艾滋病与非结核分枝杆菌的双重感染研究进展
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摘要
非结核分枝杆菌(non-tuberculous mycobacterium,NTM)感染是指除了结核分枝杆菌复合群和麻风分枝杆菌以外的分枝杆菌引起的感染。属于条件致病菌,常见于有基础疾病和存在免疫缺陷的患者,最好发于HIV感染者,被认为是引起艾滋病患者发生常见机会性感染的病原菌之一,尤其常见于CD4~+T细胞小于50个/μL的艾滋病患者。近年来,由非结核分枝杆菌引起的感染在全球各地的报道呈现明显上升趋势,严重威胁着人类尤其是艾滋病患者的健康。由于NTM感染的相关临床症状、体征以及影像学表现等缺乏典型,容易被误诊为结核感染,且病死率高。故了解NTM的病原学分类、感染途径、HIV患者感染NTM后两者之间的相互作用机制,以及该病相关临床表现、实验室诊断方法和目前关于该病的治疗方法等显得至关重要,因此本综述就上述内容的研究进展做一概述。
Non-tuberculous mycobacteria(NTM) infectionsare caused by a diverse group of mycobacteria but they do not include Mycobacterium tuberculosis and Mycobacterium leprosy. This pathogen is a conditional pathogen and is common in patients with underlying diseases and immunodeficiency, most commonly in HIV-infected individuals. It is considered to be one of the pathogens causing common opportunistic infections in AIDS patients, especially in AIDS patients with CD4~+T cells less than 50 cells/μL. Over the recentpast years, reports of infections caused by non-tuberculous mycobacteria have shown a clear upward trend in the world, seriously threatening the health of humans, especially AIDS patients. Due to the lack of typical clinical symptoms, signs, and imaging performance of NTM infection, it is easy to be misdiagnosed as tuberculosis infection,and has a high mortality rate. It is important to understand the etiology classification of NTM, the route of infection, the interaction mechanisms between HIV and NTM, as well as the clinical manifestations, laboratory diagnostic methods, and current treatment methods for the diseases. Therefore, this paper reviews the research progress of the above contents.
Non-tuberculous mycobacteria(NTM) infectionsare caused by a diverse group of mycobacteria but they do not include Mycobacterium tuberculosis and Mycobacterium leprosy. This pathogen is a conditional pathogen and is common in patients with underlying diseases and immunodeficiency, most commonly in HIV-infected individuals. It is considered to be one of the pathogens causing common opportunistic infections in AIDS patients, especially in AIDS patients with CD4~+T cells less than 50 cells/μL. Over the recentpast years, reports of infections caused by non-tuberculous mycobacteria have shown a clear upward trend in the world, seriously threatening the health of humans, especially AIDS patients. Due to the lack of typical clinical symptoms, signs, and imaging performance of NTM infection, it is easy to be misdiagnosed as tuberculosis infection,and has a high mortality rate. It is important to understand the etiology classification of NTM, the route of infection, the interaction mechanisms between HIV and NTM, as well as the clinical manifestations, laboratory diagnostic methods, and current treatment methods for the diseases. Therefore, this paper reviews the research progress of the above contents.
引文
[1]BENSI E P,PANUNTO P C,RAMOSM D E C.Incidence of tuberculous and non-tuberculous mycobacteria,differentiated by multiplex PCR,in clinical specimens of a large general hospital[J].Clinics,2013,68(2):179-184.
[2]MWIKUMA G,KWENDA G,HANG'OMBE B M,et al.Molecular identification of non-tuberculous mycobacteria isolated from clinical specimens in Zambia[J].Ann Clin Microbiol Antimicrob,2015,14:1.
[3]KENDALL B A,WINTHROP K L.Update on the epidemiology of pulmonary nontuberculous mycobacterial infections[J].Semin Respir Crit Care Med,2013,34(1):87-94.
[4]áLVARO-MECA A,RODRíGUEZ-GIJóN L,DíAZ A,et al.Trends in nontuberculous mycobacterial disease in hospitalized subjects in Spain(1997-2010)according to HIV infection[J].HIV Med,2015,16(8):485-493.
[5]邓西子,陈万山,兰芸,等.广州地区HIV/AIDS患者合并感染非结核分枝杆菌的耐药分析[J].热带医学杂志,2015,15(2):170-173.
[6]KASPERBAUER S H,DE GROOTE M A.The treatment of rapidly growing mycobacterial infections[J].Clin Chest Med,2015,36(1):67-78.
[7]陈晓红,吴迪.肺外非结核分枝杆菌病的临床特点和诊断[J].中国医刊,2016,51(3):6-9.
[8]DOS SANTOS R P,SCHEID K,GOLDANI L Z.Disseminated nontuberculous mycobacterial disease in patients with acquired immune deficiency syndrome in the south of Brazil[J].Trop Doct,2010,40(4):211-213.
[9]唐神结,顾瑾.肺外非结核分枝杆菌病的临床诊治特点[J].中华结核和呼吸杂志,2018,41(1):6-9.
