Menetrey Q, Dupont C, Chiron R, Marchandin H
HydroSciences Montpellier, CNRS, IRD, université de Montpellier, Montpellier, France.
HydroSciences Montpellier, CNRS, IRD, laboratoire d'écologie microbienne hospitalière, université de Montpellier, CHU de Montpellier, Montpellier, France.
Rev Mal Respir. 2020 Sep;37(7):561-571. doi: 10.1016/j.rmr.2020.06.006. Epub 2020 Jul 16.
Common major pathogens like Pseudomonas aeruginosa are identified in the airways of patients with cystic fibrosis (CF) and non-CF bronchiectasis. However, other opportunistic bacterial pathogens like Achromobacter xylosoxidans complex, Stenotrophomonas maltophilia and non-tuberculous mycobacteria are currently emerging in CF and are also reported in non-CF bronchiectasis.
The emergence of opportunistic bacterial pathogens has been recognized in CF through annual national reports of sputum microbiology data. Despite common factors driving the emergence of bacteria identified in CF and non-CF bronchiectasis patients, bronchiectasis registries have been created more recently and no longitudinal analysis of recorded microbiological data is currently available in the literature, thereby preventing the recognition of emerging bacteria in patients with non-CF bronchiectasis.
A longitudinal follow-up of microbiological data is still needed in non-CF bronchiectasis to identify emerging opportunistic bacterial pathogens. Homogeneity in practice of sputum microbiological examination is also required to allow comparative analysis of data in CF and non-CF bronchiectasis.
Bacterial pathogens recognized as emerging in CF have to be more carefully monitored in non-CF bronchiectasis in view of their association with deterioration of the lung disease.
常见的主要病原体,如铜绿假单胞菌,在囊性纤维化(CF)患者和非CF支气管扩张患者的气道中被发现。然而,其他机会性细菌病原体,如木糖氧化无色杆菌复合体、嗜麦芽窄食单胞菌和非结核分枝杆菌,目前在CF中正在出现,并且在非CF支气管扩张中也有报道。
通过每年的全国痰液微生物学数据报告,CF中机会性细菌病原体的出现已得到认可。尽管CF和非CF支气管扩张患者中细菌出现的常见驱动因素相同,但支气管扩张登记处是最近才建立的,目前文献中尚无对记录的微生物学数据的纵向分析,从而无法识别非CF支气管扩张患者中出现的细菌。
非CF支气管扩张仍需要对微生物学数据进行纵向随访,以识别新出现的机会性细菌病原体。还需要痰液微生物学检查实践的同质性,以便对CF和非CF支气管扩张的数据进行比较分析。
鉴于CF中出现的细菌病原体与肺部疾病恶化的关联,在非CF支气管扩张中必须更仔细地监测它们。