贵阳市2018-2021年83株临床分离非结核分枝杆菌的菌种分布及流行情况

Distribution and prevalence of 83 clinical Nontuberculous mycobacteria isolates in Guiyang city from 2018 to 2021

目的了解贵阳市临床分离的非结核分枝杆菌(NTM)菌种分布及流行情况。方法收集2018-2021年鉴定为NTM感染的菌株83株,经罗氏培养基分离培养后采用16S rRNA基因测序方法进行菌种鉴定;应用Excel 2016与SPSS 26.0软件对数据进行整理分析,利用非参数检验与卡方检验对NTM菌种来源、菌种分布、感染患者性别及年龄等特征进行分析。结果83株菌株样本来源主要以痰液为主,感染疾病前3的分别为结核感染(38.55%)、肺部感染(30.12%)及肺部阴影(6.02%);分离培养及16SrRNA测序鉴定出17种NTM,主要以脓肿分枝杆菌(44.58%)为主、其次为鸟分枝杆菌(8.43%);发现三重分枝杆菌、外来分枝杆菌、败素分枝杆菌等6株不同于贵州省以往报道过的NTM。感染NTM患者男女比例为1.5∶1,感染高峰年龄段为45~<60岁,不同年龄NTM感染患者菌种分布差异有统计学意义(χ^(2)=133.926,P<0.05);女性患者脓肿分枝杆菌的感染率大于男性,差异有统计学意义(χ^(2)=8.053,P<0.05)。结论2018-2021年贵阳市NTM感染主要为中老年人群、男性居多;NTM感染菌株以脓肿分枝杆菌为主,女性感染率高于男性,发现6株不同于之前报道的新NTM菌株。

Objective To understand the distribution and prevalence of clinical Nontuberculous mycobacteria(NTM)isolates in Guiyang city.Methods A total of 83 NTM strains identified between 2018 and 2021 were collected.The strains were isolated and cultured using L wenstein-Jensen medium,and then identified by 16S rRNA gene sequencing.Data were organized and analyzed using Excel 2016 and SPSS 26.0 software.Nonparametric tests and chi-square tests were used to analyze the sources,distribution,gender,and age characteristics of NTM strains.Results The analysis showed that sputum was the main sample source.The top three diseases associated with NTM infections were tuberculosis(38.55%),pulmonary infections(30.12%),and pulmonary shadows(6.02%).Seventeen NTM species were identified through isolation,culture,and 16S rRNA sequencing,with Mycobacterium abscessus(44.58%)being the most common,followed by Mycobacterium avium(8.43%).Six NTM species,including Mycobacterium triplex,Mycobacterium xenopi,and Mycobacterium haemophilum,were identified that differed from previous reports in Guizhou province.The male-to-female ratio of NTM-infected patients was 1.5∶1,with a peak age range of 45-60 years.The distribution of NTM species among patients of different ages showed statistically significant differences(χ^(2)=133.926,P<0.05).The infection rate of M.abscessus was higher in females than in males,with a statistically significant difference(χ^(2)=8.053,P<0.05).Conclusion From 2018 to 2021,NTM infection in Guiyang was mainly elderly and male;NTM infection strains were mainly M.abscessus,and female infection rate was higher than male,and 6 new NTM strains different from previous gut were found.