Fayos Marina, Silva Jose Tiago, López-Medrano Francisco, Aguado José María
Unit of Infectious Diseases, Department of Internal Medicine, University Hospital 12 de Octubre, 28041 Madrid, Spain.
Instituto de Investigación Hospital 12 de Octubre (Imas12), 28041 Madrid, Spain.
J Clin Med. 2022 Sep 23;11(19):5619. doi: 10.3390/jcm11195619.
Non-tuberculous mycobacteria (NTM) and pulmonary co-infection occurs in patients with underlying lung disease and is rarely reported. We conducted a systematic search of NTM and pulmonary co-infection in PubMed, EMBASE, and Cochrane Library to identify cases published from 1977 to May 2022. We included 507 articles comprising 1538 cases (only 817 patients with partial relevant clinical data). Of these, 54.3% of patients were men, with a mean age of 57.7 years. Chronic obstructive pulmonary disease (21.1%), previous diagnosis of tuberculosis (18%), and asthma (11.1%) were the most common chronic lung diseases, and corticosteroids were used in 36.8% of patients. The most frequent symptoms were cough (68.2%), dyspnea (59.1%), and hemoptysis (34.1%). The most common radiological findings were bronchiectasis (52.3%) and cavitation (40.8%). NTM and were treated simultaneously in 47.3% of cases, whereas NTM-targeted therapy only was performed in 23.4% and only in 1.6%. The remaining 27.7% did not receive any treatment and were considered to be colonized. The global mortality rate was 43% (159/370). There was an increased prevalence of NTM and pulmonary aspergillosis among patients with underlying chronic lung diseases, which led to severe pulmonary affection with a poor global prognosis.
非结核分枝杆菌（NTM）与肺部合并感染发生于有基础肺部疾病的患者中，且鲜有报道。我们在PubMed、EMBASE和Cochrane图书馆系统检索了NTM与肺部合并感染的相关文献，以识别1977年至2022年5月发表的病例。我们纳入了507篇文章，共1538例病例（仅有817例患者有部分相关临床数据）。其中，54.3%的患者为男性，平均年龄为57.7岁。慢性阻塞性肺疾病（21.1%）、既往有结核病诊断史（18%）和哮喘（11.1%）是最常见的慢性肺部疾病，36.8%的患者使用了皮质类固醇。最常见的症状为咳嗽（68.2%）、呼吸困难（59.1%）和咯血（34.1%）。最常见的影像学表现为支气管扩张（52.3%）和空洞形成（40.8%）。47.3%的病例同时对NTM和 进行了治疗，而仅针对NTM进行治疗的占23.4%，仅针对 进行治疗的占1.6%。其余27.7%未接受任何治疗，被认为是定植状态。全球死亡率为43%（159/370）。在有基础慢性肺部疾病的患者中，NTM与肺曲霉病的患病率增加，这导致严重的肺部病变，全球预后较差。
