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囊性纤维化患儿和青少年中分枝杆菌非结核感染的流行病学:英国囊性纤维化登记研究分析。

Epidemiology of Nontuberculous Mycobacteria Infection in Children and Young People With Cystic Fibrosis: Analysis of UK Cystic Fibrosis Registry.

机构信息

Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne.

Department of Child Health, University of Liverpool.

出版信息

Clin Infect Dis. 2019 Feb 15;68(5):731-737. doi: 10.1093/cid/ciy531.

Abstract

BACKGROUND

Infection with nontuberculous mycobacteria (NTM) is of growing clinical concern in people with cystic fibrosis (CF). The epidemiology of infection in children and young people remains poorly understood. Our goal was to investigate the epidemiology of NTM infection in the pediatric age group using data from the UK CF Registry.

METHODS

Data from 2010-2015 for individuals aged <16 years (23200 observations from 5333 unique individuals) were obtained. Univariate analysis of unique individuals comparing all key clinical factors and health outcomes to NTM status was performed. The significant factors that were identified were used to generate a multivariate logistic regression model that, following step-wise removal, generated a final parsimonious model.

RESULTS

The prevalence of individuals with a NTM-positive respiratory culture increased every year from 2010 (45 [1.3%]) to 2015 (156 [3.8%]). Allergic bronchopulmonary aspergillosis (odds ratio [OR], 2.66; P = 5.0 × 10-8), age (OR, 1.08; P = 3.4 × 10-10), and intermittent Pseudomonas aeruginosa infection (OR, 1.51; P = .004) were significantly associated with NTM infection.

CONCLUSIONS

NTM infection is of increasing prevalence in the UK pediatric CF population. This study highlights the urgent need for work to establish effective treatment and prevention strategies for NTM infection in young people with CF.

摘要

背景

分枝杆菌(NTM)感染在囊性纤维化(CF)患者中越来越受到临床关注。儿童和青少年感染的流行病学仍知之甚少。我们的目标是使用英国 CF 登记处的数据来研究儿科人群中 NTM 感染的流行病学。

方法

获取了 2010-2015 年年龄<16 岁(5333 名个体中的 23200 个观察值)的个体数据。对所有关键临床因素和健康结果与 NTM 状态进行个体的单变量分析。确定了显著的因素,用于生成多变量逻辑回归模型,经过逐步删除,生成了最终的简约模型。

结果

2010 年(45 [1.3%])至 2015 年(156 [3.8%]),有 NTM 阳性呼吸道培养的个体患病率逐年增加。变应性支气管肺曲霉病(比值比[OR],2.66;P = 5.0×10-8)、年龄(OR,1.08;P = 3.4×10-10)和间歇性铜绿假单胞菌感染(OR,1.51;P =.004)与 NTM 感染显著相关。

结论

NTM 感染在英国儿科 CF 人群中患病率不断增加。本研究强调了迫切需要为 CF 青少年制定有效的 NTM 感染治疗和预防策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/735d/6376093/5960f0119015/ciy53101.jpg

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