非結核分枝桿菌與醫療照護相關感染

Non-tuberculosis Mycobacterium and Healthcare-associated Infection

非結核分枝桿菌（Non-tuberculosis mycobacterium；NTM）存在於環境中，在土壤、塵埃、動物及食物身上皆可發現，也可聚生於輸水管線內。除肺部疾病外，NTM也可能於人類身上造成以下疾病，表淺部淋巴腺炎、瀰漫性疾病及皮膚及軟組織感染。由於實驗室診斷技術、分枝桿菌培養及鑑定能力進步，愈來愈多NTM被鑑定分離出。但因為NTM在實驗室抗酸菌抹片及培養皆呈陽性反應，常造成臨床相當大困擾，因此快速及準確鑑定TB及NTM技術亦愈受重視。感染控制團隊需建立適當監視系統，實驗室技術配合，快速找出感染源及有效感染控制方法設立等才能有效預防NTM造成之醫療照護相關感染。

Non-tuberculosis mycobacterium is found in the soil, dust, animals, food, etc., and it colonizes the walls of pipes as well. In addition to pulmonary diseases, non-tuberculosis mycobacterium causes diseases such as superficial lymphadenitis, disseminated disease, and skin and soft tissue diseases. Advancements in the techniques of laboratory diagnosis and culture have led to the identification of a large number of non-tuberculosis mycobacteria. In addition, acid-fast staining and culture of non-tuberculosis mycobacterium also yield positive results, which may create a major problem in clinical diagnosis. Therefore, an efficient and rapid diagnosis that differentiates tuberculosis mycobacterium from non-tuberculosis mycobacterium is essential. The infection control personnel must establish an efficient surveillance system and cooperate with laboratory diagnosis. Immediate identification of the infectious source and establishment of effective methods for infection control can effectively prevent healthcare-associated infection due to non-tuberculosis mycobacteria.