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煤矿里的金丝雀?

: the canary in the coal mine?

作者信息

Condit Daniel, Avery Lori, Daley Charles L, Metersky Mark

机构信息

Division of Pulmonary, Critical Care and Sleep Medicine, University of Connecticut School of Medicine, Farmington, CT, USA.

Department of Pathology and Laboratory Medicine, University of Connecticut School of Medicine, Farmington, CT, USA.

出版信息

J Thorac Dis. 2024 May 31;16(5):3366-3370. doi: 10.21037/jtd-23-1648. Epub 2024 May 16.

Abstract

() is a species of nontuberculous mycobacteria (NTM) that rarely causes infection. It has previously been labeled the most common NTM contaminant. Bronchiectasis is a disease characterized by abnormal airway dilation leading to chronic cough, sputum production and pulmonary infections. Patients with bronchiectasis are at higher risk of NTM-lung disease with more pathogenic NTM species including complex (MAC) and (). The relationship between bronchiectasis and less-pathogenic NTM species such as is less well understood. We performed a retrospective study on patients who had isolated from respiratory specimens at UConn Health between May 2, 2010 and October 18, 2022. was isolated 74 times from 56 patients. It was isolated 35 (47.3%) times from 31 patients with bronchiectasis and 39 (52.7%) times from 26 patients without bronchiectasis. Data was available on all mycobacterial cultures sent from May 2 2018 to October 18 2022. Mycobacterial cultures sent from patients with bronchiectasis were significantly more likely to grow than patients without bronchiectasis (4.3% . 1.6%, P=0.007). Furthermore, when considered at the patient level, there remained a significant increased rate of isolation among patients with bronchiectasis (7.1% . 2.2%, P<0.001). We then looked at past and future isolation of more pathogenic NTM species and found a non-statistically increased rate of isolation of more pathogenic NTM species including MAC and in patients with bronchiectasis (45.2% . 29%, P=0.09). Based on our results, isolation of should raise suspicion of chronic airway disease and defects in host immune response, such as those seen in bronchiectasis. Furthermore, isolation of may suggest increased risk of infection with more pathogenic NTM species such as MAC and .

摘要

()是一种非结核分枝杆菌(NTM),很少引起感染。它以前被标记为最常见的NTM污染物。支气管扩张是一种以气道异常扩张为特征的疾病,导致慢性咳嗽、咳痰和肺部感染。支气管扩张患者患NTM肺病的风险更高,感染的NTM种类更具致病性,包括鸟分枝杆菌复合群(MAC)和()。支气管扩张与致病性较低的NTM种类如()之间的关系尚不太清楚。我们对2010年5月2日至2022年10月18日期间在康涅狄格大学健康中心从呼吸道标本中分离出()的患者进行了一项回顾性研究。从56名患者中分离出()74次。从31名支气管扩张患者中分离出35次(47.3%),从26名无支气管扩张患者中分离出39次(52.7%)。有2018年5月2日至2022年10月18日所有送检分枝杆菌培养物的数据。支气管扩张患者送检的分枝杆菌培养物比无支气管扩张患者更有可能培养出()(4.3%对1.6%,P = 0.007)。此外,在患者层面考虑时,支气管扩张患者中()的分离率仍然显著增加(7.1%对2.2%,P < 0.001)。然后我们查看了过去和未来更具致病性的NTM种类的分离情况,发现支气管扩张患者中包括MAC和()在内的更具致病性的NTM种类的分离率有非统计学意义的增加(45.2%对29%,P = 0.09)。根据我们的结果,()的分离应引起对慢性气道疾病和宿主免疫反应缺陷的怀疑,如支气管扩张中所见。此外,()的分离可能表明感染更具致病性的NTM种类如MAC和()的风险增加。

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