Research progress on comprehensive treatment beyond antibiotic therapy for nontuberculous mycobacterium pulmonary disease

doi:10.19982/j.issn.1000-6621.20240019

Abstract

Abstract:

In recent years, the incidence and prevalence of pulmonary disease caused by non-tuberculous mycobacteria (NTM) infection have been increasing rapidly. However, non-tuberculous mycobacterial pulmonary disease (NTM-PD) has the characteristics of low cure rate, high case fatality rate and high recurrence rate. Therefore, some scholars have proposed that clinicians should first manage the host factors and handle the controllable characteristics of NTM-PD, followed by optimizing anti-NTM treatment. This paper provides a review of the current status of comprehensive treatment beyond antibiotic therapy for NTM-PD, and propose that the important measures to improve the cure rate and reduce the recurrence rate of the disease are as follows: strengthening the comprehensive treatment beyond antibiotic therapy during treating NTM-PD, reducing or avoiding exposure to the NTM environment, enhancing the body’s immunity and improving the pulmonary internal environment caused by structural lung disease.

Key words: Mycobacterium infections, Lung diseases, Combined modality therapy, Immunity

CLC Number:

R563
R459.9

Tan Shouyong. Research progress on comprehensive treatment beyond antibiotic therapy for nontuberculous mycobacterium pulmonary disease[J]. Chinese Journal of Antituberculosis, 2024, 46(8): 967-970. doi: 10.19982/j.issn.1000-6621.20240019

References 21

[1]	Tan Y, Deng Y, Yan X, et al. Nontuberculous mycobacterial pulmonary disease and associated risk factors in China: A prospective surveillance study. J Infect, 2021, 83 (1): 46-53. doi:10.1016/j.jinf.2021.05.019. pmid: 34048821
[2]	Liu CF, Song YM, He WC, et al. Nontuberculous mycobacteria in China: incidence and antimicrobial resistance spectrum from a nationwide survey. Infect Dis Poverty, 2021, 10(1): 59. doi:10.1186/s40249-021-00844-1.
[3]	全国第五次结核病流行病学抽样调查技术指导组, 全国第五次结核病流行病学抽样调查办公室. 2010年全国第五次结核病流行病学抽样调查报告. 中国防痨杂志, 2012, 34 (8): 485-508.
[4]	沙巍. 大力推进我国非结核分枝杆菌肺病高质量的治疗性研究. 中华临床感染病杂志, 2023, 16(3): 169-173. doi:10.3760/cma.j.issn.1674-2397.2023.03.002.
[5]	Sharma SK, Upadhyay V. Epidemiology, diagnosis & treatment of non-tuberculous mycobacterial diseases. Indian J Med Res, 2020, 152(3): 185-226. doi:10.4103/ijmr.IJMR_902_20.
[6]	Shu CC, Wu MF, Pan SW, et al. Host immune response against environmental nontuberculous mycobacteria and the risk populations of nontuberculous mycobacterial lung disease. J Formos Med Assoc, 2020, 119 Suppl 1: S13-S22. doi:10.1016/j.jfma.2020.05.001.
[7]	中华医学会结核病学分会. 非结核分枝杆菌病诊断与治疗指南(2020年版). 中华结核和呼吸杂志, 2020, 43(11): 918-946. doi:10.3760/cma.j.cn 112147-20200508-00570.
[8]	Pavlik I, Ulmann V, Hubelova D, et al. Nontuberculous Mycobacteria as Sapronoses: A Review. Microorganisms, 2022, 10(7): 1345. doi:10.3390/microorganisms10071345.
[9]	Maekawa K, Ito Y, Hirai T, et al. Environmental risk factors for pulmonary Mycobacterium avium-intracellulare complex disease. Chest, 2011, 140(3): 723-729. doi:10.1378/chest.10-2315. pmid: 21393389
[10]	王桂荣, 黄海荣. 非结核分枝杆菌的分布和生长影响因素及其传播途径研究. 中国防痨杂志, 2016, 38(10): 869-874. doi:10.3969/j.issn.1000-6621.2016.10.016.
[11]	Tzou CL, Dirac MA, Becker AL, et al. Association between Mycobacterium avium Complex Pulmonary Disease and Mycobacteria in Home Water and Soil. Ann Am Thorac Soc, 2020, 17 (1): 57-62. doi:10.1513/AnnalsATS.201812-915OC.
[12]	鲁阔, 陈善泽, 陈荣昌, 等. 非结核分枝杆菌病的宿主因素. 中华结核和呼吸杂志, 2022, 45(7): 716-720. doi:10.3760/cma.j.cn112147-20211210-00872.
[13]	陈品儒, 谭守勇. 非结核分枝杆菌肺病患者外周血T淋巴细胞亚群与营养状况相互关系的探讨. 实用医学杂志, 2014, 30(11):1768-1771. doi:10.3969/j.issn.1006-5725.2014.11.026.
[14]	中国人民解放军总医院第八医学中心全军结核病研究所/全军结核病防治重点实验室/结核病诊疗新技术北京市重点实验室, 《中国防痨杂志》编辑委员会, 中国医疗保健国际交流促进会结核病防治分会基础和临床学部. 活动性结核病患者免疫功能状态评估和免疫治疗专家共识(2021年版). 中国防痨杂志, 2022, 44 (1): 9-27. doi:10.19982/j.issn.1000-6621.20210680.
[15]	中国营养学会. 中国居民膳食指南(2022). 北京: 人民卫生出版社, 2022.
[16]	谭守勇. 结核后肺疾病健康管理. 结核与肺部疾病杂志, 2023, 4(5): 342-345. doi:10.19983/j.issn.2096-8493.20230098.
[17]	中华人民共和国国务院办公厅. 国务院办公厅关于印发国民营养计划(2017—2030年)的通知. 国办发〔2017〕60号. 2017-06-30.
[18]	陈华, 陈品儒, 谭守勇. 支气管扩张并非结核分枝杆菌感染临床流行病学分析. 中国医刊, 2016, 51(3): 43-47. doi:10.3969/j.issn.1008-1070.2016.03.014.
[19]	Wang P, Marras TK, Hassan M, et al. Incremental mortality associated with nontuberculous mycobacterial lung disease among US Medicare beneficiaries with chronic obstructive pulmonary disease. BMC Infect Dis, 2023, 23(1): 749. doi:10.1186/s12879-023-08689-9. pmid: 37914999
[20]	支气管扩张症专家共识撰写协作组, 中华医学会呼吸病学分会感染学组. 中国成人支气管扩张症诊断与治疗专家共识. 中华结核和呼吸杂志, 2021, 44(4): 311-321. doi:10.3760/cma.cn112147-20200617-00717.
[21]	中华医学会呼吸病学分会慢性阻塞性肺疾病学组, 中国医师协会呼吸医师分会慢性阻塞性肺疾病工作委员会. 慢性阻塞性肺疾病诊治指南(2021年修订版). 中华结核和呼吸杂志, 2021, 44(3): 170-205. doi:10.3760/cma.j.cn112147-20210109-00031.