摘要
结核分枝杆菌及非结核分枝杆菌(NTM)同属分枝杆菌属,致病机制及临床表现类似,传统病原微生物技术因检测周期长、敏感度低、阳性率低等局限性常难以对菌种进行精准鉴别,导致临床误诊、漏诊及治疗延误。近年来,基于二代测序的宏基因组测序(mNGS)以其高通量、覆盖度广、速度快、灵敏度高、不依赖传统分离培养、无需特异性引物等优点在病原微生物鉴定中展现了独特的优势,同时也成为一种鉴定结核分枝杆菌复合群及NTM的重要补充手段。本文报道宜昌市中心人民医院借助mNGS确诊的1例结核分枝杆菌及NTM混合感染引起的肺结核患者及1例NTM感染引起的NTM肺病患者的诊疗经过,并进行相关文献复习,以提高临床对这两种疾病的认识及鉴别诊断水平,同时提升临床工作者对mNGS在复杂感染性疾病病原微生物鉴定中应用的认识。
Both Mycobacterium tuberculosis and non-tuberculosis Mycobacterium(NTM)belong to Mycobacterium,pathogenic mechanism and clinical manifestations are similar.Due to the limitations of traditional pathogenic microorganism technology,such as long detection cycle,low sensitivity and low positive rate,it is often difficult to accurately identify bacteria,resulting in clinical misdiagnosis,missed diagnosis and treatment delay.In recent years,metagenomic nextgeneration sequencing(mNGS)has shown unique advantages in pathogenic microorganisms identification because of its high throughput,wide coverage,fast speed,high sensitivity,independent of traditional isolation and culture,and no need of specific primers.It has also become an important supplementary means to identify Mycobacterium tuberculosis complex and NTM.This paper reported the diagnosis and treatment process of one case of pulmonary tuberculosis caused by mixed infection of Mycobacterium tuberculosis and NTM and one case of NTM lung disease caused by NTM infection confirmed by mNGS in Yichang Central People's Hospital,and reviewed the relevant literature,in order to improve the clinical understanding and the level of differential diagnosis of the two diseases,and to enhance the clinical workers'understanding of the application of mNGS in the identification of pathogenic microorganisms of complex infectious diseases.
作者
马潇枭
高宝安
牟干
刘玲
MA Xiaoxiao;GAO Baoan;MOU Gan;LIU Ling(The First College of Clinical Medical Science,China Three Gorges University/Department of Pulmonary and Critical Care Medicine,Yichang Central People's Hospital,Yichang 443003,China)
出处
《实用心脑肺血管病杂志》
2021年第1期122-127,共6页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
结核
肺
结核分枝杆菌
非结核分枝杆菌
宏基因组
病例报告
Tuberculosis,pulmonary
Tuberculosis Mycobacterium
Non-tuberculosis Mycobacterium
Metagenome
Case reports
