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PLoS ONE:研究人员找出易感非结核分枝杆菌的危险因素

来源:生物谷 2014-03-18 20:48

2014年3月18日讯 /生物谷BIOON/--近日,伊利诺伊大学研究人员报告称:与引起那些导致结核病的细菌同属于一个家族的细菌,会引起的严重、有时甚至是致命的肺部疾病,这种细菌感染疾病比以前认为更常见,其中55岁以上白种人风险最大。

这项研究发表在3月14日的PLoS ONE。非结核分枝杆菌(NTM)包括超过150种细菌,主要在水和土壤中发现,吸入时可传染肺部。不像肺结核,NTM不能从人到人传播。NTM感染是可以治疗的,但抗生素治疗是昂贵的,可能需要长达两年。

NTM感染率自1980年代以来已显著攀升。研究人员怀疑,NTM引起的死亡人数均有所上升,但相关危险因素仍然未知。已经有一些研究表明在北美,NTM造成的肺部感染一直呈上升趋势,尤其是年龄在50岁或以上的人更易患NTM造成的肺部感染。

Mehdi Mirsaeidi博士说:我们希望更多地了解究竟谁最有可能感染NTM,哪些人感染后会容易死亡,这样我们就可以制定预防感染策略。研究人员观察了1999年至2010年间美国人死亡的原因。 NTM被列为直接原因,导致2.990人死亡,其中87%的死亡者是55岁以上,85%是白人,52%为女性。此外,研究发现NTM有关的死亡也与吸烟,癌症,HIV感染和慢性阻塞性肺疾病相关。Mirsaeidi说:但老年人和NTM疾病死亡之间的相关性最强。

人们和医生需要注意NTM,因为它早期像很多其他肺部疾病,Mirsaeidi说:通常表现为咳嗽,正确诊断患者可能需要数年。更好的理解NTM相关的风险因素会给我们一个机会更好的诊断它。(生物谷Bioon.com)

 

doi:10.1371/journal.pone.0091879
Nontuberculous Mycobacterial Disease Mortality in the United States, 1999–2010: A Population-Based Comparative Study

Mehdi Mirsaeidi,et al.

Background

Environmental nontuberculous mycobacteria (NTM) are ubiquitous organisms with which humans commonly interact. The epidemiologic characteristics of NTM diseases including mortality rate and its associated factors remain largely unknown. In this study, we explored the geographical area of exposure and mortality and comorbid conditions of affected persons to determine environment, host, and host-pathogen interactive factors.

Methods

We analyzed mortality related to nontuberculous mycobacterial infections from 1999 through 2010 by examining multiple-cause-of-death data from the National Center for Health Statistics. Among those who died with these diseases, we analyzed age-adjusted mortality rates, trends, associations with demographic variables, and comorbid conditions and correlated this information with similar data for tuberculosis-related mortality during the same time.

Measurements and Mean Results

From 1999 through 2010, nontuberculous mycobacterial disease was reported as an immediate cause of death in 2,990 people in the United States with a combined overall mean age-adjusted mortality rate of 0.1 per 100,000 person-years. A significant increase in the number of NTM related deaths was seen from 1999 through 2010 (R2 = 0.72, p<0.0001), but it was not significant after adjustment for age. Persons aged 55 years and older, women, those living in Hawaii and Louisiana, and those of non-Hispanic, white ethnicity had higher mortality rates. Compared to tuberculosis-related mortality, chronic obstructive pulmonary disease, bronchiectasis, HIV, interstitial lung diseases, and tobacco use were significantly more common in persons with nontuberculous mycobacteria-related deaths.

Conclusions

Nontuberculous mycobacteria-related death numbers are rising and are unevenly distributed. The strong association of nontuberculous mycobacterial disease with age suggests that its prevalence will increase as the United States population ages.

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