患者的比较分析。在39例MM病例中,27例患者接受了SCT。12例患者存在中性粒细胞减少。中性粒细胞减少组和非中性粒细胞减少组在MM菌血症发生时发热情况存在显著差异(92%对42%;P=0.005)。33例病例中存在中心静脉导管(CVC)。所有患者均接受了1种以上抗生素治疗。最常用的联合抗生素方案包括克拉霉素和阿米卡星。抗生素治疗的中位持续时间为42天。所有病例在拔除CVC并进行联合抗生素治疗后菌血症均得到缓解。

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