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中国一家三级医院中局限性与播散性诺卡菌病的临床特征及治疗结果比较

Comparison of Clinical Characteristics and Treatment Outcome Between Localized and Disseminated Nocardiosis in a Tertiary Hospital in China.

作者信息

Zhang Li, Zhou Menglan, Wang Ziran, Zhu Hongqiong, Lin Jing, Lu Minya, Ge Ying, Xu Yingchun, Li Taisheng, Liu Zhengyin

机构信息

Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.

Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

Infect Drug Resist. 2024 Jun 14;17:2379-2387. doi: 10.2147/IDR.S458124. eCollection 2024.

Abstract

BACKGROUND

In China, due to the large population, infections caused by Nocardia may not be as rare. Unfortunately, there is still inadequate knowledge of the clinical impact caused by Nocardia. This study aimed to compare the clinical characteristics and treatment of localized and disseminated nocardiosis.

METHODS

The clinical and microbiological data of patients diagnosed with nocardiosis in a tertiary hospital in Beijing from July 2011 to July 2021 were collected and retrospectively analyzed.

RESULTS

Among the 54 nocardiosis cases, 34 cases were in the localized infection group, while 20 cases in the disseminated infection group. The proportion of patients with chronic structural lung disease was higher in the localized group (=0.010). In contrast, patients with disseminated infections were more prone to receive long-term glucocorticoids and/or immunosuppressants (=0.027). Pulmonary nodules were prominent features of imaging changes in patients with disseminated infections (=0.027) whereas bronchial dilatation was more common in patients with localized infections (=0.025). In addition, the disseminated group had longer average hospitalization days relative to the localized group (=0.016), but there was no significant difference in mortality between them (=0.942).

CONCLUSION

There were differences in the clinical profiles between patients with localized and disseminated nocardiosis in terms of clinical presentation, infection site, radiological features, treatment, and prognosis. These findings may provide references for the management and treatment of patients with nocardiosis.

摘要

背景

在中国,由于人口众多,诺卡菌引起的感染可能并不罕见。遗憾的是,目前对诺卡菌所致临床影响的认识仍不足。本研究旨在比较局限性和播散性诺卡菌病的临床特征及治疗情况。

方法

收集并回顾性分析2011年7月至2021年7月在北京某三级医院诊断为诺卡菌病的患者的临床和微生物学资料。

结果

54例诺卡菌病患者中,局限性感染组34例,播散性感染组20例。局限性感染组慢性结构性肺病患者比例更高(=0.010)。相比之下,播散性感染患者更易接受长期糖皮质激素和/或免疫抑制剂治疗(=0.027)。肺部结节是播散性感染患者影像学改变的突出特征(=0.027),而支气管扩张在局限性感染患者中更常见(=0.025)。此外,播散性感染组平均住院天数相对于局限性感染组更长(=0.016),但两组间死亡率无显著差异(=0.942)。

结论

局限性和播散性诺卡菌病患者在临床表现、感染部位、影像学特征、治疗及预后等方面的临床特征存在差异。这些发现可为诺卡菌病患者的管理和治疗提供参考。

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