沿海地区11例手部分枝杆菌感染分析

Analysis on 11 non-tuberculous mycobacterium infection of hand in littoral area

目的探讨沿海地区手部非结核分枝杆菌感染的体外培养技术和要领,为临床确诊,治疗提供直接证据。方法对2001年6月—2004年9月收治的28例可疑手部分枝杆菌感染作组织块匀浆后的涂片抗酸染色,分枝杆菌培养,分枝杆菌生化分型,分枝杆菌的核酸测序分型。结果分枝杆菌培养阳性11例,具体为海分枝杆菌占8例,偶发1例,鸟1例,结核1例,其中直接抗酸染色检查阳性2例。结论手部慢性可疑分枝杆菌感染患者应同时做抗酸染色及分枝杆菌培养。非结核分枝杆菌感染尤其是海分枝杆菌远比结核分枝杆菌常见,是沿海地区手部非典型感染的主要致病因素。在分枝杆菌培养时必须同时在30℃、35℃两种温度下进行培养。

Objective To explore the in-vivo culturing technique of myeobacteria from special hand infections in laboratory, and to provide the direct evidence for clinical diagnosis. Method To review Acid - Fast Stain, mycobacterial culture, identification by chemistry and gene sequesing of 28 cases of hand special chronic infections. Results Only 2 cases were positive in Acid-Fast Stain, 10 cases showed positive by mycobacterial culture, and 8 M. mariaura, 1 M.fortuitum, 1 M. avium. Conclusion Mycabacterium were the major factor of hand special chronic infections, and of all non-tuberculous mycobacterium（NTM）, M. marinum was the most important one which should be paid more attention when culturing. It is necessarily to culture them at both 35 ℃ and 30 ℃.