病原体基因型和宿主表型的Mycobacterium的肺部疾病在台湾
Yu-Hsun Chiang1, Jia-Yih Feng2, Chin-Chung Shu3
1Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Journal of infection and public health
|July 16, 2025
概括
患有腔腔或双边疾病的患者不太可能患有抗宏化物耐药的Mabs. 对表型特异性的研究对于在Mabs-PD中指导治疗决策至关重要.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 肺部医学 肺部医学
背景情况:
- 菌根的肺病 (Mabs-PD) 提出了治疗挑战,特别是亚种 (Mabs-a) 菌株,这些菌株往往是抗宏化物耐药的.
- 亚种massiliense (Mabs-m) 菌株通常表现出对类的敏感性,与Mabs-a.不同.
- 马布斯基因变异和马布斯-PD的临床表现之间的相关性尚未得到充分理解.
研究的目的:
- 调查Mabs-PD和肺外疾病 (Mabs-ED) 患者中Mycobacterium遗传变异和临床特征之间的关系.
- 确定不同Mabs亚种中抗巨化物基因变异的流行率及其与疾病严重程度和进展的关联.
- 探索Mabs亚种和耐药性概况对患者管理的临床影响.
主要方法:
- 一项回顾性队列研究分析了在2016年至2018年期间被诊断患有Mabs-PD或Mabs-ED的患者.
- 测序Mabs分离物以确定亚种 (Mabs-a与Mabs-m) 和宏化物耐药性遗传标记物 (rrl突变, erm(41) T28序列).
- 根据抗生素需求或增加的肺病变以及与疾病表型 (腔腔,双边,单边) 的相关性,评估严重或渐进的Mabs-PD.
主要成果:
- 梅布斯-PD患者比梅布斯-ED患者更老,更瘦.
- 在84.6%的Mabs-a和9.4%的Mabs-m分离物中发现了对宏类抗性的遗传变异 (p < 0.001).
- 洞腔和非洞腔双边Mabs-PD与严重/进展性疾病的风险增加有关,并且更有可能携带Mabs-m分离物. 双边疾病与宏抗性遗传变异呈反向关联 (aOR 0.187,p=0.008).
结论:
- 患有洞腔或双边疾病的Mabs-PD患者,通常需要治疗,患有抗宏化物抗性Mabs的患病率较低.
- 这些发现强调了在对Mabs-PD的临床决策中考虑Mabs亚种和耐药性概况的重要性.
- 对表型特异性的研究对于优化梅布斯-PD的治疗策略至关重要.
相关概念视频
01:28Pulmonary Tuberculosis II
378
Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
378
01:31Pulmonary Tuberculosis III
448
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
448
01:29Pulmonary Tuberculosis I
330
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
330
01:26Pulmonary Tuberculosis IV
207
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
207