Ravnholt Cecilie, Kolpen Mette, Skov Marianne, Moser Claus, Katzenstein Terese L, Pressler Tania, Høiby Niels, Qvist Tavs
Cystic Fibrosis Center Copenhagen, Rigshospitalet, Copenhagen, Denmark.
Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
APMIS. 2018 Dec;126(12):885-891. doi: 10.1111/apm.12903.
Mycobacterium abscessus complex can cause severe lung infections and has proven to be a serious threat to patients with cystic fibrosis and a challenge for clinicians due to difficulties in timely diagnosis and complex multidrug treatment regimes. Mycobacterial culture is the gold standard for diagnosis, but in most cystic fibrosis centers it is performed less frequently than culture for other pathogens. Consensus today recommends just one annual mycobacterial culture for asymptomatic patients with cystic fibrosis, a strategy likely to lead to diagnostic delays. Postponement of diagnosis might be the deciding factor in whether an early colonization turns into chronic infection. This review highlights the latest developments in knowledge about the pathogenicity and clinical consequences of M. abscessus complex pulmonary disease, addressing the central theme of why pulmonary infection requires early identification and aggressive antibiotic treatment. The window of opportunity, before M. abscessus complex transforms from a mucosal colonizer to a chronic biofilm infection, is where microbial eradication is most likely to be successful, making early diagnosis essential for improved outcomes.
脓肿分枝杆菌复合群可导致严重的肺部感染，已被证明对囊性纤维化患者构成严重威胁，并且由于难以及时诊断和采用复杂的多药治疗方案，对临床医生来说也是一项挑战。分枝杆菌培养是诊断的金标准，但在大多数囊性纤维化中心，其进行频率低于对其他病原体的培养。目前的共识是，对于无症状的囊性纤维化患者，每年仅进行一次分枝杆菌培养，这一策略可能会导致诊断延迟。诊断的延迟可能是早期定植是否会转变为慢性感染的决定性因素。本综述重点介绍了关于脓肿分枝杆菌复合群肺部疾病的致病性和临床后果的最新知识进展，探讨了肺部感染为何需要早期识别和积极抗生素治疗这一核心主题。在脓肿分枝杆菌复合群从黏膜定植菌转变为慢性生物膜感染之前的这个机会窗口，是微生物根除最有可能成功的阶段，因此早期诊断对于改善预后至关重要。
