2016–2021年四川地区非结核分枝杆菌感染临床特点分析

Clinical Characteristics of Nontuberculous Mycobacterium Infection Cases in Sichuan,China in 2016–2021:A Retrospective Study

目的分析四川地区非结核分枝杆菌(NTM)感染的菌种分布、临床特点及药敏数据,为非结核分枝杆菌病的防治提供诊治依据。方法收集2016年7月–2021年7月在成都市公共卫生临床医疗中心就诊的NTM感染病例的临床资料,回顾性分析患者感染特点。结果最终纳入分析病例264例,其中173例进行NTM药敏试验。四川地区NTM感染具有性别、年龄和基础疾病差异,其中AIDS以20~40岁中青年男性易感,肺部疾病以>60岁老年男性易感,支气管扩张以>40岁中老年女性易感。呼吸道是NTM感染的主要途径。四川地区NTM优势菌种是龟/脓肿分枝杆菌。鸟、龟/脓肿分枝杆菌耐药率较高。结论不同人口学特点及基础疾病患者NTM感染时其感染部位、菌种、耐药性等特点均不同。明确病原学诊断是NTM感染治疗中的关键,应重视不同的NTM感染时采用个性化的治疗方案。

Objective To study the distribution of nontuberculous mycobacterium(NTM)strains,clinical characteristics and drug sensitivity data of NTM infections so as to provide support for the prevention and treatment of diseases caused by NTM infection in Sichuan.Methods The clinical data of NTM infection cases treated at the Public Health Clinical Center of Chengdu between July 2016 and July 2021 were collected and the characteristics of the infections were retrospectively reviewed.Results There were differences in sex,age and underlying diseases among the NTM infection cases in Sichuan.Specifically,young and middle-aged men aged between 20 and 40 were susceptible to AIDS,older men aged over 60 were susceptible to lung diseases,and middle-aged and older women over 40 were susceptible to bronchiectasis.Respiratory tract was the main route of NTM infection.The dominant strain in Sichuan was M.chelonae/abscessus.The drug resistance rate of M.avium and M.chelonae/abscessus were relatively higher.Conclusion For NTM infection patients with different demographic characteristics and underlying diseases,the NTM infection sites,strains,and drug resistance are also different.Definite etiological diagnosis is essential to the treatment of NTM infection.We should highlight the importance of adopting individualized treatment for different NTM infections.