Introduction

Nontuberculous mycobacteria (NTM) comprise several pathogens with a complex profile of virulence, diverse epidemiological and clinical patterns as well as host specificity. Recently, an increase in the number of NTM infections has been observed; therefore, the objective of this study was to evaluate the clinical characteristics and outcomes of these infections.

Methods

We included patients with NTM infections between 2001–2017 and obtained risk factors, clinical features and outcomes; finally, we compared this data between slowly growing (SGM) and rapidly growing mycobacteria (RGM).

Results

A total of 230 patients were evaluated, 158 (69%) infected and 72 (31%) colonized/pseudoinfected. The average annual incidence in the first 11 years of the study was 0.5 cases per 1000 admissions and increased to 2.0 cases per 1000 admissions later on. The distribution of NTM infections was as follows: bloodstream and disseminated disease 72 (45%), lung infection 67 (42%), skin and soft tissue infection 19 (12%). Mycobacterium avium complex was the most common isolate within SGM infections, and HIV-infected patients were the most affected. Within RGM infections, M. fortuitum was the most common isolate from patients with underlying conditions such as cancer, type-2 diabetes mellitus, presence of invasive devices, and use of immunosuppressive therapy. We did not find significant differences in deaths and persistent infections between disseminated SGM infection when compared to disseminated RGM infection (42% vs. 24%, p = 0.22). However, disseminated SGM infection required a longer duration of therapy than disseminated RGM infection (median, 210 vs. 42 days, p = 0.01). NTM lung disease showed no significant differences in outcomes among treated versus non-treated patients (p = 0.27).

Conclusions

Our results show a significant increase in the number of Non-tuberculosis-mycobacteria infections in our setting. Patients with slow-growing-mycobacteria infections were mainly persons living with human immunodeficiency virus . Older patients with chronic diseases were common among those with rapidly-growing-mycobacteria infections. For non-tuberculosis-mycobacteria lung infection, antibiotic therapy should be carefully individualized.

中文翻译：

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2001-2017 年墨西哥三级护理中心的非结核分枝杆菌感染。

介绍

非结核分枝杆菌 (NTM) 包括几种病原体，具有复杂的毒力、不同的流行病学和临床模式以及宿主特异性。最近，观察到 NTM 感染数量有所增加；因此，本研究的目的是评估这些感染的临床特征和结果。

方法

我们纳入了 2001 年至 2017 年期间 NTM 感染的患者，并获得了风险因素、临床特征和结果；最后，我们比较了缓慢生长（SGM）和快速生长分枝杆菌（RGM）之间的数据。

结果

总共评估了 230 名患者，其中 158 名 (69%) 被感染，72 名 (31%) 被定植/假感染。该研究前 11 年的平均年发病率为每 1000 例入院患者 0.5 例，随后增加到每 1000 例入院患者 2.0 例。NTM感染分布如下：血流和播散性疾病72例（45%），肺部感染67例（42%），皮肤和软组织感染19例（12%）。鸟分枝杆菌复合体是 SGM 感染中最常见的分离物，感染 HIV 的患者受影响最大。在 RGM 感染中，偶然分枝杆菌是从患有潜在疾病（如癌症、2 型糖尿病、存在侵入性设备和使用免疫抑制疗法）的患者中最常见的分离物。与播散性 RGM 感染相比，我们没有发现播散性 SGM 感染在死亡和持续感染方面存在显着差异（42% 对 24%，p  = 0.22）。然而，播散性 SGM 感染比播散性 RGM 感染需要更长的治疗时间（中位数，210 天 vs. 42 天，p  = 0.01）。NTM 肺病在治疗和未治疗患者的结果上没有显着差异 ( p  = 0.27)。

结论

我们的结果显示，在我们的环境中，非结核分枝杆菌感染的数量显着增加。生长缓慢的分枝杆菌感染患者主要是人类免疫缺陷病毒感染者。患有慢性疾病的老年患者在快速生长的分枝杆菌感染患者中很常见。对于非结核分枝杆菌肺部感染，抗生素治疗应谨慎个体化。