Parra-Villamil Juanita María, Ramos-Ospina Natalia, Montes-Tello Sofia Alexandra, Torres-Morales Angie Valeria, Moreno-Turriago Mabel, García-Goez José Fernando
Clinical Research Center, Fundación Valle del Lili, Cali, Colombia.
Health Sciences Faculty, Universidad Icesi, Cali, Colombia.
BMC Infect Dis. 2025 Mar 31;25(1):444. doi: 10.1186/s12879-025-10681-4.
The increasing prevalence of extrapulmonary nontuberculous mycobacterial (NTM) infections poses significant challenges in clinical management due to their inherent drug resistance, the need for prolonged antibiotic regimens and the complexities associated with surgical management. Although these infections are infrequent in daily clinical practice, detailed information on associated clinical outcomes is lacking in the local literature.
This descriptive observational study examined 17 patients with extrapulmonary NTM infection from the General Mycobacteria Registry of Fundación Valle del Lili University Hospital (FVL), a leading reference care center located in Cali, a city in southwestern Colombia. Notably, Cali is classified as a high-risk area for tuberculosis. The study reviewed a total of 391 patients between 2007 and 2021.
A predominance of women with a history of cosmetic surgery was observed, with the skin being the most common site of involvement, especially for M. fortuitum complex and M. abscessus complex. Clarithromycin based therapy was given to 14/18 (82.3%) of the patients. The mean duration of treatment was 4-6 months, for a cure rate of 15/17 (88.2%).
The treatment regimens implemented mostly align with the literature recommendations. However, it is essential to note that while the observed cure rate exceeds 80%, this assertion is tempered by the limitation imposed by the lack of confirmatory imaging in some cases. A contributing factor to the higher cure rate observed in this study may be the use of more extensive surgical interventions, with some patients undergoing more than one procedure. Given the limited number of case series on extrapulmonary nontuberculous mycobacterial infections, these findings emphasize the potential importance of surgical management in achieving higher cure rates. The observed cure rate suggests potentially better clinical management of these infections in our region and underscores the need for future research to understand the factors contributing to this comparative therapeutic success.
肺外非结核分枝杆菌（NTM）感染的患病率不断上升，因其固有的耐药性、需要长期抗生素治疗方案以及与手术管理相关的复杂性，给临床管理带来了重大挑战。尽管这些感染在日常临床实践中并不常见，但当地文献缺乏有关相关临床结局的详细信息。
这项描述性观察性研究检查了来自瓦莱德尔利利大学医院（FVL）普通分枝杆菌登记处的17例肺外NTM感染患者，该医院是位于哥伦比亚西南部城市卡利的一家领先的参考医疗中心。值得注意的是，卡利被归类为结核病高风险地区。该研究回顾了2007年至2021年间的391例患者。
观察到以有美容手术史的女性为主，皮肤是最常见的受累部位，尤其是偶然分枝杆菌复合群和脓肿分枝杆菌复合群。14/18（82.3%）的患者接受了基于克拉霉素的治疗。平均治疗持续时间为4 - 6个月，治愈率为15/17（88.2%）。
实施的治疗方案大多与文献建议一致。然而，必须指出的是，虽然观察到的治愈率超过80%，但由于某些情况下缺乏确认性影像学检查的限制，这一说法有所缓和。本研究中观察到较高治愈率的一个促成因素可能是使用了更广泛的手术干预措施，一些患者接受了不止一次手术。鉴于肺外非结核分枝杆菌感染的病例系列数量有限，这些发现强调了手术管理在实现更高治愈率方面的潜在重要性。观察到的治愈率表明我们地区对这些感染的临床管理可能更好，并强调需要未来的研究来了解促成这种相对治疗成功的因素。
