四例皮肤非结核分枝杆菌感染临床分析

非结核分枝杆菌（NTM）是除结核分枝杆菌复合群及麻风分枝杆菌以外的其他分枝杆菌,广泛分布于土壤、水、灰尘等自然环境,也可在水管、填充材料及医疗器械设备中定植。作为环境来源的机会致病菌,越来越多的研究认为,NTM是人类疾病的病原体。由于皮肤NTM感染的自觉症状轻,皮损多形以及NTM种类繁多,病原体培养困难,因此,临床上常误诊或漏诊。本文通过回顾分析4例NTM患者,分析其临床特点及诊疗方案,为临床诊治提供参考……     

皮肤及软组织非结核分枝杆菌病研究进展

近年来非结核分枝杆菌(Nontuberculosis mycobacteria,NTM)感染率日益增多,NTM既可以引起系统性感染,也可以引起局部皮肤和软组织感染.NTM感染临床表现尚缺乏特异性,容易造成误诊及漏诊.目前传统的抗结核药物对大多数NTM活性较差,治疗仍存在一定困难.开展NTM 菌种快速鉴定技术,提高NTM...     

皮肤及软组织非结核分枝杆菌病研究进展

近年来非结核分枝杆菌(Nontuberculosis mycobacteria,NTM)感染率日益增多,NTM既可以引起系统性感染,也可以引起局部皮肤和软组织感染.NTM感染临床表现尚缺乏特异性,容易造成误诊及漏诊.目前传统的抗结核药物对大多数NTM活性较差,治疗仍存在一定困难.开展NTM 菌种快速鉴定技术,提高NTM 病的诊疗水平,已成为当前防治NTM病的重点.     

皮肤非结核分枝杆菌病及其治疗

<正>非结核分枝杆菌(nontuberculous mycobacteria,NTM)以前被称为非典型分枝杆菌,是一种环境生长菌,在自然界中广泛存在于农村或城市的湿土壤、沼泽地及河流中,属于条件致病菌,是一种具有抗酸染色特性却有别于结核分枝杆菌和麻风分枝杆菌的细菌,目前全世界已发现NTM约154种,但大部分为腐生菌,真正致病者仅占少数。近年来,国内NTM病发病率不断增长,主要见于免疫损伤     

皮肤非结核分枝杆菌感染

正非结核分枝杆菌(nontuberculous mycobacteria,NTM)是指除结核杆菌和麻风杆菌以外的分枝杆菌,可引起多种不同系统和器官感染,主要受累器官为肺、淋巴结、皮肤、软组织和骨,其临床表现错综复杂。随着HIV感染患者的增多及免疫抑制剂等使用的增加,NTM感染的报道日     

Liflandii分枝杆菌研究进展

Liflandii分枝杆菌（M.liflandii）属非结核分枝杆菌（NTM）,其染色体结构接近于海分枝杆菌,而致病性类似溃疡分枝杆菌,能产生分枝杆菌内酯,可引起受感染的蛙类致死性疾病。该分枝杆菌的序列已通过宏基因组测序的方法在人体皮肤标本检测到,但目前尚未从人类的感染标本中分离和培养出该病原体。有限的研究集中在国外微生物领域,目前国内医学界对其认识不足。本文从M.liflandii的种系发现、生物学特征、基因组一般特征、菌株的致病性和毒性、病理特点等方面作一综述,提高对其认识。     

嗜血分枝杆菌感染的研究进展

嗜血分枝杆菌(mycobacterium haemophilum)是一种抗酸杆菌,属于非结核分枝杆菌(nontuberculous mycobacteria,NTM)中的一种。近年来国外关于嗜血分枝杆菌感染的病例报道越来越多,但国内尚无相关报道。本文对其临床表现、诊断及治疗等方面的研究进展进行综述,以提高对该病的认识。     

分枝杆菌在北京水源环境中的分布:M.arupense国内首次报告

目的:研究北京水源中分枝杆菌的分布,应用表型鉴定方法和分子生物学方法进行分枝杆菌鉴定,并比较两种方法的准确性和优缺点.方法:采集水源环境标本,进行分枝杆菌分离培养,通过生化反应对所有分离株进行鉴定.同时从培养菌落中提取分枝杆菌DNA,用PCR扩增65 ku热休克蛋白基因,扩增产物分别应用两种限制性内切酶BstEⅡ和Hae Ⅲ酶切,进行限制性片段长度多态性(RFLP)分析和PCR产物的测序分析.结果:从30份养鱼水中分离出35株分枝杆菌.①表型鉴定结果:Runyon Ⅰ群1株,可疑为海分枝杆菌;Runyon Ⅱ群7株,确定为戈登分枝杆菌或疑似戈登分枝杆菌;Runyon Ⅲ群9株,未鉴定到种;Runyon Ⅳ群18株,其中龟-偶发分枝杆菌复合群9株,其余9株未鉴定到种.②PCR-RFLP鉴定结果:戈登分枝杆菌8株,龟-偶发分枝杆菌复合群8株(包括M.peregrinum 1株),疑似日内瓦分枝杆菌10株,其余9株未鉴定到种.③PCR产物测序鉴定:戈登分枝杆菌10株,M.arupense9株,偶发分枝杆菌7株,土分枝杆菌6株,不产色分枝杆菌1株,M.peregrinum 1株,脓肿分枝杆菌1株.结论:非结核分枝杆菌(NTM)广泛存在于养鱼水中,分枝杆菌采用65 ku热休克蛋白基因PCR扩增配合测序鉴定较传统表型鉴定和PCR-RFLP更准确.     

