PDF(Pubmed)
Abstract：
Mycobacterium thermoresistibile is a thermotolerant nontuberculous mycobacterium which can rarely result in human infection. Although immunosuppression has been identified as a risk factor for infection, it is possible that mycobacterial laboratories may have previously under-recognized M. thermoresistibile as standard mycobacterial incubation temperatures are suboptimal for culture of this organism. Here, we present a case of severe M. thermoresistibile pneumonia associated with achalasia requiring life support in the intensive care unit. We speculated that the interplay between specific host and environmental risk factors contributed to acquisition of infection. Infection with this fastidious organism required prolonged treatment with multiple antimicrobials and adjunctive therapeutic drug monitoring which led to clinical cure despite residual lung injury. We also reviewed literature documenting cases of human infection with M. thermoresistibile. The diagnosis of M. thermoresistibile requires a high degree of clinical suspicion considering its association with immunosuppressive conditions, postulated environmental inoculation and eponymous culture growth characteristics.
摘要：
热抗性胆汁分枝杆菌是一种耐热的非结核分枝杆菌，很少导致人类感染。尽管免疫抑制已被确定为感染的危险因素，分枝杆菌实验室可能先前未充分认识到热抵抗病分枝杆菌,因为标准分枝杆菌培养温度对于该生物体的培养并不理想.这里,我们介绍了一例严重的热抵抗性胆汁结核分枝杆菌肺炎伴贲门失弛缓症,在重症监护病房需要生命支持.我们推测，特定宿主和环境危险因素之间的相互作用促成了感染的获得。这种挑剔的生物感染需要使用多种抗菌剂和辅助治疗药物监测的长期治疗，尽管有残留的肺损伤，但仍可导致临床治愈。我们还回顾了文献，记录了人类感染热抵抗病分枝杆菌的病例。考虑到其与免疫抑制疾病的相关性，热抵抗性胆汁的诊断需要高度的临床怀疑。假定环境接种和同名培养物生长特征。
