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

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。

Abstract: 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.