基于熔解曲线法对肺部感染分枝杆菌菌种的研究

Study of Mycobacterium species analysis in patients with pulmonary infection based on melting curve method

目的分析荧光PCR熔解曲线法检测分枝杆菌的结果,了解肺部感染分枝杆菌的菌种分布情况及肺部感染非结核分枝杆菌的易感因素。方法选取肺部感染患者的合格痰进行分枝杆菌培养,将培养阳性的菌株应用荧光PCR熔解曲线技术进行菌种鉴定,分析分枝杆菌的分布特点及NTM的易感因素。结果330份临床分离株中鉴定出7种分枝杆菌,分别为结核分枝杆菌85.9%,胞内分枝杆菌4.1%,龟分枝杆菌脓肿亚种4.4%,鸟分枝杆菌1.5%,猿猴分枝杆菌1.2%,偶然分枝杆菌0.6%,戈登分枝杆菌0.6%,有1.8%的菌株无法确定菌种。排出肺结核的混合感染者,35例NTM感染者中26例有合并症。结论采用荧光PCR熔解曲线技术对肺部感染分枝杆菌的临床分离株进行菌种鉴定,为临床快速诊断分枝杆菌病提供实验依据,有利于肺部感染分枝杆菌患者的精准治疗。

Objective To analyze the results of Mycobacterium detected by fluorescence PCR melting curve,understand the distribution of mycobacterium species in pulmonary infection,and explore the susceptible factors of pulmonary infection caused by nontuberculous mycobacterium(NTM).Methods All qualified sputum samples collected from patients with pulmonary infection were selected for Mycobacterium culture.The positive strains were identified by fluorescence PCR melting curve technology.The distribution characteristics of mycobacteria and the susceptible factors of NTM were further analyzed.Results Seven kinds of mycobacteria were identified from the 330 clinical isolates,which were Mycobacterium tuberculosis(85.9%),Mycobacterium intracellular(4.1%),Mycobacterium cheloni abscess subspecies(4.4%),Mycobacterium avium(1.5%),Mycobacterium similaris(1.2%),Mycobacterium fortuitous(0.6%),Mycobacterium Gordon(0.6%).1.8%of species could not be identified.Excluding those with tuberculosis and NTM infection,26 of 35 NTM patients had complications.Conclusion The fluorescence PCR fusion curve technology can be used to rapidly identify the bacteria strain of Mycobacterium pulmonary infection,which provides experimental basis for rapid clinical diagnosis of mycobacterial disease and is conducive to the accurate treatment of pulmonary infection.