脓肿分枝杆菌复合群的研究进展

Research progress of Mycobacterium abscessus complex

脓肿分枝杆菌复合群（Mycobacterium abscessus complex，MABC）是可引起人体致病的重要非结核分枝杆菌（non-tuberculous Mycobacteria，NTM），它由脓肿分枝杆菌、马赛分枝杆菌和Mycobacterium bolletii 3个菌种组成。多靶位基因测序为MABC准确可靠的菌种鉴定方法。克拉霉素是MABC感染所致疾病治疗的基石，近年来，MABC研究较大的进展就是红霉素核糖体甲基化酶（41）[erythromycin ribosome methytransferase，erm（41）]基因的发现，erm（41）与克拉霉素诱导耐药相关。脓肿分枝杆菌和M．bolletii均携带完整的erm（41）基因，而马赛分枝杆菌erm（41）基因有2个片段缺失。脓肿分枝杆菌28位碱基具有多态性，T28序列型可诱导耐药，C28序列型不诱导耐药。为检测脓肿分枝杆菌是否对克拉霉素诱导耐药，建议培养时间由3d延长至14d。另外，已有证据表明MABC可能在人与人之间传染，有必要研究MABC的基因分型技术。

Mycobacterium abscessus complex （MABC）, an important non-tuberculous mycobacteria （NTM） that can cause human diseases, eonsistes of Mycobacterium abscessus, Mycobacterium rnassiliense and Mycobacterium bolletii. Multi target gene sequencing is deemed to be the most accurate and reliable method for species identification of MAtK2. Clarithromycin plays a role of cornerstone in the treatment of MABC diseases. Recently, one of the greatest progress of the discovery of erythromycin ribosome methylase （ erm （ 41 ）） which is associated with inducing resistance to clarithromycin. M. abscessus and M. bolletii both have an intact erm （41） gene while M. massiliense has two deletions in erm （41） gene. M. abscessus strains have a T/C polymorphism at the 28th nucleotide： T28 strains demonstrates inducible clarithromycin resistance, while C28 strains are susceptible. For the purpose of detecting induced resistance to elarithromycin of Mycobacterium abscessus, it＇s advised to prolong the incubation from 3 days to 14 days. In addition, recent evidences had raised the possibility that person-to-person transmission could occur among highly susceptible individuals, so it is necessary to study the genotyping of MABC.