检测和治疗结核分枝杆菌感染。

Testing and Treating Mycobacterium tuberculosis Infection.

机构信息

Department of Epidemiology, Biostatistics & Occupational Health, McGill University, 1020 Pine Avenue, West Montreal, H3A 1A2, Canada; McGill International TB Centre, Research Institute of the McGill University Health Centre, 5252 boul.de Maisonneuve, West Montreal, Quebec, H4A 3S5, Canada; Department of Medicine, Insituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan, Mexico City, 14000, Mexico.

Department of Epidemiology, Biostatistics & Occupational Health, McGill University, 1020 Pine Avenue, West Montreal, H3A 1A2, Canada; McGill International TB Centre, Research Institute of the McGill University Health Centre, 5252 boul.de Maisonneuve, West Montreal, Quebec, H4A 3S5, Canada; Department of Medicine, McGill University, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3J1, Canada.

出版信息

Med Clin North Am. 2022 Nov;106(6):929-947. doi: 10.1016/j.mcna.2022.08.001.

DOI:10.1016/j.mcna.2022.08.001

PMID:36280337

Abstract

After infection with Mycobacterium tuberculosis, a minority of individuals will progress to tuberculosis disease (TB). The risk is higher among persons with well-established risk factors and within the first year after infection. Testing and treating individuals at high risk of progression maximizes the benefits of TB preventive therapy; avoiding testing of low-risk persons will limit potential harms. Several treatment options are available; rifamycin-based regimens offer the best efficacy-safety balance. In this review, we present an overview of the diagnosis and treatment of TB infection, and summarize common clinical scenarios.

摘要

感染结核分枝杆菌后，少数人会发展为结核病（TB）。具有明确危险因素的人群以及感染后 1 年内，其患病风险更高。对进展风险高的个体进行检测和治疗可最大化 TB 预防性治疗的获益；对低风险个体进行检测则会限制潜在危害。有几种治疗选择；利福平为基础的方案提供了最佳的疗效-安全性平衡。在本综述中，我们介绍了 TB 感染的诊断和治疗概述，并总结了常见的临床情况。