浙江省非结核分枝杆菌病原谱的分析

Analysis of pathogen spectrum of nontuberculosis Mycobacteria in Zhejiang province

目的了解浙江省非结核分枝杆菌病原谱,掌握浙江省优势流行的非结核分枝杆菌,为其有效防治提供参考依据。方法 2011年-2014年,收集全省11个地市经PNB/TCH判定为疑似非结核分枝杆菌的临床分离株442株,采用hsp65基因测序法作进一步菌种鉴定。结果 442株可疑非结核分枝杆菌中共分离出3类菌群,分别是结核分枝杆菌复合群(67株)、非结核分枝杆菌(372株)和诺卡菌(3株)。其中在372株非结核分枝杆菌菌种鉴定中共分离出19种非结核分枝杆菌,前6位分别是胞内分枝杆菌、龟-脓肿分枝杆菌、鸟分枝杆菌、堪萨斯分枝杆菌、戈登分枝杆菌、马赛分枝杆菌,分别占非结核分枝杆菌总数的52.15%、14.52%、10.22%、9.68%、5.38%、2.69%。结论浙江省优势非结核分枝杆菌群以胞内分枝杆菌、龟-脓肿分枝杆菌、鸟分枝杆菌为主,应用分子生物学可快速准确地鉴定非结核分枝杆菌菌种,为临床诊治提供依据。

Objective To understand pathogen spectrum of nontuberculosis Mycobacteria and the dominant nontuberculosis Mycobacteria in Zhejiang province and provide reference basis for effective prevention and control. Methods 442 clinical isolates of nontuberculosis Mycobacteria which were preliminary identified by PNB / TCH were collected and then further species identification were done with hsp65 gene sequencing method. Results 442 strains of suspected nontuberculosis Mycobacteria were isolated from three kinds of bacteria. They were Mycobacterium tuberculosis（ 67 strains）,nontuberculosis Mycobacteria（ 372strains） and Nocardia（ 3 strains）. 19 kinds of nontuberculosis Mycobacteria were isolated from the 372 strains of nontuberculosis Mycobacteria strains,and the first six were M. intracellulare（ 52. 15%）,M. chrlonae- abscess（ 14. 52%）,M. avium（ 10. 22%）,M. Kansasii（ 9. 68%）,M. Gordonae（ 5. 38%）,M. marseille（ 2. 69%）. Conclusion The dominant nontuberculosis Mycobacteria in Zhejiang province were mainly M. intracellulare,M. chrlonae- abscess and M. Avium. The application of molecular biology can rapidly and accurately identify the species of nontuberculosis Mycobacteria,and can provide relevant evidence for clinical diagnosis and therapy.