非结核分枝杆菌病诊治六十年

doi:10.19982/j.issn.1000-6621.20240114

摘要/Abstract

摘要：

人类发现非结核杆菌(nontuberculous mycobacteria,NTM)病已有60多年,对其诊治水平不断提高。20世纪90年代,通过随机对照多中心研究,发现大环内酯为核心的方案对鸟分枝杆菌复合群疾病有较好疗效。几乎同一时期,以分子生物学为基础的菌种鉴定取代了生化实验为基础的菌种鉴定,使医疗机构广泛开展NTM病的诊治成为可能。近年,该领域也出现较多进步,如实现了临床标本分枝杆菌的快速菌种鉴定,发现再感染是NTM病治疗失败的重要原因,以及发现阿米卡星脂质体用于鸟分枝杆菌复合群肺病的价值。基于结核病诊治的经验,未来的NTM诊治要不断探索核心药物敏感性快速诊断方法,实现短疗程的NTM病治疗新方案。

关键词: 非典型性细菌, 分枝杆菌感染, 诊断, 治疗应用

Abstract:

Nontuberculous mycobacteria (NTM) diseases have been recognized for over six decades, with progressively advancing levels of diagnosis and treatment. During the 1990s, a pivotal randomized controlled multicenter study demonstrated the efficacy of macrolide-based regimens against Mycobacterium avium complex infections. Concurrently, the advent of molecular biology techniques for bacterial identification supplanted traditional biochemical methods, greatly enhancing the capacity of medical institutions to diagnose and treat NTM infections. Recent years have witnessed critical developments, including the rapid identification of Mycobacterium species in clinical specimens, the recognition of reinfection as a primary cause of treatment failures in NTM disease, and the proven effectiveness of amikacin liposomes in treating Mycobacterium avium complex pulmonary disease. Drawing on experiences from tuberculosis management, future strategies for NTM should focus on developing rapid diagnostic tests for core drug sensitivities to facilitate the formulation of concise and effective treatment regimens.

Key words: Atypical mycobacteria, Mycobacterium infections, Diagnosis, Therapeutic uses

中图分类号:

R378.91

段鸿飞. 非结核分枝杆菌病诊治六十年[J]. 中国防痨杂志, 2024, 46(8): 863-868. doi: 10.19982/j.issn.1000-6621.20240114

Duan Hongfei. Diagnosis and treatment of nontuberculous mycobacteria diseases in the past 60 years[J]. Chinese Journal of Antituberculosis, 2024, 46(8): 863-868. doi: 10.19982/j.issn.1000-6621.20240114

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