Desai Angel N, Hurtado Rocío M
Massachusetts General Hospital, Division of Infectious Diseases, 55 Fruit Street, Boston, MA 02114 USA.
Harvard Medical School, 25 Shattuck St, Boston MA 02115 USA.
Curr Treat Options Infect Dis. 2018 Jun;10(2):169-181. doi: 10.1007/s40506-018-0165-9. Epub 2018 Apr 25.
Non-tuberculous mycobacterial [NTM] infections in the hospital setting are a complex and often challenging entity. The goal of this review is to discuss diagnostic and treatment strategies for established as well as emerging nosocomial NTM infections.
NTM outbreaks have been documented in a variety of hospital settings. Contamination of medical devices or aqueous solutions is often implicated in the spread of infection. More recently, the slow grower has been reported in the setting of contaminated heater-cooler devices used for cardiopulmonary bypass and extracorporeal membrane oxygenation. In addition, increases in medical tourism for cosmetic surgery have led to outbreaks of rapidly growing mycobacteria.
Diagnosis and treatment of nosocomial NTM pose many challenges for the clinician. Surgical resection or debridement as well as combination antimycobacterial therapy are a mainstay in therapeutic management. Strict infection control and prevention practices are critical to the identification and cessation of outbreaks.
医院环境中的非结核分枝杆菌（NTM）感染是一个复杂且常常具有挑战性的问题。本综述的目的是讨论已确诊的以及新出现的医院获得性NTM感染的诊断和治疗策略。
NTM暴发已在多种医院环境中被记录。医疗设备或水溶液的污染常与感染传播有关。最近，在用于体外循环和体外膜肺氧合的污染的热交换器装置中报告了缓慢生长菌。此外，美容手术医疗旅游的增加导致了快速生长分枝杆菌的暴发。
医院获得性NTM的诊断和治疗给临床医生带来了许多挑战。手术切除或清创以及联合抗分枝杆菌治疗是治疗管理的主要手段。严格的感染控制和预防措施对于识别和终止暴发至关重要。
