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重庆地区合并及未合并HIV/AIDS患者中非结核分枝杆菌的分布情况

Distribution of nontuberculous mycobacteria in patients with and without HIV/AIDS in Chongqing.

作者信息

Nie Jingmin, Deng Xizi, Zeng Qingling, Du Xiang, Chen Yaokai, Hu Fengyu

机构信息

Chongqing Public Health Medical Center, Chongqing, China.

Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.

出版信息

HIV Med. 2022 Mar;23 Suppl 1:54-63. doi: 10.1111/hiv.13249.

Abstract

INTRODUCTION

In this study, the distribution of nontuberculous mycobacteria (NTM) strains in patients with and without HIV/AIDS in Chongqing, China was evaluated.

METHODS

A retrospective study was performed in January-December 2020 at Chongqing Public Health Medical Center. NTM strains were assessed by a multi locus phylogenetic analysis. The distribution of NTM strains in HIV/AIDS and non-HIV/AIDS groups was compared. CD4+ cell counts, imaging changes, and characteristics of mycobacterial species were determined.

RESULTS

In total, 324 patients with NTM infection (50 patients with HIV/AIDS and 274 patients without HIV/AIDS) were included. The most common etiological agent was M. abscessus (29%), followed by M. paraintracellulare (12%) and M. colombiense (11%). Predominant NTM species were M. avium (26%), M. colombiense (24%), and M. kansasii (18%) in patients with HIV/AIDS and were M. abscessus (32%), M. paraintracellulare (13%), M. fortuitum (10%), and M. intracellulare (10%) in patients without HIV/AIDS. For a CD4+ cell count of <200/μl, the predominant species were M. aviumin the HIV/AIDS group and M. abscessus in the non-HIV/AIDS group. With respect to radiologic characteristics, different NTM strains were associated with distinct imaging manifestations; for example, M. marseillense, M. kansasii, and M. parasenchytosis were more likely to induce cavities. Imaging cavities, bronchiectasis, and acinar-like changes were more common in the non-HIV/AIDS groups.

CONCLUSIONS

The infection rates of HIV and NTM in Chongqing are high, while M. abscessus, M. paraintracellulare, and M. colombiense are the main pathogens causing NTM diseases in Chongqing, and NTM strains differed significantly between patients with and without HIV/AIDS. Monitoring these indicators can help develop prevention strategies.

摘要

引言

本研究评估了中国重庆地区感染和未感染人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者中非结核分枝杆菌(NTM)菌株的分布情况。

方法

于2020年1月至12月在重庆公共卫生医疗中心进行了一项回顾性研究。通过多位点系统发育分析评估NTM菌株。比较了HIV/AIDS组和非HIV/AIDS组中NTM菌株的分布情况。测定了CD4+细胞计数、影像学变化以及分枝杆菌菌种特征。

结果

共纳入324例NTM感染患者(50例HIV/AIDS患者和274例非HIV/AIDS患者)。最常见的病原体是脓肿分枝杆菌(29%),其次是胞内分枝杆菌(12%)和哥伦比亚分枝杆菌(11%)。HIV/AIDS患者中主要的NTM菌种是鸟分枝杆菌(26%)、哥伦比亚分枝杆菌(24%)和堪萨斯分枝杆菌(18%),非HIV/AIDS患者中是脓肿分枝杆菌(32%)、胞内分枝杆菌(13%)、偶然分枝杆菌(10%)和细胞内分枝杆菌(10%)。对于CD4+细胞计数<200/μl的情况,HIV/AIDS组中主要菌种是鸟分枝杆菌,非HIV/AIDS组中是脓肿分枝杆菌。关于放射学特征,不同的NTM菌株与不同的影像学表现相关;例如,马赛分枝杆菌、堪萨斯分枝杆菌和实质旁分枝杆菌更易诱发空洞形成。影像学空洞、支气管扩张和腺泡样改变在非HIV/AIDS组中更常见。

结论

重庆地区HIV和NTM的感染率较高,而脓肿分枝杆菌、胞内分枝杆菌和哥伦比亚分枝杆菌是重庆地区引起NTM疾病的主要病原体,且HIV/AIDS患者和非HIV/AIDS患者的NTM菌株存在显著差异。监测这些指标有助于制定预防策略。

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