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支气管切除症患者的非结核性真菌菌菌 (NTM) 感染:一项回顾性美国注册表队列研究
Myriam Drysdale1, Radmila Choate2, Amanda E Brunton3
1GSK, London, United Kingdom.
Pulmonary pharmacology & therapeutics
|September 23, 2023
概括
许多患有支气管切除和非结核性菌根 (NTM) 感染的患者,特别是Mycobacterium avium复合体 (MAC),未接受治疗或经历延迟治疗. 与MAC感染相比,Mycobacterium abscessus complex (MABSC) 感染的治疗时间更快.
科学领域:
- 肺部医学 肺部医学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 纵向数据对于在患有支气管切除症的患者中管理非结核性菌根性 (NTM) 肺病至关重要.
- 了解这种人群中NTM的流行病学和临床过程对于改善患者护理至关重要.
研究的目的:
- 描述美国支气管炎和NTM研究注册表 (US BRR) 中NTM感染的流行病学,患者管理和治疗结果.
- 分析NTM患病率和发病率在支气管切除症患者中的趋势.
主要方法:
- 使用美国BRR (2008-2019) 数据进行的回顾性队列研究.
- 在基线或随访期间包括阳性NTM呼吸道培养的患者.
- 对Mycobacterium avium复合体 (MAC) 和Mycobacterium abscessus复合体 (MABSC) 感染的发病率,流行率,患者特征,治疗方法和结果的分析.
主要成果:
- 37.9%的符合条件的支气管切除症患者患有MAC和/或MABSC感染.
- 从2009年到2019年,MAC患病率有所增加;发病率保持相对稳定.
- 很大一部分MAC (44.9%) 和MABSC (37.1%) 感染没有接受治疗;MAC治疗往往延迟 (>90天).
- MABSC感染比MAC感染更早得到治疗.
- 对MAC和MABSC的治疗成功率相似,治疗失败率很高.
结论:
- 相当多的MAC和MABSC感染仍未得到治疗,或者治疗的时间延误很大.
- 与MAC感染相比,MABSC感染显示了及时开始治疗的可能性更高.
- 需要进一步的研究来评估"延迟监测"策略,并完善NTM治疗支气管病的临床指南.
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