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免疫功能低下患者中由非结核分枝杆菌和真菌引起的机会性合并感染

Opportunist Coinfections by Nontuberculous Mycobacteria and Fungi in Immunocompromised Patients.

作者信息

Joao Ines, Bujdáková Helena, Jordao Luisa

机构信息

National Institute of Health Doutor Ricardo Jorge, 1649-016 Lisboa, Portugal.

Department of Microbiology and Virology, Faculty of Natural Sciences, Comenius University in Bratislava, 842 15 Bratislava, Slovakia.

出版信息

Antibiotics (Basel). 2020 Nov 2;9(11):771. doi: 10.3390/antibiotics9110771.

Abstract

Nontuberculous mycobacteria (NTM) and many fungal species (spp.) are commonly associated with opportunistic infections (OPIs) in immunocompromised individuals. Moreover, occurrence of concomitant infection by NTM (mainly spp. of complex and complex) and fungal spp. (mainly, , and ) is very challenging and is associated with poor patient prognosis. The most frequent clinical symptoms for coinfection and infection by single agents (fungi or NTM) are similar. For this reason, the accurate identification of the aetiological agent(s) is crucial to select the best treatment approach. Despite the significance of this topic it has not been sufficiently addressed in the literature. This review aims at summarizing case reports and studies on NTM and fungi coinfection during the last 20 years. In addition, it briefly characterizes OPIs and coinfection, describes key features of opportunistic pathogens (e.g., NTM and fungi) and human host predisposing conditions to OPIs onset and outcome. The review could interest a wide spectrum of audiences, including medical doctors and scientists, to improve awareness of these infections, leading to early identification in clinical settings and increasing research in the field. Improved diagnosis and availability of therapeutic options might contribute to improve the prognosis of patients' survival.

摘要

非结核分枝杆菌(NTM)和许多真菌物种通常与免疫功能低下个体的机会性感染(OPIs)相关。此外,NTM(主要是 复合体和 复合体的物种)和真菌物种(主要是 、 和 )同时感染的情况极具挑战性,且与患者预后不良相关。同时感染以及单一病原体(真菌或NTM)感染最常见的临床症状相似。因此,准确识别病原体对于选择最佳治疗方法至关重要。尽管该主题具有重要意义,但文献中对此并未进行充分探讨。本综述旨在总结过去20年中关于NTM与真菌同时感染的病例报告和研究。此外,它简要描述了机会性感染和同时感染,阐述了机会性病原体(如NTM和真菌)的关键特征以及人类宿主引发机会性感染发生和转归的易感条件。该综述可能会引起包括医生和科学家在内的广泛受众的兴趣,以提高对这些感染的认识,从而在临床环境中实现早期识别并增加该领域的研究。改进诊断和提供治疗选择可能有助于改善患者的生存预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/071e/7693372/f97edf7d2d7b/antibiotics-09-00771-g001.jpg

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