Aayushi J Rajani, Dawn Roach, Darshankumar Raval, Juhi Amin, Prakash Kempaiah, Rohit Chitale, Ravindra Durvasula, Justin Oring
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引用次数: 0
摘要
背景:奈布拉斯康分枝杆菌是一种罕见、生长缓慢的非结核分枝杆菌,记录在案的病例有限。本系统综述旨在通过分析现有文献,包括我们在本文中介绍的一例新报告病例,全面分析奈布拉斯肯分枝杆菌感染的临床特征、表现和处理方法:方法:使用 PubMed 和 Google Scholar 进行了全面搜索,以确定截至 2023 年 10 月的相关病例。结果:我们的分析揭示了几个主要发现:我们的分析揭示了几个重要发现。首先,我们观察到了性别差异,女性更容易感染奈布拉斯肯菌。此外,相当一部分患者表现为无症状感染。大多数患者的年龄在60岁以上,这说明潜在的易感性与年龄有关。不同病例的合并症情况差异很大,原有肺部合并症的患者感染风险更高。治疗还是观察取决于临床表现,即使是免疫抑制患者也不一定需要治疗。关于治疗,考虑到多西环素和米诺环素的耐药性报道,我们建议使用阿米卡星、克拉霉素或利福布汀等经验性药物。为了尽量减少耐药性的产生,我们通常采用联合疗法,这与分枝杆菌感染的治疗方法是一致的:本研究强调了进一步研究的必要性,以验证这些发现并加深我们对尼泊金霉菌感染的了解。由于现有数据有限,本综述旨在为了解这种罕见的新兴病原体提供有价值的见解,以指导临床实践和未来的研究工作。
A systemic review of Mycobacterium nebraskense case reports up to october 2023, featuring our unique case study.
Background: Mycobacterium nebraskense is a rare, slow growing nontuberculous mycobacterium species with limited documented cases. This systematic review aims to comprehensively analyze the clinical characteristics, presentation, and management of M. nebraskense infections by analyzing the available literature, including a newly reported case that we present in this article.
Methods: A comprehensive search was conducted using PubMed and Google Scholar to identify relevant cases up to October 2023. Only seven reported cases were found, highlighting the scarcity of information on this pathogen.
Results: Our analysis revealed several key findings. First, gender disparities were observed, with females being more susceptible to M. nebraskense infections. Additionally, a significant portion of patients presented with asymptomatic infections. Most affected individuals were over the age of 60, emphasizing potential age-related susceptibility. Comorbidity profiles varied widely among cases, and patients with preexisting lung comorbidities were at an increased risk of infection. The decision to treat or observe depended on clinical presentation, with even immunosuppressed individuals not always requiring treatment. Regarding treatment, we proposed an empirical approach with amikacin, clarithromycin, or rifabutin, considering the reported resistance to doxycycline and minocycline. Combination therapy was commonly employed to minimize resistance development, consistent with mycobacterial infection management.
Conclusion: This study underscores the need for further research to validate these findings and enhance our understanding of M. nebraskense infections. As limited data are available, this review aims to provide valuable insights into a rare and emerging pathogen to guide clinical practice and future research endeavors.