[10]KOTWAL A,RAGHUVANSHI S,SINDHWANI G,et al.Mycobacterium tuberculosis and nontuberculosis mycobacteria co-infection:Two cases from the sub-Himalayan region of North India in a year[J].Lung India,2017,34(5):494-496.
[11]PESSLER F,CRON R Q.Reciprocal regulation of the nuclear factor of activated T cells and HIV-1[J].Genes Immun,2004,5(3):158-167.
[12]HOSHINO Y,NAKATA K,HOSHINO S,et al.Maximal HIV-1 replication in alveolar macrophages during tuberculosis requires both lymphocyte contact and cytokines[J].J Exp Med,2002,195(4):495-505.
[13]TOOSSI Z,MAYANJA-KIZZA H,LAWN S D,et al.Dynamic variation in the cellular origin of HIV type 1 during treatment of tuberculosis in dually infected subjects[J].AIDS Res Hum Retroviruses,2007,23(1):93-100.
[14]REED M B,DOMENECH P,MANCA C,et al.A glycolipid of hypervirulent tuberculosis strains that inhibits the innate immune response[J].Nature,2004,431(7004):84-87.
[15]BRENNAN P J,CRICK D C.The cell-wall core of Mycobacterium tuberculosis in the context of drug discovery[J].Curr Top Med Chem,2007,7(5):475-488.
[16]RICHTER E,WESSLING J,LüGERING N,et al.Mycobacterium avium subsp.paratuberculosis infection in a patient with HIV,Germany[J].Emerging Infect Dis,2002,8(7):729-731.
[17]NAKAHARA Y,OONISHI Y,TAKIGUCHI J,et al.Nontuberculous mycobacterial lung disease accompanied by organizing pneumonia[J].Intern Med,2015,54(8):945-951.
[18]CIET P,SERRA G,BERTOLO S,et al.Assessment of CF lung disease using motion corrected PROPELLER MRI:A comparison with CT[J].Eur Radiol,2016,26(3):780-787.
[19]程睿儇,吴利先,王国富.AIDS合并非结核分枝杆菌肺病的研究进展[J].中国病原生物学杂志,2018,13(6):671-673,680.
[20]张静波,褚海青.非结核分枝杆菌肺病临床特征及其影像学特点[J].中国感染与化疗杂志,2016,16(1):86-91.
[21]GONZALEZ-SANTIAGO T M,DRAGE L A.Nontuberculous mycobacteria:skin and soft tissue infections[J].Dermatol Clin,2015,33(3):563-577.
[22]BI S,HU F S,YU H Y,et al.Nontuberculous mycobacterial osteomyelitis[J].Infectious Diseases,2015,47(10):673-685.
[23]中华医学会结核病学分会,非结核分枝杆菌病实验室诊断专家共识编写组.非结核分枝杆菌病实验室诊断专家共识[J].中华结核和呼吸杂志,2016,39(6):438-443.
[24]曹仕鹏,傅满姣,罗丹.非结核分枝杆菌肺病54例临床特点分析及诊治体会[J].广西医学,2016,38(3):328-331.
[25]尉理梁.血清蛋白质HP、TIMP-1和PEPD与肺结核病理的关联性研究[J].中国病原生物学杂志.2016,11(03).200-203.
[26]唐神结.非结核分枝杆菌病诊断与治疗专家共识解读[J].中国医刊,2016,51(3):21-24.
[27]中华医学会感染病学分会艾滋病学组.艾滋病诊疗指南(第三版)[J].中华传染病杂志,2015,33(10):577-593.
[28]黄葵,李勇.AIDS合并非结核分枝杆菌肺病的诊治进展[J].传染病信息,2017,30(2):118-121.
[29]SARRIA J C,CHUTKAN N B,FIGUEROA J E,et al.Atypical mycobacterial vertebral osteomyelitis:Case report and review[J].CLININFECT DIS,1998,26(2):503-505.
[30]TORRIANI F J,BEHLING C A,MCCUTCHAN J A,et al.Disseminated mycobacterium avium complex:Correlation between blood and tissue burden[J].Journal of Infectious Diseases,1996,173(4):942-949.
[31]CLARK R B.Osteomyelitis and synovitis produced by Mycobacterium marinum in a fisherman[J].Journal of clinical microbiology,1990,28(11).2570-2572.
[2]MWIKUMA G,KWENDA G,HANG'OMBE B M,et al.Molecular identification of non-tuberculous mycobacteria isolated from clinical specimens in Zambia[J].Ann Clin Microbiol Antimicrob,2015,14:1.
[3]KENDALL B A,WINTHROP K L.Update on the epidemiology of pulmonary nontuberculous mycobacterial infections[J].Semin Respir Crit Care Med,2013,34(1):87-94.
[4]áLVARO-MECA A,RODRíGUEZ-GIJóN L,DíAZ A,et al.Trends in nontuberculous mycobacterial disease in hospitalized subjects in Spain(1997-2010)according to HIV infection[J].HIV Med,2015,16(8):485-493.
[5]邓西子,陈万山,兰芸,等.广州地区HIV/AIDS患者合并感染非结核分枝杆菌的耐药分析[J].热带医学杂志,2015,15(2):170-173.
