对非结核分枝杆菌肺病患者的治疗效果和存活率进行全国性评估。

IF 3.4 3区医学 Q2 INFECTIOUS DISEASES

International Journal of Tuberculosis and Lung Disease Pub Date : 2024-10-01 DOI:10.5588/ijtld.24.0068

M J Makek, G Glodic, I Sabol, L Zmak, M Samarzija, A Sola, A Marusic, I Marekovic, L K Bulat, L Corak, M Obrovac, J van Ingen

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引用次数: 0

摘要

背景在现实世界中，非结核分枝杆菌肺病（NTM-PD）的治疗效果和长期存活率很难评估，尤其是对非结核分枝杆菌复合体（MAC）的治疗效果和长期存活率。结果98/137（71.5%）名患者开始接受治疗，其中纤维空洞症和/或痰涂片阳性患者的治疗率明显更高。39/98（39.8%）例患者治疗失败（14 例死亡和 25 例治疗失败）。一年和五年全因死亡率分别为 18.2% 和 37.6%。50/98（51%）名接受治疗的患者开始接受基于指南的治疗（GBT），35.7%（35/98）的患者按照建议的疗程接受治疗。与治疗不当/未接受治疗的患者相比，这种治疗方法的治愈率更高（OR 3.79，95% CI 1.29 至 11.1；P = 0.012）。对于异种分枝杆菌疾病，采用 GBT 和非 GBT 治疗方案的治愈率都很高（>80%）。GBT对MAC疾病治疗结果的影响是显而易见的，但对M. xenopi病患者没有明显的影响。

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Nationwide evaluation of treatment outcomes and survival of patients with non-tuberculous mycobacterial pulmonary disease.

BACKGROUNDTreatment outcomes and long-term survival of non-tuberculous mycobacterial pulmonary disease (NTM-PD) in a real-world setting are difficult to assess, especially for species other than Mycobacterium avium complex (MAC).METHODSThis was a retrospective cohort study on all Croatian residents with respiratory NTM isolates from 2006 to 2015, with follow-up to 2020.RESULTSTherapy was started in 98/137 (71.5%) of patients, significantly more often in patients with fibrocavitary disease and/or sputum smear positivity. Unsuccessful treatment outcomes were recorded in 39/98 (39.8%) patients (14 deaths and 25 treatment failures). One-year and 5-year all-cause mortality were respectively 18.2% and 37.6%. Guideline-based treatment (GBT) was started in 50/98 (51%) of treated patients and followed for the recommended duration in 35.7% (35/98). This resulted in a higher chance of cure (OR 3.79, 95% CI 1.29 to 11.1; P = 0.012) than inadequately treated/untreated patients. For Mycobacterium xenopi disease, high cure rates (>80%) were achieved both with GBT and non-GBT treatment regimens.CONCLUSIONGuideline-based therapy resulted in a four-time higher chance of being cured. The impact of GBT on treatment outcomes was clear for MAC disease, but no apparent effect was observed for patients with M. xenopi disease..

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来源期刊

International Journal of Tuberculosis and Lung Disease 医学-传染病学

CiteScore

4.90

自引率

20.00%

发文量

266

审稿时长

2 months

期刊介绍： The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.