诊断学理论与实践 ›› 2023, Vol. 22 ›› Issue (04): 402-406.doi: 10.16150/j.1671-2870.2023.04.012
收稿日期:
2022-04-01
出版日期:
2023-08-25
发布日期:
2023-12-18
通讯作者:
卢洪洲 E-mail: 基金资助:
HU Jingjing1,2, SHEN Yinzhong2, LIU Li2(), LU Hongzhou3(
)
Received:
2022-04-01
Online:
2023-08-25
Published:
2023-12-18
摘要:
非结核分枝杆菌(non-tuberculous mycobacteria,NTM)作为一种机会性致病菌,一般很少在免疫功能正常的人群中引起疾病,除非宿主免疫防御功能受损。获得性免疫缺陷综合征(acquired immune deficiency syndrome,AIDS)患者由于体内人类免疫缺陷病毒(human immunodeficiency virus,HIV)破坏CD4+T淋巴细胞,使得机体免疫功能严重缺陷,当患者感染NTM时,NTM很可能定植,并最终导致患者出现播散性NTM病(disseminated non-tuberculous mycobacterial disease, DNTM)。近年来,全球结核病患者数量呈下降趋势,然而随着AIDS流行、免疫抑制人群数量增加以及实验室NTM检测技术不断进步等因素,AIDS合并NTM的患者数呈上升趋势。与结核病相比,我国公共卫生管理系统未将NTM感染纳入上报系统,而且以往临床重视程度不足,因此系统研究也较少。国内一些地区AIDS合并DNTM患者的5年病死率已高达26.7%,该病极大威胁着患者的生命健康,并消耗了大量医疗资源。我国在NTM的鉴别诊断、治疗、高病死率等方面,面临巨大挑战。因此,迫切需要加强临床对DNTM的临床认知,提升疾病防控及应对能力。
中图分类号:
胡静静, 沈银忠, 刘莉, 卢洪洲. 艾滋病合并播散性非结核分枝杆菌病诊治现状及研究进展[J]. 诊断学理论与实践, 2023, 22(04): 402-406.
HU Jingjing, SHEN Yinzhong, LIU Li, LU Hongzhou. Current status and research progress of diagnosis and treatment of AIDS with disseminated non-tuberculous mycobacterial disease[J]. Journal of Diagnostics Concepts & Practice, 2023, 22(04): 402-406.
[1] |
JONES D, HAVLIR D V. Nontuberculous mycobacteria in the HIV infected patient[J]. Clin Chest Med, 2002, 23(3):665-674.
pmid: 12371002 |
[2] |
HORSBURGH C R Jr, SELIK R M. The epidemiology of disseminated nontuberculous mycobacterial infection in the acquired immunodeficiency syndrome (AIDS)[J]. Am Rev Respir Dis, 1989, 139(1):4-7.
doi: 10.1164/ajrccm/139.1.4 URL |
[3] |
FORDHAM VON R C, ARBEIT R D, TOSTESON A N, et al. The international epidemiology of disseminated Mycobacterium avium complex infection in AIDS. International MAC Study Group[J]. AIDS, 1996, 10(9):1025-1032.
doi: 10.1097/00002030-199610090-00014 URL |
[4] |
XU D, HAN C, WANG M S, et al. Increasing prevalence of non-tuberculous mycobacterial infection from 2004-2009 to 2012-2017: a laboratory-based[J]. J Infect, 2018, 76(4):422-424.
doi: 10.1016/j.jinf.2017.12.007 URL |
[5] |
RISTOLA M A, VON REYN C F, ARBEIT R D, et al. High rates of disseminated infection due to non-tuberculous mycobacteria among AIDS patients in Finland[J]. J Infect, 1999, 39(1):61-67.
pmid: 10468131 |
[6] | COLLINS L F, CLEMENT M E, STOUT J E. Incidence, long-term outcomes, and healthcare utilization of patients with human immunodeficiency virus/acquired immune deficiency syndrome and disseminated mycobacterium avium complex from 1992-2015[J]. Open Forum Infect Dis, 2017, 4(3):x120. |
[7] |
TO K, CAO R, YEGIAZARYAN A, et al. General Overview of Nontuberculous Mycobacteria Opportunistic Pathogens: Mycobacterium avium and Mycobacterium abscessus[J]. J Clin Med, 2020, 9(8):2541.
