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戈登分枝杆菌感染在免疫抑制和免疫功能正常宿主中的研究:7 例系列病例报道及文献复习。

Mycobacterium gordonae infection in immunocompromised and immunocompetent hosts: A series of seven cases and literature review.

机构信息

Departments of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Departments of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

J Formos Med Assoc. 2021 Jan;120(1 Pt 2):524-532. doi: 10.1016/j.jfma.2020.06.029. Epub 2020 Jul 4.

Abstract

BACKGROUND/PURPOSE: Mycobacterium gordonae is a ubiquitous environmental mycobacteria and has been long considered an opportunistic pathogen, causing infections only in immunocompromised hosts. Cases of M. gordonae related infections in immunocompetent host have rarely been reported, and the pathogenicity of M. gordonae remained uncertain.

METHODS

From January 2016 to December 2018, seven cases of M. gordonae infection were diagnosed and treated at National Taiwan University Hospital.

RESULTS

Six cases had at least one underlying disease affecting immune status, while one case had no identifiable underlying disease. The sites of infection were lung (n = 3), skin and soft tissue (n = 3), and one had disseminated disease involving the lung and bone marrow. All patients were cured after anti-mycobacterial treatment, except one patient died of refractory leukemia.

CONCLUSION

Compatible with the literature reports, we demonstrate that M. gordonae could be pathogenic and causing infection not only in the immunocompromised host, but also in the otherwise healthy population. Multi-antimicrobial combination and adequate source control could have good therapeutic effect for patients with M. gordonae infections.

摘要

背景/目的:戈登分枝杆菌是一种普遍存在于环境中的分枝杆菌,长期以来被认为是一种机会致病菌,仅在免疫功能低下的宿主中引起感染。免疫功能正常宿主中戈登分枝杆菌相关感染的病例很少见,其致病性仍不确定。

方法

2016 年 1 月至 2018 年 12 月,在国立台湾大学医院诊断并治疗了 7 例戈登分枝杆菌感染病例。

结果

6 例至少有一种影响免疫状态的基础疾病,而 1 例无明确的基础疾病。感染部位为肺部(n=3)、皮肤和软组织(n=3),1 例为肺部和骨髓播散性疾病。除 1 例因难治性白血病死亡外,所有患者经抗分枝杆菌治疗后均治愈。

结论

与文献报道一致,我们证明戈登分枝杆菌不仅在免疫功能低下的宿主中具有致病性并导致感染,而且在其他健康人群中也具有致病性。对于戈登分枝杆菌感染患者,多抗菌药物联合治疗和充分的病因控制可能具有良好的治疗效果。

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