BACTEC MGIT960培养管内浑浊生长抗酸杆菌的分析

Analysis of acid fast bacilli with turbidity growth in the BACTEC MGIT 960 culture tubes

收集2012年11月至2015年12月西安市胸科医院分枝杆菌培养阳性标本中，在BACTECMGIT960培养管内浑浊生长且萋一尼抗酸染色阳性的标本58份（来自58例患者）。通过萋一尼染色、对硝基苯甲酸（PNB）鉴别培养、MPB64蛋白免疫胶体金法检测、结核分枝杆菌（MTB）及非结核分枝杆菌（NTM）特异性基因片段PCR-荧光探针法检测、DNA微阵列芯片法菌种鉴定及耐药基因检测等方法对这58例标本进行菌种鉴定，并回顾58例患者的相关标本的MTB及NTM特异性基因片段PCR荧光探针法的检测结果。结果发现，58份标本浑浊生长抗酸杆菌呈分散逗点、杆状生长；其中56份标本有NTM单独生长，1份为MTB单独生长，1份为NTM和MTB混合生长。58例患者中有5例存在NTM与MTB混合感染，且MTB的利福平和异烟肼耐药基因均为野生型。由此可初步判定浑浊生长的培养管需排除管内NTM生长后，才能判断MTB单独感染。

Specimens with mycobacterium positive from Xi＇ an Chest Hospital between November 2012 and December 2015 were collected, and of them, 58 specimens from 58 patients were with turbidity growth in culture tubes and were found positive using acid-fast staining. The 58 specimens were dealt with acid fast staining, PNB differential culture, immune colloidal of MPB64 protein, non-tuberculosis mycobacteria （NTM） specific real time fluorescence quantitative PCR, DNA microarray and drug resistance gene to identify the component o{ the bacteria. Results of Mycobacterium tuberculosis （MTB） and NTM specific real-time fluorescence quantitative PCR were reviewed and it was found that all the 58 specimens with turbidity growth growing in types of comma and pod; 56 of them separately grew with NTM, one with MTB separately and one with MTB and NTM mixed. Five cases were infected by both MTB and NTM, and resistance genes of RFP and INH were both wild type. Hence, separate infection of MTB could be confirmed only after ruling out the growth of NTM.