两株形态不同脓肿分枝杆菌的鉴定与分析

Identification and analysis of two Mycobacterium abscess with different morphology

分析比较临床1例重症肺炎患者痰标本培养出的平滑型脓肿分枝杆菌(Mab^(S))和粗糙型脓肿分枝杆菌(Mab^(R)),并进行药敏试验研究,为临床诊断治疗提供科学依据。对Mab^(S)和MabR进行菌体形态观察、基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)和16S rRNA基因序列测序比对,构建系统发育进化树进行同源性分析,并采用比例法和肉汤法进行体外药敏试验。Mab^(S)和Mab^(R)菌落形态不同,MALDI-TOF MS分析MabR有223个蛋白峰,Mab^(S)有147个蛋白峰。16s RNA基因测序MabS为1 397 bp,Mab^(R)为1 402 bp,药敏试验显示二者对抗结核药几乎耐药,对绝大部分抗菌药物敏感。Mab^(S)和Mab^(R)对抗结核治疗药物普遍耐药,而对抗菌药物几乎敏感,联合使用抗菌药物治疗有较好的疗效,可供临床参考。

Two types of Mycobacterium abscesses(Mab)were found in sputum from a patient with severe pneumonia in May 2020.One was Mycobacteriumabscessus with smooth morphology(Mab^(S)),the other was Mycobacteriumabscessus with rough morphology(Mab^(R)).Both of them were compared and drug susceptibility testing were performed to provide clinical scientific diagnosis and treatment.Morphology,matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF MS)and 16S rRNA were used to analyze MabS and MabR,phylogenetic evolution tree was constructed by gene sequence alignment for homology,proportion and broth drug test were used for in vitro drug sensitivity test.There were morphological differences between Mab^(S) and MabR.MALDI-TOF MS analysis showed that there were 223 protein peaks in MabR and 147 protein peaks in Mab^(S).Mab^(S) contained 1397 bp and Mab^(R) contained 1402 bp as 16s rRNA gene sequencing revealed.Drug susceptibility testing showed that both of them were almost resistant to all antituberculosis drugs,but sensitive to most of antibiotics.MabS and Mab^(R) were not only different in manifestations,but also in protein and gene comparison.Both of them were generally resistant to antituberculosis drugs.Antibiotic combined therapy has been confirmed to be an effective treatment in clinic.