摘要
目的了解河南省结核病患者中非结核分枝杆菌(NTM)分布情况及其耐药性,为其临床诊治提供支持。方法采用传统PNB/TCH生长试验对分枝杆菌培养阳性标本初步鉴定。用探针熔解曲线法和PCR产物测序鉴定NTM菌种,采用比例法检测分离菌株的抗结核药物敏感性。结果从PNB/TCH生长试验结果阳性的404株菌株中,鉴定出NTM菌株363株,其中357株为单一感染,6株为混合感染。363株菌株中,胞内分枝杆菌273株(74.93%),堪萨斯分枝杆菌34株(9.37%),脓肿分枝杆菌21株(5.79%),鸟分枝杆菌11株(3.03%),其他25株(6.89%)。其中南阳、洛阳、平顶山、濮阳、开封、许昌、郑州、周口和驻马店等地市胞内分枝杆菌比例都高于50%;安阳、鹤壁和商丘等地市堪萨斯分枝杆菌比例较高。河南省NTM总分离率为3.93%。18个地市中鹤壁市NTM分离率最高为11.20%,其次为南阳10.23%;分离率最低的为周口1.11%,其次为商丘1.21%,差异有统计学意义(χ2=135.604,P<0.001)。结论河南省NTM分离以胞内分枝杆菌、堪萨斯分枝杆菌、脓肿分枝杆菌和鸟分枝杆菌为主。河南省NTM分离率较低,但各地市间分离率差异较大。NTM分离菌株对常用抗结核药物普遍耐药。
This study was aimed at investigating the distribution and drug resistance of nontuberculous mycobacteria(NTM)in patients with tuberculosis in Henan Province,to provide guidance for clinical diagnosis and treatment.Mycobacterial culture positive samples were preliminarily identified with traditional PNB/TCH growth tests.NTM strains were identified with the melting curve method and PCR sequencing.The susceptibility of the isolates to anti-tuberculous drugs was detected with a proportional method.Among 404 strains with positive PNB/TCH growth test results,363 strains of NTM strains were identified,of which 357 strains were single infections,and six strains were mixed infections.Among the 363 samples,273 strains(74.93%)were M.intracellulare,34 strains(9.37%)were M.kansasii,21 strains(5.79%)were M.abscessus,11 strains(3.03%)were M.avium,and the other 25 strains(6.89%).The proportion of M.intracellulare in Nanyang,Luoyang,Pingdingshan,Puyang,Kaifeng,Xuchang,Zhengzhou,Zhoukou and Zhumadian exceeded 50%.The proportion of M.kansasii in Anyang,Hebi and Shangqiu was high.The total separation rate of NTM in Henan Province was 3.93%.Among the 18 prefectures,the highest separation rate of NTM was 11.20%in Hebi,followed by 10.23%in Nanyang;the lowest separation rate was 1.11%in Zhoukou,followed by 1.21%in Shangqiu.The difference was statistically significant(χ~2=135.604,P<0.001).M.intracellulare,M.kansasii,M.abscessus and M.avium were the main isolates of NTM in Henan Province.The separation rate of NTM in Henan Province was low,but substantial differences were observed among prefectures.NTM isolates were generally resistant to common anti-tuberculosis drugs.
作者
王少华
常文静
苏茹月
马晓光
郑丹薇
朱岩昆
石洁
孙国清
孙定勇
WANG Shao-hua;CHANG Wen-jing;SU Ru-yue;MA Xiao-guang;ZHENG Dan-wei;ZHU Yan-kun;SHI Jie;SUN Guo-qing;SUN Ding-yong(Henan Provincial Center for Disease Control and Prevention,Zhengzhou 450016,China)
出处
《中国人兽共患病学报》
CAS
CSCD
北大核心
2023年第2期124-130,共7页
Chinese Journal of Zoonoses
基金
河南省科技攻关项目(No.192102310136)
河南省医学科技攻关项目(No.SBGJ202002013)。
关键词
分枝杆菌
非结核分枝杆菌
菌种鉴定
耐药
Mycobacteria
nontuberculous mycobacteria
strain identification
drug resistance
