非结核分枝杆菌皮肤、软组织和骨骼感染的流行病学、临床特征和结果:来自单一中心的10年时间

IF 1.9 Q3 INFECTIOUS DISEASES
Mary B. Ford , Jason F. Okulicz , Jesse R. Salinas , John L. Kiley
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引用次数: 0

摘要

非结核分枝杆菌(NTM)引起各种各样的临床综合征。指导NTM皮肤软组织感染(SSTI)和骨感染诊断和治疗的数据有限。我们试图更好地了解NTM引起的SSTI和骨感染。方法对2012 - 2022年在布鲁克陆军医疗中心回收的NTM临床分离株进行筛选;包括SSTI和骨分离株。对电子健康记录进行流行病学、微生物学和临床数据的审查。感染被定义为从皮肤、软组织或骨骼培养中恢复一个或多个NTM分离物,并伴有相应的临床综合征。结果分析了29例患者皮肤、软组织、骨源性分离株40株。20例(69%)患者(多数为女性(14/20,70%)有感染分离株,最常见的是继发于手术(35%)或创伤(35%)。20人中有6人(30%)患有骨感染。从症状出现到隔离恢复的中位时间为61天(IQR 43-95)。内科/外科联合治疗8例(40%),单纯手术治疗8例(40%),单纯药物治疗4例(20%)。脓肿分枝杆菌多见于真感染患者。结论支持NTM SSTI/骨感染诊断和治疗决策的数据较少。在本研究中,大多数分离的NTM是真正的感染。我们确认手术和创伤是最常见的暴露途径。症状发作和定向治疗之间的延迟以及治疗方案的多样性突出了对诊断和治疗标准的进一步研究的需要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Epidemiology, clinical characteristics, and outcomes of nontuberculous mycobacterial skin, soft tissue, and bone infections from a single center over a 10-year period

Introduction

Non-tuberculous mycobacteria (NTM) cause a wide variety of clinical syndromes. Data guiding diagnosis and treatment of NTM skin and soft tissue infections (SSTI) and bone infections are limited. We sought to better understand SSTI and bone infections caused by NTM.

Methods

All NTM clinical isolates recovered at Brooke Army Medical Center from 2012 to 2022 were screened; SSTI and bone isolates were included. Electronic health records were reviewed for epidemiologic, microbiologic, and clinical data. Infections were defined as recovery of one or more NTM isolate from skin, soft tissue, or bone cultures with a corresponding clinical syndrome.

Results

Forty isolates of skin, soft tissue, or bone origin from 29 patients were analyzed. Twenty (69 %) patients, majority female (14/20, 70 %), had infecting isolates, most commonly secondary to surgery (35 %) or trauma (35 %). Six of 20 (30 %) had bone infections. Time from symptom onset to isolate recovery was a median 61 days (IQR 43–95). Eight (40 %) had combined medical/surgical therapy, 8 (40 %) had surgery alone, and 4 (20 %) had medical therapy alone. M. abscessus was more frequently isolated from patients with true infections.

Conclusions

Data supporting diagnosis and treatment decisions in NTM SSTI/bone infections is sparse. In this study the majority of NTM isolated were true infections. We confirm that surgery and trauma are the most common routes of exposure. The delay between symptom onset and directed therapy and the wide variety of treatment regimens highlight a need for additional studies delineating criteria for diagnosis and treatment.

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来源期刊
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine
CiteScore
4.00
自引率
5.00%
发文量
44
审稿时长
30 weeks
期刊介绍: Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.
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