Clinical Education Centre, Kyushu University Hospital, Fukuoka, Japan; Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
J Infect Chemother. 2018 Jan;24(1):78-81. doi: 10.1016/j.jiac.2017.08.011. Epub 2017 Oct 6.
In patients undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT), post-transplant lung infection is critical for their prognosis. Mycobacterium abscessus complex is not fully recognized as a nontuberculous mycobacteria (NTM) pathogen of post-SCT lung infection. Here, we present three post-allogeneic SCT patients who developed pulmonary infection caused by M. abscessus complex including M. abscessus and M. massiliense. In all three cases, macrolide antibiotics had been administered for bronchiolitis obliterans syndrome (BOS) before the confirmation of their infection, and macrolide resistance was noted in the M. abscessus isolates, one of which resulted in an unfavorable treatment outcome. It is important to consider M. abscessus lung infection as well as other NTM in patients receiving allo-SCT, particularly those receiving macrolide therapy for BOS.
在接受异基因造血干细胞移植 (allo-SCT) 的患者中，移植后肺部感染对其预后至关重要。脓肿分枝杆菌复合体尚未被完全认为是移植后肺部感染的非结核分枝杆菌 (NTM) 病原体。在这里，我们介绍了 3 例接受异基因 SCT 后发生由脓肿分枝杆菌复合体引起的肺部感染的患者，包括脓肿分枝杆菌和马萨诸塞分枝杆菌。在所有 3 例病例中，在确认感染之前，均已使用大环内酯类抗生素治疗细支气管炎闭塞性综合征 (BOS)，并且在脓肿分枝杆菌分离株中发现了大环内酯类耐药性，其中 1 例导致治疗结果不佳。对于接受 allo-SCT 的患者，特别是那些接受大环内酯类药物治疗 BOS 的患者，需要考虑脓肿分枝杆菌肺部感染以及其他 NTM。
