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Infeção por micobactérias não tuberculosas na fibrose quística
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Resumo(s)
As micobactérias não tuberculosas (MNT) são organismos ubíquos no ambiente que causam infeção pulmonar crónica, principalmente em indivíduos com doenças pulmonares pré-existentes, como é o caso da Fibrose Quística (FQ). As espécies de MNT identificadas mais frequentemente em doentes com FQ são o Mycobacterium avium complex (MAC) e o M. abscessus complex (MABSC), responsáveis por mais de 95% das infeções pulmonares por MNT. O isolamento de MNT em amostras de expetoração de doentes com FQ tem vindo a aumentar e atualmente a doença pulmonar causada por MNT é considerada a ameaça emergente mais importante para os doentes com FQ, uma vez que tem um significativo impacto na morbilidade e mortalidade dos doentes com FQ. No entanto, devido à limitação de informação e de estudos nesta área, o diagnóstico e tratamento da infeção por MNT em doentes com FQ é um desafio recente e de extrema importância clínica.
Tendo em conta estes aspetos e com base nas guidelines e evidência clínica mais recente, ao longo desta revisão serão abordados os vários aspetos relacionados com a infeção por MNT na FQ, tais como epidemiologia e patogénese, fatores de risco, apresentação clínica, vigilância, critérios de diagnóstico e, por fim, o tratamento.
Nontuberculous mycobacteria (NTM) are ubiquitous microorganisms of the environment that cause chronic pulmonary infection, mostly in individuals with pre-existing pulmonary diseases, such as Cystic Fibrosis (CF). The species of NTM that are most often identified in patients with CF are Mycobacterium avium complex (MAC) and M. abscessus complex (MABSC), which are responsible for more than 95% of NTM pulmonary infections. The isolation of NTM from sputum samples of patients with CF has increased. Currently MNT pulmonary disease is considered the most important emergent threat for patients with CF, taking in consideration its significant impact in the morbidity and mortality of patients with CF. Nevertheless, due to the limited amount of information and studies in this area, the diagnosis and treatment of NTM infection in patients with CF it’s a recent challenge of high clinical value. Baring that in mind and taking in consideration the most recent guidelines and clinic evidence, this review will address the several aspects related with the NTM infection in patients with CF, such as epidemiology, pathogenesis, risk factors, clinical presentation, surveillance, diagnostic criteria and, at last, treatment.
Nontuberculous mycobacteria (NTM) are ubiquitous microorganisms of the environment that cause chronic pulmonary infection, mostly in individuals with pre-existing pulmonary diseases, such as Cystic Fibrosis (CF). The species of NTM that are most often identified in patients with CF are Mycobacterium avium complex (MAC) and M. abscessus complex (MABSC), which are responsible for more than 95% of NTM pulmonary infections. The isolation of NTM from sputum samples of patients with CF has increased. Currently MNT pulmonary disease is considered the most important emergent threat for patients with CF, taking in consideration its significant impact in the morbidity and mortality of patients with CF. Nevertheless, due to the limited amount of information and studies in this area, the diagnosis and treatment of NTM infection in patients with CF it’s a recent challenge of high clinical value. Baring that in mind and taking in consideration the most recent guidelines and clinic evidence, this review will address the several aspects related with the NTM infection in patients with CF, such as epidemiology, pathogenesis, risk factors, clinical presentation, surveillance, diagnostic criteria and, at last, treatment.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
Fibrose quística Micobatérias não tuberculosas Infeção pulmonar Pneumologia