脓肿分枝杆菌脓毒血症1例并文献复习  

Septicopyemia Caused by Mycobacterium Abscessus: A Case Report and Literature Review

作　　者：王义翔 程兆忠[2] 

机构地区：[1]青岛医学院,山东 青岛 [2]青岛大学附属医院呼吸内科,山东 青岛

出　　处：《临床医学进展》2023年第3期4752-4758,共7页Advances in Clinical Medicine

摘　　要：非结核分枝杆菌(Non-Tuberculous Mycobacteria, NTM)指除外结核分枝杆菌复合群和麻风分枝杆菌之外的其他分枝杆菌,其种类多样,大部分为寄生菌,仅少部分致病。我国以戈尔登分枝杆菌、脓肿分枝杆菌较为多见。非结核分枝杆菌可引起肺部和肺外的病变,多累及肺部、淋巴结、骨骼、关节等组织器官,临床中非结核分枝杆菌肺病多见,但非结核分枝杆菌引起的脓毒血症极为少见,指南中对其治疗方案未做详细阐述,我国近年来已发布《非结核分枝杆菌病诊断与治疗指南(2020年版)》以指导临床。常规的治疗方法以克拉霉素或阿奇霉素联合乙胺丁醇方案为主,该方案虽然能延缓病情发展,但远期疗效欠佳,药物耐药性较高,患者的预后较差。本文以1例非结核分枝杆菌脓毒血症为例,探讨非结核分枝杆菌脓毒血症的治疗方案及临床疗效。Non-tuberculous mycobacteria (NTM) are mycobacteria other than Mycobacterium tuberculosis complex and Mycobacterium leprae. Most of them are parasitic bacteria and only a few are patho-genic. Mycobacterium golden and Mycobacterium abscessus are more commonly found in China. Non-tuberculous mycobacteria can cause lung and extrapulmonary lesions, often involving lungs, lymph nodes, bones, joints and other tissues and organs. Non-tuberculous mycobacteria lung dis-ease is common in clinical practices, but non-tuberculous mycobacteria sepsis is extremely rare, and the treatment of non-tuberculous mycobacteria is not elaborated in the guidelines. In recent years, China has published the Guidelines for the Diagnosis and Treatment of non-tuberculous My-cobacterial diseases (2020 edition) to guide clinical practices. The conventional treatment methods are mainly clarithromycin or azithromycin combined with ethambutol regimen. Although this reg-imen can slow the development of the disease, the long-term efficacy is poor, the drug resistance is high, and the prognosis of patients is poor. In this paper, a case of non-tuberculous mycobacterial sepsis was taken as an example for discussion on the treatment plan and clinical efficacy of non-tuberculous mycobacterial sepsis.

关 键 词：非结核分枝杆菌感染 脓肿分枝杆菌 脓毒血症 

分 类 号：R44[医药卫生—诊断学]