Comparison of Susceptibilities of M. tuberculosis H37Ra and M. chelonei subsp. Abscessus to Disinfectants

Objective To determine the susceptibilities of M. tuberculosis H37Ra and M. chelonei subsp. absecessus to several frequently-used disinfectants and to evaluate the practicability of surrogating M. tuberculosis by the latter. Methods A suspension quantitative bactericidal test was set up in accordance with Chinese Technique Standard for Disinfection to evaluate the susceptibility of each mycobacteria strain to each selected disinfectant. Killing log value was used as criterion in comparing the susceptibility to disinfectants between the two strains. Results M. chelonei subsp. abscessus was more resistant to chlorine disinfectant than M. tuberculosis while the two strains were similarly resistant to iodophor disinfectant, peracetic acid, alcohol and glutaraldehyde disinfectant. Conclusion M. chelonei subsp. abscessus has the potential to surrogate M. tuberculosis in evaluating mycobactericidal efficacies of disinfectants.

Novel Species Including Mycobacterium fukienense sp. Is Found from Tuberculosis Patients in Fujian Province, China, Using Phylogenetic Analysis of Mycobacterium chelonae/abscessus Complex

Objective To identify the novel species ‘Mycobacterium fukienense＇ sp. nov of Mycobacterium chelonoe/abscessus complex from tuberculosis patients in Fujian Province, China. Methods Five of 27 clinical Mycobucterium isolates （CIs） were previously identified as M. chelonoe/obscessus complex by sequencing the hsp65, rpoB, 165-235 rRNA internal transcribed spacer region （its）, recA and sodA house-keeping genes commonly used to describe the molecular characteristics of Mycobocterium. Clinical Mycobecterium isolates were classified according to the gene sequence using a clustering analysis program. Sequence similarity within clusters and diversity between clusters were analyzed. Results The 5 isolates were identified with distinct sequences exhibiting 99.8% homology in the hsp65 gene. However, a complete lack of homology was observed among the sequences of the rpoB, 165-235 rRNA internal tronscribed spacer region （its）, sodA, and recA genes as compared with the M. obscessus. Furthermore, no match for rpoB, sodA, and recA genes was identified among the published sequences. Conclusion The novel species, Mycobacterium fukienense, is identified from tuberculosis patients in Fujian Province, China, which does not belong to any existing subspecies of M. cheloneo/abscessus complex.

hsp65 and rpoB PCR-RFLP用于龟/脓肿分枝杆菌复合群种的快速鉴定(英文)

目的探讨和评价hsp65and rpoB PCR-RFLP用于龟/脓肿分枝杆菌复合群种的快速鉴定。方法收集经PNB/TCH鉴别培养基表型鉴定和16s rRNA基因测序鉴定为龟/脓肿分枝杆菌复合群的临床分离菌株,用hsp65and rpoBPCR-RFLP进行种/亚种鉴定。结果经表型鉴定为非结核分枝杆菌的27株临床菌株,16s rRNA基因测序分析与龟/脓肿分枝杆菌的同源性达到99.7%。经hsp65PCR-RFLP and rpoBPCR-RFLP鉴定18株为脓肿分枝杆菌(M.abscessus),4株为溃疡分枝杆菌(M.absecces),另5株表现为独特的指纹特征,可能是一个新的亚种。结论能够快速进行龟/脓肿分枝杆菌复合群种/亚种的鉴定。