doi: 10.3390/jcm9082541 URL |
[8] |
WU U I, HOLLAND S M. Host susceptibility to non-tuberculous mycobacterial infections[J]. Lancet Infect Dis, 2015, 15(8):968-980.
doi: 10.1016/S1473-3099(15)00089-4 URL |
[9] |
NAIK E, LEBLANC S, TANG J, et al. The complexity of HLA class II (DRB1, DQB1, DM) associations with disseminated Mycobacterium avium complex infection among HIV-1-seropositive whites[J]. J Acquir Immune Defic Syndr, 2003, 33(2):140-145.
doi: 10.1097/00126334-200306010-00004 URL |
[10] |
SANGARI F J, GOODMAN J, PETROFSKY M, et al. Mycobacterium avium invades the intestinal mucosa prima-rily by interacting with enterocytes[J]. Infect Immun, 2001, 69(3):1515-1520.
doi: 10.1128/IAI.69.3.1515-1520.2001 URL |
[11] |
UCHIYA K, TAKAHASHI H, YAGI T, et al. Comparative genome analysis of Mycobacterium avium revealed genetic diversity in strains that cause pulmonary and disseminated disease[J]. PLoS One, 2013, 8(8):e71831.
doi: 10.1371/journal.pone.0071831 URL |
[12] |
MCGARVEY J A, BERMUDEZ L E. Phenotypic and genomic analyses of the Mycobacterium avium complex reveal differences in gastrointestinal invasion and genomic composition[J]. Infect Immun, 2001, 69(12):7242-7249.
doi: 10.1128/IAI.69.12.7242-7249.2001 URL |
[13] |
JOHANSEN M D, HERRMANN J L, KREMER L. Non-tuberculous mycobacteria and the rise of Mycobacterium abscessus[J]. Nat Rev Microbiol, 2020, 18(7):392-407.
doi: 10.1038/s41579-020-0331-1 |
[14] |
GRIFFITH D E, AKSAMIT T, BROWN-ELLIOTT B A, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases[J]. Am J Respir Crit Care Med, 2007, 175(4):367-416.
doi: 10.1164/rccm.200604-571ST URL |
[15] | 中华医学会热带病与寄生虫学分会艾滋病学组. 人类免疫缺陷病毒/艾滋病患者合并非结核分枝杆菌感染诊治专家共识[J]. 传染病信息, 2019, 32(6):481-489. |
AIDS Professional Group, Society of Tropical Disease and Parasitology of Chinese Medical Association. Expert consensus on diagnosis and treatment of HIV/AIDS patients combined with nontuberculous mycobacteria infection[J]. Infect Dis Inform, 2019, 32(6):481-489. | |
[16] | 中华医学会结核病学分会. 非结核分枝杆菌病诊断与治疗指南(2020年版)[J]. 中华结核和呼吸杂志, 2020, 43(11):918-946. |
Chinese Society for Tuberculosis, Chinese Medical Association. Guidelines for the diagnosis and treatment of non-tuberculous mycobacterial disease (2020 edition)[J]. Chin J Tuberc Respir Dis, 2020, 43(11):918-946. | |
[17] | 缪青, 王美霞, 潘珏, 等. 基于CT综合评分系统的非结核分枝杆菌肺病的影像学特征及影响因素[J]. 中国临床医学, 2022, 29(3):409-414. |
MIAO Q, WANG MX, PAN Y, et al. Composite CT score-based assessment for comparative analysis of radiological feature and clinical factor in pulmonary non-tuberculous mycobacterial disease[J]. Chin J Clin Res, 2022, 29(3):409-414. | |
[18] | KANADE S, NATARAJ G, SURYAWANSHI R, et al. Utility of MPT 64 antigen detection assay for rapid charac-terization of mycobacteria in a resource constrained setting[J]. Indian J Tuberc, 2012, 59(2):92-96. |
[19] |
SEBASTIAN G, NAGARAJA SB, VISHWANATHA T, et al. Non-tuberculosis mycobacterium speciation using HPLC under Revised National TB Control Programme (RNTCP) in India[J]. J Appl Microbiol, 2018, 124(1):267-273.