皮肤非结核分枝杆菌感染2例报告

背景：非结核分枝杆菌的培养比较困难，国内关于确诊非结核分枝杆菌感染的报告很少，目的：探讨非结核分枝杆菌感染的实验室诊断方法及非结核分枝杆菌感染的治疗措施。方法：应用聚合酶链反应和ELISA技术进行实验室诊断，并以联合疗法分别治疗之。结果：2例非结核分枝杆菌感染患者经联合疗法治疗有显著疗效。结论：所用的聚合酶链反应和ELISA有助于诊断非结核分枝杆菌感染，氟嗪酸、利福平、氨苯砜联合疗法治疗有显著疗效。     

分枝杆菌疫苗的历史与现状

分枝杆菌包括结核分枝杆菌、麻风分枝杆菌以及非结核分枝杆菌,是引起结核、麻风及非结核分枝杆菌感染的致病菌,这些感染性疾病对社会造成了重大的经济负担。疫苗接种可在一定程度上保护易感者,并且与标准药物联合用于免疫治疗,对降低传染病的发病率和流行率具有重要意义。本文针对分枝杆菌疫苗的历史和现状,对分枝杆菌的流行病学、疫苗研发及展望进行综述,以期对分枝杆菌疫苗有更深入认识。     

皮肤分枝杆菌感染的研究进展

皮肤分枝杆菌感染是一类复杂的皮肤疾病,临床和病理无特异表现,易漏诊误诊。临床上大致分为3类,皮肤结核、麻风、非结核分枝杆菌感染性皮肤病。本文就各类分枝杆菌感染相关的皮肤疾病进行流行病学特征、临床表现、诊断及治疗进展进行综述。     

Rapid identification of cutaneous infections by nontubercular mycobacteria by polymerase chain reaction-restriction analysis length polymorphism of the hsp65 gene

BACKGROUND: Nontubercular mycobacteria (NTM) may cause cutaneous infections which are difficult to interpret due to the variability of the clinical manifestations. This study involved eight patients (four men and four women) with primary cutaneous infections caused by NTM; the skin lesions included dermo-hypodermal abscesses, suppurative granulomas, and papulonodules localized on the legs, arms, hands, and face. The general condition of the patients was relatively good and they were not immunosuppressed. METHODS: All samples were processed with standard methods and the isolates were identified by pattern restriction analysis after polymerase chain reaction (PCR-PCA) amplification of the heat shock protein of 65 kDa. RESULTS: In this way, we were able to identify three Mycobacterium chelonae strains, two Mycobacterium marinum, two Mycobacterium fortuitum, and one Mycobacterium avium. The lesions disappeared in 3 or 4 weeks after treatment with two or more antimicrobials. CONCLUSIONS: For a correct diagnosis of cutaneous infection by NTM, demonstrating the presence of mycobacteria is essential; routinely available techniques lack sensitivity and are extremely tedious; often mycobacteria are not seen after acid-fast stain. We used PCR-PCA to identify mycobacteria grown in liquid media; the time of identification of mycobacteria was shortened relative to conventional methods.     

29例皮肤非结核分枝杆菌感染临床分析

目的:分析皮肤非结核分枝杆菌感染的临床特点,探讨常见诱因、临床特点及其诊断方法。方法:分析29例患者临床特征,比较不同检测方法在NTM感染诊断中的价值。结果:29例患者中,外伤诱发者8例,美容、注射诱发者6例。皮损主要以结节为主(19例),其中伴溃疡者7例;病变单发者18例,多发者11例,以四肢的创伤部位为主。病理以肉芽肿性炎症为主(17例)。mNGS阳性率(4/4,100%),PCR-RDB(13/15,86.7%),C-基因芯片杂交法1例阳性(1/5,20%),组织培养阳性率最低(1/12,8%)。临床采用抗生素治疗,15例临床治愈(51.7%),4例好转(13.8%),3例无效(1例死亡),7例失访。结论:皮肤NTM感染中外伤或美容手术、注射为近年来不可忽视的诱因,组织病理改变无致病菌特异性。聚合酶链反应-反向斑点杂交法及宏基因组学检测有助于尽早明确NTM的病原学依据,早期诊断及治疗。     

Nontuberculous mycobacterial cutaneous infections: an updated review

Nontuberculous mycobacteria (NTM) cause cutaneous infections more commonly than Mycobacterium tuberculosis, and the incidence of infection with these organisms is increasing with the use of immunosuppressive agents. Diagnosis of NTM cutaneous infections is not always straightforward. Therefore, a high index of clinical suspicion is needed to make a diagnosis of NTM cutaneous infection.     

