同情一氧化氮辅助治疗囊性纤维化患者持续分枝杆菌感染。
Compassionate Nitric Oxide Adjuvant Treatment of Persistent Mycobacterium Infection in Cystic Fibrosis Patients.
出版信息
Pediatr Infect Dis J. 2018 Apr;37(4):336-338. doi: 10.1097/INF.0000000000001780.
BACKGROUND
Mycobacterium abscessus is one of the most antibiotic-resistant pathogens in cystic fibrosis (CF) patients. Nitric oxide (NO) has broad-spectrum antimicrobial activity. Clinical studies indicated that it is safe and tolerable when given as 160 ppm intermittent inhalations.
METHODS
A prospective compassionate adjunctive inhaled NO therapy in 2 CF patients with persistent Mycobacterium abscessus infection.
RESULTS
No adverse events were reported. Both subjects showed significant reduction in quantitative polymerase chain reaction results for Mycobacterium abscessus load in sputum during treatment; estimated colony forming unit decreased from 7000 to 550 and from 3000 to 0 for patient 1 and patient 2, respectively.
CONCLUSIONS
Intermittent inhalations with 160 ppm NO are well tolerated, safe and result in significant reduction of Mycobacterium abscessus load. It may constitute an adjuvant therapeutic approach for CF patients with Mycobacterium abscessus lung disease. Further studies are needed to define dosing, duration and long-term clinical outcome.
背景
脓肿分枝杆菌是囊性纤维化 (CF) 患者中对抗生素耐药性最强的病原体之一。一氧化氮 (NO) 具有广谱抗菌活性。临床研究表明，以 160ppm 间歇性吸入的方式给药时，其安全性和耐受性良好。
方法
对 2 例持续性脓肿分枝杆菌感染的 CF 患者进行前瞻性同情性辅助吸入 NO 治疗。
结果
未报告不良事件。在治疗期间，2 例患者的痰中脓肿分枝杆菌负荷的定量聚合酶链反应结果均显著降低；患者 1 和患者 2 的估计菌落形成单位分别从 7000 下降至 550 和从 3000 下降至 0。
结论
160ppm 的 NO 间歇性吸入耐受性良好、安全，并能显著降低脓肿分枝杆菌负荷。它可能是脓肿分枝杆菌肺病 CF 患者的一种辅助治疗方法。需要进一步研究来确定剂量、持续时间和长期临床结果。
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