Abad Cybele L, Razonable Raymund R
Division of Infectious Diseases and the William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, 55905 MN, United States.
J Clin Tuberc Other Mycobact Dis. 2016 Apr 27;4:1-8. doi: 10.1016/j.jctube.2016.04.001. eCollection 2016 Aug.
Non-tuberculous mycobacteria are ubiquitous environmental organisms that are now increasingly recognized as important causes of clinical disease in solid organ transplant recipients. Risk factors of non-tuberculous mycobacteria infection are severe immunologic defects and structural abnormalities. Lung transplant recipients are at higher risk for non-tuberculous mycobacterial disease compared to recipients of other solid organs. The clinical presentation could be skin and soft tissue infection, osteoarticular disease, pleuropulmonary infection, bloodstream (including catheter-associated) infection, lymphadenitis, and disseminated or multi-organ disease. Management of non-tuberculous mycobacteria infection is complex due to the prolonged treatment course with multi-drug regimens that are anticipated to interact with immunosuppressive medications. This review article provides an update on infections due to non-tuberculous mycobacteria after solid organ transplantation, and discusses the epidemiology, risk factors, clinical presentation, and management.
非结核分枝杆菌是普遍存在于环境中的微生物,如今越来越被认为是实体器官移植受者临床疾病的重要病因。非结核分枝杆菌感染的危险因素包括严重的免疫缺陷和结构异常。与其他实体器官移植受者相比,肺移植受者发生非结核分枝杆菌病的风险更高。临床表现可能为皮肤和软组织感染、骨关节疾病、胸膜肺部感染、血流(包括导管相关)感染、淋巴结炎以及播散性或多器官疾病。由于多药联合方案治疗疗程长且预计会与免疫抑制药物相互作用,非结核分枝杆菌感染的管理较为复杂。这篇综述文章提供了实体器官移植后非结核分枝杆菌感染的最新情况,并讨论了其流行病学、危险因素、临床表现和管理。