2O13—2015年广州市旧城区各类分枝杆菌流行情况

Prevalence of mycobacterium species in the inner cities of Guangzhou between 2013 and 2015

目的了解2013-2015年广州市旧城区分枝杆菌的流行情况。方法选取广州市胸科医院2013年1月至2015年12月门诊和住院患者作为研究对象，共10743例。研究对象均由结核病实验室收集了痰液、尿液、胸腹腔积液、脑脊液和穿刺液等标本，并经分枝杆菌培养为阳性。采用结核菌群特异性分泌蛋白MPB64免疫胶体金法进行菌群鉴定，对MPB64检测阴性或阳性但怀疑非结核分枝杆菌（non-tuberculosis mycobacteria，NTM）混合生长者，使用基因芯片法进行菌种鉴定，对芯片法无法鉴定者进行基因测序。结果10743例研究对象中，有201例鉴定为无分枝杆菌，涂片结果为杂菌生长。共鉴定出8012株MTB（76．00％），2530株NTM（24．00％）。NTM种群分布达17种，最常见的是龟一脓肿复合群分枝杆菌、胞内分枝杆菌、鸟分枝杆菌，分别占10．64％（1122／10542）、6．24％（658／lO542）、3．00％（316／10542）。NTM阳性患者中，男性占49．48％（1133／2290），女性占50．52％（1157／2290），男性、女性感染比例最高的年龄段均为55-64岁，分别占26．30％（298／1133）和25．32％（293／1157）。结论2013-2015年广州市旧城区分枝杆菌感染者中MTB为主要致病菌。NTM感染菌群种类较多，中老年人感染比例较高。

Objective To investigate the prevalence of mycobacterium species in the inner cities of Guangzhou between 2013 and 2015. Methods A total of 10 743 cases, including outpatient and hospitalized patients, from Guangzhou Chest Hospital between January 2013 and December 2015 were selected. All of the subjects were culture positive specimens from sputum, urine, abdominal effusion, cerebrospinal fluid and puncture fluid. TB-specific se- cretory protein MPB64 immune colloidal gold method was used to identify strains, while specimens with MPB64 tested negative or MPB64 tested positive but were suspected of no-tuberculous mycobacteria （NTM） mixed growth were identified by gene chip method. Strains which could not be determined by gene chip were then sequenced. Results Of the 10 743 cases, 201 were with no-mycobacterial but mixed bacterium, 8012 （76.00%） were with mycobacterium tuberculosis （MTB）, 2530 （24.00%） were with NTM. NTM included 17 bacteria population, the turtle-abscess complex group mycobacteria, M. intracellulare, M. aviurn were the top three, accounted for 10. 64% （1122/10 542）, 6. 24% （658/10 542）, and 3.00% （316/10 542）, respectively. Among the NTM positive patients, 49.48% （1133/2290） were male and 50. 52% （1157/2290） were female, with the highest proportion of 55 to 64 years old, which accounted for 26.30% （298/1133） and 25.32% （293/1157）. Conclusion MTB was the main pathogen in the inner cities of Guangzhou between 2013 and 2015. NTM is various, and the infection percent- age is higher in the elder.