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非结核分枝杆菌。一种新兴威胁?

Non-Tuberculous Mycobacteria. An Emerging Threat?

机构信息

Unidad de Referencia Regional de Micobacterias, Servicio de Microbiología, AGC Laboratorio de Medicina, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.

Servicio de Neumología, Hospital Santa Marina, Bilbao, Bizkaia, España.

出版信息

Arch Bronconeumol. 2017 Oct;53(10):554-560. doi: 10.1016/j.arbres.2017.02.014. Epub 2017 Apr 19.

Abstract

INTRODUCTION AND OBJECTIVE

Non-tuberculous mycobacteria (NTM) isolates are becoming more common. The main objective of our study was to establish the number and diversity of NTM species in our region and their distribution according to the source sample, age and gender of the patients, and to analyse clinically significant isolates.

METHODOLOGY

Prospective study of all NTM isolated in Asturias from 2005 to 2012. Samples were processed following internationally accepted guidelines. Statistical analysis was based on Fisher's exact test for 2×2 contingency tables.

RESULTS

A total of 3,284 mycobacteria were isolated: 1,499 Mycobacterium tuberculosis complex (MTB) and 1,785 NTM.During the study, NTM isolation rates increased while MTB isolation decreased. NTM were more frequent in men (P<.001). M.gordonae was the most frequently isolated species but did not cause disease in any case. NTM isolates from 212 patients were associated with clinically significant disease (17.1%). M.kansasii and M.avium were most commonly associated with disease. The number of M.kansasii isolates from men was statistically significant (P<.01).

CONCLUSIONS

In our study, NTM isolates increased by 35%, compared with a 21% decline in cases of MTB. Both isolation of NTM and clinically significant cases were more common in men. Only 17.1% of NTM isolates were associated with disease, most commonly M.avium complex and M.kansasii.

摘要

介绍和目的

非结核分枝杆菌(NTM)分离株越来越常见。我们研究的主要目的是确定我们地区 NTM 物种的数量和多样性,以及根据患者的样本来源、年龄和性别进行分布,并分析临床显著分离株。

方法

对 2005 年至 2012 年在阿斯图里亚斯分离的所有 NTM 进行前瞻性研究。样品按照国际公认的指南进行处理。统计分析基于 2x2 列联表的 Fisher 精确检验。

结果

共分离出 3284 株分枝杆菌:1499 株结核分枝杆菌复合体(MTB)和 1785 株 NTM。研究期间,NTM 分离率增加,而 MTB 分离率下降。NTM 在男性中更为常见(P<.001)。M.gordonae 是最常分离的物种,但在任何情况下都不会引起疾病。212 例患者的 NTM 分离株与临床显著疾病相关(17.1%)。M.kansasii 和 M.avium 与疾病最相关。从男性分离出的 M.kansasii 菌株数量具有统计学意义(P<.01)。

结论

在我们的研究中,与 MTB 下降 21%相比,NTM 分离株增加了 35%。NTM 的分离和临床显著病例在男性中更为常见。只有 17.1%的 NTM 分离株与疾病相关,最常见的是 M.avium 复合体和 M.kansasii。

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