摘要
目的分析非结核分枝杆菌(NTM)鉴定方法和病原谱分布情况,为临床NTM的鉴定和病原谱分布提供依据和参考。方法连续纳入2020年度安徽省胸科医院培养阳性的分枝杆菌培养物进行病原谱分析,采用MPB64抗原和PNB鉴别培养基对培养阳性菌株进行初步鉴定,熔解曲线法进行NTM分子生物学鉴定,并采用微孔板法进行药敏分析。结果2563株分枝杆菌培养阳性菌株,最终有207株鉴定为NTM,NTM的分离率为8.08%其中,117例为男性感染者,62.80%的感染者年龄超过60岁。排名前3位的菌种依次为胞内分枝杆菌(76.67%)、堪萨斯分枝杆菌(6.19%)、脓肿分枝杆菌(5.71%)。不同NTM对利奈唑胺、克拉霉素、莫西沙星和阿米卡星的敏感性较高,对多西环素、米诺环素、亚胺培南、磺胺甲𫫇唑的耐药率较高。结论安徽省胸科医院NTM感染以男性和60岁以上感染者居多,胞内分枝杆菌为主要菌种,不同菌种的耐药率有所差异,应提升实验室检测NTM和耐药性的水平,为临床精准诊治NTM提供依据。
Objective To identify and analyze the pathogen spectrum distribution of nontuberculous mycobacteria(NTM),to provide a basis and reference for clinical NTM identification and pathogen spectrum distribution.Methods The positive cultures of mycobacteria from Anhui Chest Hospital in 2020 were continuously included for identification and analysis.MPB64 antigen and PNB identification medium were used to preliminarily identify the culture-positive strains.The melting curve method was used for molecular biological identification of NTM.The antimicrobial susceptibility analysis of NTM was carried out using the microplate method.Results There were 2563 culture positive strains of mycobacteria,and finally 207 strains were identified as NTM.The separation rate of NTM was 8.08%.Among the patients with NTM infections,117 were male,and 62.80%were over 60 years old.The top three strains were Mycobacterium intracellulare(76.67%),Mycobacterium kansas(6.19%),and Mycobacterium abscesses(5.71%).The NTMs were sensitive to linezolid,clarithromycin,moxifloxacin,and amikacin,and had high resistance rates to doxycycline,minocycline,imipenem,and sulfamethazole.Conclusion The majority of cases with NTM infections are male and over 60 years old.Mycobacterium intracellulare is the main strain of NTM,and the resistance rates of different strains are different.The level of laboratory testing for NTM and drug resistance should be improved to provide a basis for clinical accurate diagnosis and treatment of NTM infections.
作者
包训迪
吴丹丹
江跃
梁锁
王超
王舒
王庆
Bao Xundi;Wu Dandan;Jiang Yue;Liang Suo;Wang Chao;Wang Shu;Wang Qing(Department of Clinical Lab,Chest Hospital of Anhui Province,Hefei 230022,China)
出处
《中华临床医师杂志（电子版）》
CAS
北大核心
2022年第1期38-42,共5页
Chinese Journal of Clinicians(Electronic Edition)
基金
2020年安徽省胸科医院(省结核病防治研究所)科研计划项目(2020kj018B)。
关键词
非结核分枝杆菌
病原谱分析
药物敏感性试验
精准诊治
Non-tuberculous mycobacteria
Pathogen spectrum analysis
Drug sensitivity test
Precise diagnosis and treatment