doi: 10.1111/jam.13604 pmid: 28990320 |
[20] |
GENC G E, DEMIR M, YAMAN G, et al. Evaluation of MALDI-TOF MS for identification of nontuberculous mycobacteria isolated from clinical specimens in mycobacteria growth indicator tube medium[J]. New Microbiol, 2018, 41(3):214-219.
pmid: 29874386 |
[21] |
SOMOSKOVI A, SALFINGER M. Nontuberculous mycobacteria in respiratory infections: advances in diagnosis and identification[J]. Clin Lab Med, 2014, 34(2):271-295.
doi: 10.1016/j.cll.2014.03.001 pmid: 24856528 |
[22] |
SHARMA S, LATAWA R, WANCHU A, et al. Differential diagnosis of disseminated Mycobacterium avium and Mycobacterium tuberculosis infection in HIV patients using duplex PCR[J]. Future Microbiol, 2021, 16(3):159-173.
doi: 10.2217/fmb-2020-0133 URL |
[23] | HUH H J, KIM SY, SHIM H J, et al. GenoType NTM-DR performance evaluation for identification of Mycobacterium avium complex and Mycobacterium abscessus and determination of clarithromycin and amikacin resistance[J]. J Clin Microbiol, 2019, 57(8):e00516-e00519. |
[24] |
KAPLAN J E, BENSON C, HOLMES K K, et al. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America[J]. MMWR Recomm Rep, 2009, 58(RR-4):1-207.
pmid: 19357635 |
[25] |
CRILLY N P, AYEH S K, KARAKOUSIS P C. The new frontier of host-directed therapies for Mycobacterium avium complex[J]. Front Immunol, 2021, 11:623119.
doi: 10.3389/fimmu.2020.623119 URL |
[26] |
KILINÇ G, SARIS A, OTTENHOFF T H M, et al. Host-directed therapy to combat mycobacterial infections[J]. Immunol Rev, 2021, 301(1):62-83.
doi: 10.1111/imr.12951 pmid: 33565103 |
[27] |
LIU L, SONG Z, XUN J, et al. PD-1 inhibitor for disseminated Mycobacterium avium infection in a person with HIV[J]. Open Forum Infect Dis, 2022, 10(1):ofac700.
doi: 10.1093/ofid/ofac700 URL |
[28] |
DEDRICK R M, GUERRERO-BUSTAMANTE C A, GARLENA R A, et al. Engineered bacteriophages for treatment of a patient with a disseminated drug-resistant Mycobacterium abscessus[J]. Nat Med, 2019, 25(5):730-733.
doi: 10.1038/s41591-019-0437-z |
[29] |
DEDRICK R M, SMITH B E, CRISTINZIANO M, et al. Phage therapy of Mycobacterium infections: compassio-nate use of phages in 20 patients with drug-resistant Myco-bacterial disease[J]. Clin Infect Dis, 2023, 76(1):103-112.
doi: 10.1093/cid/ciac453 URL |
[30] | KOBAYASHI T, NISHIJIMA T, TERUYA K, et al. High Mortality of disseminated non-tuberculous Mycobacterial infection in HIV-infected patients in the antiretroviral therapy era[J]. PLoS One, 2016, 11(3):e0151682. |
[31] |
BENSON C A, WILLIAMS P L, CURRIER J S, et al. A prospective, randomized trial examining the efficacy and safety of clarithromycin in combination with ethambutol, rifabutin, or both for the treatment of disseminated Mycobacterium avium complex disease in persons with acquired immunodeficiency syndrome[J]. Clin Infect Dis, 2003, 37(9):1234-1243.
pmid: 14557969 |
[32] |
HU J, GU L, SHAO Y, et al. Long-term case-fatality rate of nontuberculous mycobacterial disease in people living with HIV[J]. Infect Dis Poverty, 2022, 11(1):16.
