皮肤非典型的真菌细菌感染:简要的回顾
Nikhil Mehta1, Mehul Tyagi1, M Ramam1
1Department of Dermatology and Venereology, AIIMS, New Delhi, India.
Indian dermatology online journal
|December 6, 2024
概括
非结核菌 (NTM) 感染正在增加,特别是肺部NTM. 诊断具有挑战性,通常需要经验性治疗,因为测试有限,特别是皮肤NTM感染.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 皮肤病学 皮肤病学
背景情况:
- 非结核菌 (NTM) 感染在全球范围内越来越多地被认可,特别是在热带地区.
- 肺部NTM感染正在增加,与耐药性和医院环境有关,而皮肤NTM没有增加.
- 临床表现的NTM感染是多样化的,非特异的,可以模仿其他慢性疾病,复杂的诊断.
研究的目的:
- 审查目前对非结核性菌根 (NTM) 感染的理解,重点关注诊断和治疗的挑战.
- 突出诊断困难和需要NTM特异性的方法,特别是皮肤和手术部位感染.
- 讨论实证治疗在因诊断局限性而导致的NTM感染管理中的作用.
主要方法:
- 审查有关NTM感染的现有文献,包括临床表现,诊断方法和治疗策略.
- 分析诊断挑战,如非特异性症状,组织病理学和染色的局限性,以及分子方法的成本/可用性.
- 评估当前的治疗方法,包括经验方案和对NTM特定疗法的需求.
主要成果:
- 随着耐药性增加,NTM感染,特别是肺部形式,越来越令人担忧.
- 皮肤NTM感染没有出现类似的增加,但诊断因非特异性症状和误导性创伤史而复杂化.
- 对于NTM的标准诊断方法通常是不敏感的或不确定的,分子测试是昂贵的,并且对于皮肤形式来说无法广泛使用.
- 由快速生长的真菌细菌引起的手术部位和移植部位NTM感染可能会抵抗标准抗生素,需要NTM特定的治疗.
- 以INDEX-Tb等指导方针为指导的实证治疗通常是必要的,但缺乏标准化的协议,需要仔细监测.
结论:
- NTM感染带来了重大的诊断和治疗挑战,特别是在皮肤形式.
- 由于诊断工具的有限可用性和高成本,需要对NTM感染进行实证治疗策略.
- 需要进一步的研究,以建立标准化,基于证据的NTM感染治疗方案,并提高诊断的可访问性.
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