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[非结核分枝杆菌]

[Nontuberculous mycobacteria].

作者信息

Emmerich K, Fabri M

机构信息

Klinik und Poliklinik für Dermatologie und Venerologie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.

出版信息

Hautarzt. 2017 May;68(5):403-411. doi: 10.1007/s00105-017-3970-z.

Abstract

Dermatologically relevant nontuberculous mycobacteria (NTM) include Mycobacterium marinum and Mycobacterium ulcerans and different rapidly growing mycobacteria (RGM). RGM are widely present in the environment and are facultative pathogenic. Diagnostic detection of nontuberculous mycobacteria is frequently challenging. Immune-competent individuals mostly develop localized infections. Immune-suppressed patients may present with severe and disseminated disease. In these cases, rapid initiation of medical treatment is important. Moreover, infections with the more aggressive Mycobacterium ulcerans should be treated early. Due to the risk for the development of inducible antibiotic resistance, antibiotic regimes for NTM infections typically require at least two drugs. Surgical treatment should also be considered. This article discusses clinical presentation, diagnostic workup, and in particular antibiotic treatment options for dermatologically relevant infections caused by NTM.

摘要

与皮肤学相关的非结核分枝杆菌(NTM)包括海分枝杆菌、溃疡分枝杆菌以及不同的快速生长分枝杆菌(RGM)。RGM广泛存在于环境中,具有兼性致病性。非结核分枝杆菌的诊断检测常常具有挑战性。免疫功能正常的个体大多发生局部感染。免疫抑制患者可能出现严重的播散性疾病。在这些情况下,迅速开始药物治疗很重要。此外,对于侵袭性更强的溃疡分枝杆菌感染应尽早治疗。由于存在诱导性抗生素耐药性发展的风险,NTM感染的抗生素治疗方案通常需要至少两种药物。还应考虑手术治疗。本文讨论了由NTM引起的与皮肤学相关感染的临床表现、诊断检查,特别是抗生素治疗选择。

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