Hoffner S E
Microbiology and Tumorbiology Center, Karolinska Institute, Stockholm, Sweden.
Eur J Clin Microbiol Infect Dis. 1994 Nov;13(11):937-41. doi: 10.1007/BF02111495.
Pulmonary mycobacteriosis is usually caused by Mycobacterium tuberculosis or Mycobacterium avium complex. There are, however, other slow-growing mycobacteria that can cause pulmonary infection. Mycobacterium kansasii, Mycobacterium malmoense, Mycobacterium xenopi, Mycobacterium szulgai and Mycobacterium simiae typically infect middle-aged to elderly persons with preexisting lung disease. Differentiation of infection with these five mycobacteria from infection with Mycobacterium tuberculosis, by culture and determination of the antimicrobial susceptibility pattern of the organism are important for several reasons. All five organisms are found in water and soil. They probably infect humans from environmental habitats; human-to-human spread of infection is thought not to occur. Furthermore, isolation of the organisms in culture may represent contamination of the specimen or colonization of the patient, and not necessarily an infection. Finally, although the antituberculosis drugs-isoniazid, ethambutol, rifampin and streptomycin-have been used for treatment of infection with these five organisms, there are often differences between the antimycobacterial susceptibility patterns of Mycobacterium tuberculosis and those of the non-tuberculous mycobacteria. Thus, the optimal choice of drug therapy may differ from that used for tuberculosis.
肺部分枝杆菌病通常由结核分枝杆菌或鸟分枝杆菌复合群引起。然而，还有其他生长缓慢的分枝杆菌可导致肺部感染。堪萨斯分枝杆菌、马尔默分枝杆菌、偶发分枝杆菌、苏尔加分枝杆菌和猿分枝杆菌通常感染患有基础肺部疾病的中老年人。通过培养以及确定该生物体的抗菌药敏模式，将这五种分枝杆菌感染与结核分枝杆菌感染区分开来很重要，原因如下。所有这五种生物体都存在于水和土壤中。它们可能从环境栖息地感染人类；一般认为不存在人与人之间的感染传播。此外，在培养物中分离出这些生物体可能代表标本污染或患者定植，而不一定是感染。最后，尽管抗结核药物异烟肼、乙胺丁醇、利福平和链霉素已用于治疗这五种生物体的感染，但结核分枝杆菌与非结核分枝杆菌的抗分枝杆菌药敏模式通常存在差异。因此，药物治疗的最佳选择可能与用于治疗结核病的选择不同。