Skin and soft tissue infection of Nontuberculous mycobacterium after injection lipolysis

Background

Injection lipolysis is used for body and face contouring due to its minimal invasiveness and cost-effectiveness, but related complications such as nontuberculous mycobacterium infection significantly affect its clinical application.

Aims

This study aimed to review the literature on NTM infection after injection lipolysis.

Methods

We conducted a literature review of scientific journals published in Medline and PubMed up to September 2022 on patients with NTM skin and soft tissue infections. We used the keywords: nontuberculous mycobacterium, infection, injection lipolysis, and lipolytic solution in various combinations with the Boolean operators AND, OR, and NOT. Only articles available in English and full version publications were considered for this review. Here, we reviewed the relevant mechanisms and drugs for injectable lipolysis and analyzed the possible correlation between NTM infection and injection lipolysis. We also summarize methods for the diagnosis and treatment of NTM infections and present some perspectives on this therapy.

Results

Many patients with NTM infections had a history of fat-related surgery or therapy. NTM infection after injection lipolysis may be related to inadequate disinfection and sterilization of injection equipment and clinical procedures, the unqualified medication itself and free fatty acids released during injection lipolysis. Currently, diagnosis and treatment of NTM infection after lipolysis injections remains challenging.

Conclusions

Injection lipolysis represents a helpful option for local fat reduction. Doctors should strictly abide by the aseptic operation standards and use qualified products for there is a correlation between skin and soft tissue infection of nontuberculous mycobacterium and injection lipolysis. Providers should understand the mechanism, indications, and associated risks of injection lipolysis when injecting fat-dissolving drugs to reduce localized fat.     

First UK report of successful treatment of Mycobacterium simiae and immune reconstitution inflammatory syndrome in an HIV-seropositive patient

Non-tuberculous mycobacteria (NTM) such as Mycobacterium avium intracellulare are commonly encountered by HIV physicians and management strategies are well established. Experience of other NTM is, however, limited. As HIV epidemiology in the United Kingdom changes, we may expect the emergence of these lesser known mycobacterial infections. We present the first UK report of an AIDS patient who has survived infection with disseminated Mycobacterium simiae despite cerebrospinal fluid involvement, an extremely high level of baseline HIV viraemia and treatment complicated by severe immune reconstitution inflammatory syndrome.     

皮肤非结核分枝杆菌病治疗进展

皮肤非结核分枝杆菌病是非结核分枝杆菌感染引起的感染性皮肤病，多数非结核分枝杆菌对常用抗结核药天然耐药，临床需根据分离菌株种类及体外药敏试验结果选择抗菌药物，另外，个体免疫状态也会影响治疗效果。近来，新型药物、免疫治疗、疫苗等的研究有了一定进展。本文对常见皮肤非结核分枝杆菌病治疗进展作了概述。     

Cutaneous infections due to nontuberculous mycobacteria: histopathological review of 28 cases. Comparative study between lesions observed in immunosuppressed patients and normal hosts

To evaluate the histopathological features observed in patients with cutaneous infections due to nontuberculous mycobacteria (NTM) and to compare the histopathological patterns observed in immunosuppressed patients and normal hosts. Twenty-eight biopsy specimens corresponding to 27 patients with cutaneous infections due to NTM were reviewed. Eighteen biopsies corresponded to normal hosts (14 Mycobacterium marinum, 2 Mycobacterium chelonae, 1 Mycobacterium terrae and 1 Mycobacterium gordonae) and 10 biopsy specimens were obtained from 9 immunosuppressed patients (3 Mycobacterium chelonae, one of which had two biopsies, 1 Mycobacterium abscessus, 2 Mycobacterium kansasii, 1 Mycobacterium marinum, 1 Mycobacterium avium complex and 1 Mycobacterium simiae). A panel of histopathological features was evaluated by two independent observers in each biopsy specimen. Epidermal changes (acanthosis, pseudoepitheliomatous hyperplasia, exocytosis) were mainly observed in M. marinum infections. In immunosuppressed patients the infiltrate tended to be deeper, involving the subcutaneous tissue (100%) with a more diffuse distribution and constant abscess formation. A marked granulomatous inflammatory reaction was observed in 83% of immunocompetent and in 60% of immunosuppressed patients. In immunosuppressed patients a relationship between the chronic evolution of the disease and granuloma formation was demonstrated. A diffuse infiltrate of histiocytes with occasionally foamy appearance was noted in three biopsy specimens from three patients with AIDS. Acute and chronic panniculitis was detected in 8 biopsy specimens. In one biopsy (M. chelonae) an acute suppurative folliculitis was observed. Different histopathological patterns can be noted in biopsy specimens from cutaneous nontuberculous mycobacterial infections. The evolution of the disease and the immunologic status of the host may explain this spectrum of morphological changes. Tuberculoid, palisading and sarcoid-like granulomas, a diffuse infiltrate of histiocytic foamy cells, acute and chronic panniculitis, non-specific chronic inflammation, cutaneous abscesses, suppurative granulomas and necrotizing folliculitis can be detected. Suppurative granulomas are the most characteristic feature in skin biopsy specimens from cutaneous NTM infections. Some histopathological patterns seem more prevalent in immunosuppressed patients.