非结核分枝杆菌临床分离株的流行病学及临床特征分析

Analyses on epidemiology and clinical feature of clinical isolates of nontuberculous mycobacteria

目的分析台州市非结核分枝杆菌临床分离株的流行病学及临床特征,为非结核分枝杆菌病的疫情监测和诊断治疗提供参考依据。方法回顾统计分析我院于2015年1月~2019年12月间检到的非结核分枝杆菌的分离率、菌种分布、混合感染情况、性别年龄构成和临床特征等。应用DNA微阵列芯片法对分枝杆菌进行菌种鉴定。结果5年间共检到非结核分枝杆菌331株,分离率为19.0%,且逐年增加。检到的主要为胞内分枝杆菌、鸟分枝杆菌和龟/脓肿分枝杆菌,以胞内分枝杆菌最为常见,占57.7%。男性高于女性,50岁以上高发。非结核分枝杆菌感染者常合并有肺结核、支气管扩张、肺部感染和慢性阻塞性肺疾病,临床表现多以咳嗽、咳痰首次就诊。结论台州市非结核分枝杆菌的分离率和患病率逐年增加,以胞内分枝杆菌最为常见,DNA微阵列芯片法可以用于分枝杆菌的快速鉴定。

Objective To analyze the epidemiology and clinical feature of clinical isolates of nontuberculous mycobacteria in Taizhou,and to provide reference for epidemic monitoring,diagnosis and treatment of nontuberculous mycobacterial diseases.Methods The isolation rate,strain distribution,mixed infection,sex and age composition and clinical feature of non-tuberculous mycobacteria admitted to our hospital from January 2015 to December 2019 were analyzed retrospectively.DNA microarray chip method was used to make strain identification on mycobacteria.Results In the past five years,a total of 331 strains of non-tuberculous mycobacteria were detected,with an isolation rate of 19.0%and increasing year by year.Mycobacterium intracellulare,mycobacterium avium and mycobacterium chelonii/abscess were the main detected species,in which mycobacterium intracellulare was the most common,accounting for 57.7%.Incidence rates in men were higher than in women,with a higher incidence rate in people above 50 years old.Tuberculosis,bronchiectasis,pulmonary infection and chronic obstructive pulmonary disease often occur in patients with nontuberculous mycobacteria infection,and cough and expectoration were the first clinical manifestations.Conclusion The isolation rate and prevalence rate of nontuberculous mycobacteria in Taizhou are increasing year by year,of which intracellular mycobacteria are the most common.DNA microarray chip method is used for rapid identification of mycobacteria.