METHODS: We retrospectively studied 131 consecutive patients with positive cultures for nontuberculous mycobacteria between 2005 and 2016. We selected those who met the criteria for nontuberculous mycobacterial lung infection. We analysed the epidemiologic data; clinical, microbiological, and radiological findings; treatment; and outcome according to treatment.
RESULTS: We included 34 patients (mean age, 55 y; 67.6% men); 50% were immunodepressed (58.8% of these were HIV+), 20.6% had COPD, 5.9% had known tumors, 5.9% had cystic fibrosis, and 29.4% had no comorbidities. We found that 20.6% had a history of tuberculosis and 20.6% were also infected with other microorganisms. Mycobacterium avium complex was the most frequently isolated germ (52.9%); 7 (20.6%) were also infected with other organisms. The most common CT findings were nodules (64.7%), tree-in-bud pattern (61.8%), centrilobular nodules (44.1 %), consolidations (41.2%), bronchiectasis (35.3%), and cavities (32.4%). We compared findings between men and women and between immunodepressed and immunocompetent patients. Treatment was antituberculosis drugs in 67.6% of patients (72% of whom showed improvement) and conventional antibiotics in 20.6% (all of whom showed radiologic improvement).
CONCLUSIONS: The diagnosis of nontuberculous mycobacterial lung infections is complex. The clinical and radiologic findings are nonspecific and a significant percentage of pateints can have other, concomitant infections.
方法:我们回顾性研究了2005年至2016年间131例非结核分枝杆菌培养阳性的连续患者。我们选择了符合非结核性分枝杆菌肺部感染标准的患者。我们分析了流行病学数据;临床,微生物,和放射学结果;治疗;和根据治疗的结果。
结果:我们包括34例患者(平均年龄,55岁;67.6%的男性);50%的人免疫低下(其中58.8%是HIV+),20.6%患有COPD,5.9%有已知肿瘤,5.9%有囊性纤维化,29.4%没有合并症。我们发现20.6%有结核病史,20.6%还感染了其他微生物。鸟分枝杆菌复合物是最常分离的细菌(52.9%);7(20.6%)也被其他生物感染。最常见的CT表现为结节(64.7%),树芽模式(61.8%),小叶中央结节(44.1%),合并(41.2%),支气管扩张(35.3%),和空洞(32.4%)。我们比较了男性和女性以及免疫低下患者和免疫功能正常患者之间的发现。67.6%的患者接受抗结核药物治疗(其中72%表现出改善),20.6%的患者接受常规抗生素治疗(所有患者均表现出放射学改善)。
结论:非结核分枝杆菌肺部感染的诊断是复杂的。临床和放射学发现是非特异性的,并且很大一部分患者可以具有其他,伴随感染。