doi: 10.1186/s40249-022-00942-8 pmid: 35130974 |
[33] | 吴跃, 邓西子, 胡凤玉, 等. AIDS合并播散性非结核分枝杆菌病的临床特征与死亡危险因素分析[J]. 中国艾滋病性病, 2017, 23(11):999-1001,1005. |
WU Y, DENG X Z, HU F Y, et al. Clinical characteristics and death risk factors of disseminated non-tuberculous mycobacterial infection in AIDS patients[J]. Chin J AIDS & STD, 2017, 23(11):999-1001,1005. | |
[34] |
LARSEN S E, REESE V A, PECOR T, et al. Subunit vaccine protects against a clinical isolate of Mycobacterium avium in wild type and immunocompromised mouse mo-dels[J]. Sci Rep, 2021, 11(1):9040.
doi: 10.1038/s41598-021-88291-8 |
[1] | 李一林, 陈杨, 李艳艳, 冯旭娇, 章程, 李健, 沈琳. 循环肿瘤细胞检测在常见恶性肿瘤精准医学中的应用和展望[J]. 诊断学理论与实践, 2023, 22(04): 332-340. |
[2] | 施仲伟. 从学术角度看高血压诊断界值不应下调至130/80 mmHg[J]. 诊断学理论与实践, 2023, 22(04): 348-361. |
[3] | 刘英婷, 易红梅, 王雪, 杨春雪, 欧阳斌燊, 许海敏, 王朝夫. 十二指肠型滤泡性淋巴瘤17例临床病理特征及预后分析[J]. 诊断学理论与实践, 2023, 22(04): 362-368. |
[4] | 张兰兰, 杨巧, 聂尊珍, 郭英. 胸膜SMARCA4缺失未分化肿瘤1例报告[J]. 诊断学理论与实践, 2023, 22(04): 389-392. |
[5] | 刘益飞. DNA甲基化检测助力肿瘤早期筛查和诊断[J]. 诊断学理论与实践, 2023, 22(04): 393-401. |
[6] | 魏坚, 孙杰, 崔诗爽. 帕金森病早期诊断诺谟图模型的建立及验证[J]. 诊断学理论与实践, 2023, 22(03): 277-282. |
[7] | 尹永芳, 唐永华, 梁妍, 陈志仁, 费晓春. Erdheim-Chester病6例临床及影像学特征分析[J]. 诊断学理论与实践, 2023, 22(03): 283-291. |
[8] | 周晓蝶, 陈巍魏, 余波, 王璇, 王建军, 石群立, 饶秋, 鲍炜. 尿路上皮癌的临床病理学特征[J]. 诊断学理论与实践, 2023, 22(03): 292-299. |
[9] | 李笑石, 秦越. 影像学技术在痛风诊断及疾病监测中的应用研究进展[J]. 诊断学理论与实践, 2023, 22(03): 311-318. |
[10] | 吴娜明, 李军, 陶娟. 恶性黑色素瘤的诊断热点[J]. 诊断学理论与实践, 2023, 22(03): 215-220. |
[11] | 徐莉, 高华杰, 杨梦歌, 李悦, 季苏琼. 合并抗TRIM21/Ro52抗体阳性的抗SRP阳性坏死性肌病患者临床特点分析[J]. 诊断学理论与实践, 2023, 22(03): 247-254. |
[12] | 杨巧, 付欣, 王哲, 刘坦坦. 甲状腺继发性肿瘤细胞病理学特征[J]. 诊断学理论与实践, 2023, 22(03): 270-276. |
[13] | 宋陆茜, 常春康. 2023年美国国立综合癌症网络(NCCN)《骨髓增生异常综合征临床实践指南》(第1版)解读[J]. 诊断学理论与实践, 2023, 22(02): 116-120. |
[14] | 郝家琪, 王鑫鹭, 胡晓帆, 潘晓霞, 徐静, 马骏. 急性肾小管间质性肾炎与急性肾小管坏死的临床鉴别分析[J]. 诊断学理论与实践, 2023, 22(02): 127-133. |
[15] | 颜凌, 王凌云, 陈勇, 杜联军. 双能CT图像深度学习重建算法在胃癌术前T分期中的应用[J]. 诊断学理论与实践, 2023, 22(02): 154-159. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||