...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of Clinical Medicine Research >MAC Attack: Clinical Correlates of Mycobacterium avium Complex Infection Among Patients With and Without Cancer
【24h】

MAC Attack: Clinical Correlates of Mycobacterium avium Complex Infection Among Patients With and Without Cancer

机译：MAC攻击：无癌症患者厌备复杂性感染的临床关联

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background:In 2007 the American Thoracic Society (ATS) released guidelines on management of Mycobacterium avium complex (MAC), an increasingly common respiratory organism worldwide. Determining when this represents a true respiratory pathogen remains controversial and becomes increasingly challenging in patients with cancer. This study aims to 1) describe the phenotype that exists among cancer patients with MAC colonization and MAC pulmonary infection when compared to non-cancer patients; 2) assess whether cancer, symptoms, and radiographs, were associated with the decision to treat MAC pulmonary infection with antibiotics.Methods:We retrospectively analyzed 550 adult, non-human immunodeficiency virus (HIV) patients, among whom MAC was identified in respiratory cultures or tissue. Radiographs, clinical symptoms and cancer status were studied. Patients were categorized as having MAC pulmonary infection based on 2007 ATS guidelines, and antibiotic treatment was thereafter reviewed. Fisher's exact test and Wilcoxon Rank sum assessed differences.Results:Median age of the 550 patients was 68 years; most were female (56%) and white (83%). Symptoms and radiographic abnormalities accompanying MAC isolation were common, occurring among 83% and 99.6% respectively of all patients. There were 444 patients with MAC who had current or inactive cancers, most commonly hematologic (30%) and lung (25%) malignancies, while 106 patients never had cancer. Cancer patients were younger (P = 0.028), less often female (P 0.001), and had less-frequent pre-existing lung disease (P = 0.017) than those without cancer. There were 196 (35%) patients determined to have MAC pulmonary infection, among whom 49 (9%) received directed antibiotics. Those receiving antibiotics had lower body mass index (BMI) (P 0.0001), more frequent pre-existing lung disease (P = 0.003) and lower cancer rates (P = 0.008) than those not receiving antibiotics. Patients receiving antibiotics were more likely to have cavitary disease (P = 0.001), cough/dyspnea (P = 0.012), hemoptysis (P 0.001), and constitutional symptoms (P = 0.001).Conclusions:In concordance with ATS guidelines, hemoptysis, constitutional symptoms, cough/dyspnea and cavitary disease were associated with highest likelihood to treat with antibiotics. The phenotype in cancer patients was quite different than the classic Lady Windermere syndrome. MAC pulmonary infection was treated less often in cancer patients. This study extends beyond the ATS guidelines to examine the potential import of malignancy on the colonization and potential treatment of MAC.Copyright 2020, Gupta et al.
机译：背景：2007年美国胸部社会（ATS）发布了关于途中厌备（MAC）的管理，越来越常见的呼吸道的指导。确定何时代表真正的呼吸道病原体仍然存在争议，并且在癌症患者中越来越具有挑战性。本研究旨在1）描述与非癌症患者相比MAC殖民化和MAC肺部感染的癌症患者存在的表型; 2）评估是否癌症，症状和射线照相与治疗MAC肺部感染与抗生素的决定有关。方法：我们回顾性地分析了550名成人，非人类免疫缺陷病毒（HIV）患者，其中在呼吸培养中鉴定了MAC或组织。研究了X型射线照片，临床症状和癌症状况。患者被分类为在2007年基于2007年进行MAC肺部感染，然后审查抗生素治疗。 Fisher的确切测试和Wilcoxon等级评估差异。结果：550名患者的中位年龄为68岁;大多数是女性（56％）和白色（83％）。伴随MAC分离的症状和射线照相异常是常见的，分别发生在所有患者的83％和99.6％之间。有444名患有MAC的患者，具有当前或非活性癌症，最常见的血液学（30％）和肺（25％）恶性肿瘤，而106名患者从未有癌症。癌症患者较年轻（P = 0.028），较少雌性（P <0.001），并且具有较少频繁的预先存在的肺病（P = 0.017），而不是没有癌症的肺病。有196名（35％）患者确定具有MAC肺部感染，其中49（9％）接受指向抗生素。接受抗生素的那些人具有较低的体重指数（BMI）（P <0.0001），更频繁的预先存在的肺病（P = 0.003）和低癌症率（P = 0.008），而不是未接受抗生素。接受抗生素的患者更有可能具有腔疾病（p = 0.001），咳嗽/呼吸困难（p = 0.012），咯血（p <0.001）和致残症状（p = 0.001）。结论：与ATS指南，咯血的一致性，宪法症状，咳​​嗽/呼吸困难和空腔疾病与抗生素治疗的最高可能性有关。癌症患者的表型比经典的Windermere综合征不同。 MAC肺部感染常常在癌症患者中均匀地治疗。本研究超出了ATS指导方针，以检查对Mac.Copyright 2020的殖民化和潜在治疗的恶性肿瘤潜在的进口。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号