Garcia-Marcos Patricia W, Plaza-Fornieles Mercedes, Menasalvas-Ruiz Ana, Ruiz-Pruneda Ramon, Paredes-Reyes Pedro, Miguelez Santiago Alfayate
Deparment of General Pediatrics, Arrixaca University Children's Hospital, University of Murcia, Murcia, Spain.
Secretaría de Pediatría, 3a planta Hospital Materno-Infantil, Ctra. Madrid-Cartagena, s/n. 30120 El Palmar, Murcia, Spain.
Eur J Pediatr. 2017 May;176(5):607-613. doi: 10.1007/s00431-017-2882-3. Epub 2017 Mar 6.
The aim of the present study is to clarify the association between environmental exposures and non-tuberculous mycobacterial (NTM) lymphadenitis, during the last decade, in a population of children. In children up to 14 years of age in a pediatric tertiary hospital, all cases of NTM lymphadenopathy with a specific microbiological diagnosis, from January 2004 to January 2015, were reviewed. This is a case-control study (1:5 proportion), in which the prevalence of environmental factors between cases and controls was compared by means of a multivariate logistic regression analysis. A total of 24 cases were diagnosed in the aforementioned period, and 18 of them included in the case-control study. Mycobacterium avium-intracellulare was the predominant mycobacterium species isolated (83.3%). Exposure to hens showed a clear trend to be significantly associated with the disease (OR = 4.33; IC95% 0.97-19.41, p = 0.055), with no significant differences for the rest of the risk factors studied.
M. avium is still the predominant bacteria causing NTM lymphadenitis in children of our region. Contact with hens has been the only risk factor for NTM lymphadenitis detected in the present study. What is Known: • M. avium is the predominant bacteria causing NTM lymphadenitis in children of our region. • There is no consensus on which environmental factors are associated with NTM lymphadenitis in children. What is New: • The only risk factor for NTM lymphadenitis found in the present study was regular contact with hens. Contact with other farm animals was not associated to NTM lymphadenitis.
本研究旨在阐明过去十年间儿童群体中环境暴露与非结核分枝杆菌(NTM)淋巴结炎之间的关联。在一家儿科三级医院14岁及以下的儿童中,对2004年1月至2015年1月期间所有经特定微生物学诊断的NTM淋巴结病病例进行了回顾。这是一项病例对照研究(比例为1:5),通过多因素逻辑回归分析比较病例组和对照组之间环境因素的患病率。在上述期间共诊断出24例病例,其中18例纳入病例对照研究。鸟分枝杆菌复合群是分离出的主要分枝杆菌种类(83.3%)。接触母鸡显示出与该病显著相关的明显趋势(比值比=4.33;95%置信区间0.97 - 19.41,p = 0.055),所研究的其他风险因素无显著差异。
鸟分枝杆菌仍然是我们地区儿童NTM淋巴结炎的主要致病菌。接触母鸡是本研究中检测到的NTM淋巴结炎的唯一风险因素。已知信息:• 鸟分枝杆菌是我们地区儿童NTM淋巴结炎的主要致病菌。• 关于哪些环境因素与儿童NTM淋巴结炎相关尚无共识。新发现:• 本研究中发现的NTM淋巴结炎的唯一风险因素是经常接触母鸡。接触其他农场动物与NTM淋巴结炎无关。