[6]KASPERBAUER S H,DE GROOTE M A.The treatment of rapidly growing mycobacterial infections[J].Clin Chest Med,2015,36(1):67-78.
[7]陈晓红,吴迪.肺外非结核分枝杆菌病的临床特点和诊断[J].中国医刊,2016,51(3):6-9.
[8]DOS SANTOS R P,SCHEID K,GOLDANI L Z.Disseminated nontuberculous mycobacterial disease in patients with acquired immune deficiency syndrome in the south of Brazil[J].Trop Doct,2010,40(4):211-213.
[9]唐神结,顾瑾.肺外非结核分枝杆菌病的临床诊治特点[J].中华结核和呼吸杂志,2018,41(1):6-9.
[10]KOTWAL A,RAGHUVANSHI S,SINDHWANI G,et al.Mycobacterium tuberculosis and nontuberculosis mycobacteria co-infection:Two cases from the sub-Himalayan region of North India in a year[J].Lung India,2017,34(5):494-496.
[11]PESSLER F,CRON R Q.Reciprocal regulation of the nuclear factor of activated T cells and HIV-1[J].Genes Immun,2004,5(3):158-167.
[12]HOSHINO Y,NAKATA K,HOSHINO S,et al.Maximal HIV-1 replication in alveolar macrophages during tuberculosis requires both lymphocyte contact and cytokines[J].J Exp Med,2002,195(4):495-505.
[13]TOOSSI Z,MAYANJA-KIZZA H,LAWN S D,et al.Dynamic variation in the cellular origin of HIV type 1 during treatment of tuberculosis in dually infected subjects[J].AIDS Res Hum Retroviruses,2007,23(1):93-100.
[14]REED M B,DOMENECH P,MANCA C,et al.A glycolipid of hypervirulent tuberculosis strains that inhibits the innate immune response[J].Nature,2004,431(7004):84-87.
[15]BRENNAN P J,CRICK D C.The cell-wall core of Mycobacterium tuberculosis in the context of drug discovery[J].Curr Top Med Chem,2007,7(5):475-488.
[16]RICHTER E,WESSLING J,LüGERING N,et al.Mycobacterium avium subsp.paratuberculosis infection in a patient with HIV,Germany[J].Emerging Infect Dis,2002,8(7):729-731.
[17]NAKAHARA Y,OONISHI Y,TAKIGUCHI J,et al.Nontuberculous mycobacterial lung disease accompanied by organizing pneumonia[J].Intern Med,2015,54(8):945-951.
[18]CIET P,SERRA G,BERTOLO S,et al.Assessment of CF lung disease using motion corrected PROPELLER MRI:A comparison with CT[J].Eur Radiol,2016,26(3):780-787.
[19]程睿儇,吴利先,王国富.AIDS合并非结核分枝杆菌肺病的研究进展[J].中国病原生物学杂志,2018,13(6):671-673,680.
[20]张静波,褚海青.非结核分枝杆菌肺病临床特征及其影像学特点[J].中国感染与化疗杂志,2016,16(1):86-91.
[21]GONZALEZ-SANTIAGO T M,DRAGE L A.Nontuberculous mycobacteria:skin and soft tissue infections[J].Dermatol Clin,2015,33(3):563-577.
[22]BI S,HU F S,YU H Y,et al.Nontuberculous mycobacterial osteomyelitis[J].Infectious Diseases,2015,47(10):673-685.
[23]中华医学会结核病学分会,非结核分枝杆菌病实验室诊断专家共识编写组.非结核分枝杆菌病实验室诊断专家共识[J].中华结核和呼吸杂志,2016,39(6):438-443.
[24]曹仕鹏,傅满姣,罗丹.非结核分枝杆菌肺病54例临床特点分析及诊治体会[J].广西医学,2016,38(3):328-331.
[25]尉理梁.血清蛋白质HP、TIMP-1和PEPD与肺结核病理的关联性研究[J].中国病原生物学杂志.2016,11(03).200-203.
[26]唐神结.非结核分枝杆菌病诊断与治疗专家共识解读[J].中国医刊,2016,51(3):21-24.
[27]中华医学会感染病学分会艾滋病学组.艾滋病诊疗指南(第三版)[J].中华传染病杂志,2015,33(10):577-593.
[28]黄葵,李勇.AIDS合并非结核分枝杆菌肺病的诊治进展[J].传染病信息,2017,30(2):118-121.
[29]SARRIA J C,CHUTKAN N B,FIGUEROA J E,et al.Atypical mycobacterial vertebral osteomyelitis:Case report and review[J].CLININFECT DIS,1998,26(2):503-505.
[30]TORRIANI F J,BEHLING C A,MCCUTCHAN J A,et al.Disseminated mycobacterium avium complex:Correlation between blood and tissue burden[J].Journal of Infectious Diseases,1996,173(4):942-949.
[31]CLARK R B.Osteomyelitis and synovitis produced by Mycobacterium marinum in a fisherman[J].Journal of clinical microbiology,1990,28(11).2570-2572.
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