20年来对非结核性菌根手部感染的洞察力
Hussam Tabaja1, Humza Y Saleem2, Karim Bakri3
1Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Open forum infectious diseases
|April 23, 2024
概括
非结核菌 (NTM) 手部感染通常需要手术和抗生素,失败率很高. 免疫抑制和类固醇使用增加了NTM手部感染失败的风险.
科学领域:
- 传染性疾病 传染性疾病
- 皮肤病学 皮肤病学
- 整形外科手术 整形外科手术
背景情况:
- 非结核性真菌菌 (NTM) 可以导致具有挑战性的手部感染.
- 在大型队列中,NTM手部感染的临床表现,管理和结果尚未明确.
研究的目的:
- 描述一大群患有非结核菌菌 (NTM) 手部感染的患者的临床表现,管理和结果.
- 为了确定NTM手部感染治疗失败的风险因素.
主要方法:
- 1998年至2018年间在梅奥诊所治疗NTM手部感染的成年患者 (≥18岁) 的回顾性评估.
- 对患者人口统计,临床表现,感染特征,治疗方式 (抗生素,手术) 和治疗结果的分析.
主要成果:
- 分析了81名患有NTM手部感染的患者队列. 常见的物种包括Mycobacterium marinum,Mycobacterium avium复合体,以及Mycobacterium chelonae/复合体.
- 深度感染 (64.2%) 很常见,86.5%的患者需要手术,32.4%需要多次手术. 5年累计治疗失败率为30.3%.
- 免疫功能受损状态和内伤性类固醇使用被确定为治疗失败的显著风险因素.
结论:
- 非结核菌 (NTM) 手部感染通常需要手术和长期抗生素治疗的结合.
- 对于精选的表面NTM手部感染,可以考虑使用抗生素单疗法.
- 免疫抑制和先前的内伤性类固醇管理是与NTM手部感染治疗失败相关的关键风险因素.
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