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肺部非结核分枝杆菌感染的当前挑战:病例系列及文献复习。

Current challenges in pulmonary nontuberculous mycobacterial infection: a case series with literature review.

机构信息

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

Division of Infectious Diseases, University of Connecticut School of Medicine, Farmington, CT, USA.

出版信息

Postgrad Med. 2024 Sep;136(7):770-781. doi: 10.1080/00325481.2024.2401766. Epub 2024 Sep 12.

Abstract

BACKGROUND

The prevalence of nontuberculous mycobacteria pulmonary disease (NTM-PD), particularly caused by Mycobacterium avium complex (MAC), is rising due to improved diagnostics, increased awareness, and more susceptible populations. NTM-PD significantly affects quality of life and imposes substantial economic costs. Understanding its clinical features, risk factors, and treatment challenges is vital for enhancing patient outcomes.

PATIENTS AND METHODS

A convenience sample from the University of Connecticut Health Center and Wayne State University involving patients with NTM-PD from 2021 to 2024 was studied retrospectively. Cases were selected to demonstrate typical diagnostic and treatment challenges, followed by a multidisciplinary roundtable discussion to examine patient-centered care strategies.

RESULTS

Analysis of six cases pinpointed chronic lung conditions and immunomodulatory therapy as key risk factors. Standard treatment, involving extensive multi-drug regimens, frequently results in poor adherence due to side effects and complex management requirements. The discussions underlined the importance of a customized, interdisciplinary approach to improve treatment effectiveness and patient quality of life.

CONCLUSIONS

NTM-PD is an escalating public health issue with notable clinical and economic consequences. Managing this disease effectively demands a comprehensive, patient-centered strategy that includes precise diagnosis, flexible treatment plans, and collaborative care.

摘要

背景

由于诊断技术的提高、人们认识的增强以及易感人群的增加,非结核分枝杆菌肺病(NTM-PD),尤其是由鸟分枝杆菌复合群(MAC)引起的 NTM-PD,其发病率正在上升。NTM-PD 显著影响生活质量,并带来巨大的经济负担。了解其临床特征、风险因素和治疗挑战对于改善患者预后至关重要。

患者和方法

本研究回顾性分析了 2021 年至 2024 年期间来自康涅狄格大学健康中心和韦恩州立大学的方便样本中的 NTM-PD 患者。选择这些病例是为了展示典型的诊断和治疗挑战,随后进行多学科圆桌讨论,以探讨以患者为中心的护理策略。

结果

对 6 例病例的分析指出,慢性肺部疾病和免疫调节治疗是关键的风险因素。标准治疗包括广泛的多药物治疗方案,但由于副作用和复杂的管理要求,常常导致患者难以坚持治疗。讨论强调了采用个性化、多学科方法来提高治疗效果和患者生活质量的重要性。

结论

NTM-PD 是一个日益严重的公共卫生问题,具有显著的临床和经济后果。有效管理这种疾病需要一种全面、以患者为中心的策略,包括准确的诊断、灵活的治疗计划和协作护理。

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