阿米卡星和左氧氟沙星对快速生长型分枝杆菌体外抑菌作用的研究

目的 探讨阿米卡星和左氧氟沙星对快速生长分枝杆菌的体外抑菌作用。方法 选取经基因芯片鉴定为龟分枝杆菌或脓肿分枝杆菌和偶然分枝杆菌的31株快速生长型分枝杆菌菌株,分别进行抗酸染色和革兰染色,检测阿米卡星和左氧氟沙星对龟分枝杆菌或脓肿分枝杆菌和偶然分枝杆菌的体外抑菌作用。结果 龟分枝杆菌或脓肿分枝杆菌和偶然分枝杆菌抗酸染色及革兰染色均呈阳性。阿米卡星对龟分枝杆菌或脓肿分枝杆菌和偶然分枝杆菌的最小抑菌浓度(MIC)50分别为2.0μg/mL和0.5μg/mL,左氧氟沙星对龟分枝杆菌或脓肿分枝杆菌和偶然分枝杆菌的MIC50分别为16.0μg/mL和0.25μg/mL。结论 快速生长分枝杆菌对阿米卡星敏感,而对左氧氟沙星有一定的耐药性,应根据菌种鉴定及药物敏感试验结果选择药物治疗。

龟分枝杆菌和脓肿分枝杆菌药物敏感性分析及E试验法应用评价

目的分析深圳地区龟分枝杆菌和脓肿分枝杆菌耐药谱，评价E试验法检测龟分枝杆菌和脓肿分枝杆菌药物敏感性的临床适用性。方法用Geno Type Mycobacterium CM分枝杆菌菌种鉴定系统筛选16株龟分枝杆菌临床菌株、20株脓肿分枝杆菌临床菌株，分别用微量肉汤稀释法和E试验法检测其对阿米卡星、头孢西丁、环丙沙星、克拉霉素、多西环素、亚胺培南、利奈唑胺、磺胺甲嗯唑／甲氧苄啶和妥布霉素9种抗生素的MIC，以微量肉汤稀释法为标准，评价E试验法的MIC值符合率和MIC解释的一致率。两组间率的比较采用，检验。结果龟分枝杆菌和脓肿分枝杆菌对阿米卡星和头孢西丁均敏感（36／36），对克拉霉素的耐药率较低（1／36），对环丙沙星、多西环素、亚胺培南和磺胺甲嗯唑／甲氧苄啶的耐药率较高（29／36）。龟分枝杆菌和脓肿分枝杆菌对利奈唑胺的耐药例数分别为2／16和12／20，对妥布霉素的耐药例数分别为7／16和16／20。E试验法检测9种抗生素的MIC值分布与微量肉汤稀释法MIC值分布的总体符合率为46％（149／324），MIC解释一致率最高的分别为阿米卡星、克拉霉素、多西环素和亚胺培南（35／36），其次为磺胺甲嗯唑／甲氧苄啶（34／36），2例（2／36）解释结果有重大误差；一致率较高的为环丙沙星（31／36）和妥布霉素（26／36）；一致率最低的为头孢西丁和利奈唑胺（14／36），易导致MIC解释出现假阳性。结论阿米卡星、头孢西丁和克拉霉素对龟分枝杆菌和脓肿分枝杆菌有良好的体外抗菌作用，利奈唑胺、妥布霉素对部分龟分枝杆菌有良好的体外抗菌作用。除头孢西丁和利奈唑胺外，阿米卡星、克拉霉素、多西环素、环丙沙星和妥布霉素均适用E试验法检测龟分枝杆菌和脓肿分枝杆菌的体外药物敏感性，需慎重采用E试验法检测磺胺甲嗯唑／甲氧苄啶的药物敏感性。

龟或脓肿分枝杆菌肺病的临床与CT表现

目的探讨龟或脓肿分枝杆菌肺病的临床与CT特点。方法回顾性分析经临床确诊的25例龟或脓肿分枝杆菌肺病患者的电子病历和CT资料。结果 25例龟或脓肿分枝杆菌肺病患者临床症状主要表现为咳嗽、咳痰和咯血,44%的患者伴原有肺结核病史,CT征象主要为小叶中心结节（96%）、支气管扩张（72%）,其次为斑片状实变灶、纤维条索灶、直径≥1.0 cm结节灶,空洞以薄壁空洞为主;厚壁空洞、胸腔积液不常见。结论龟或脓肿分枝杆菌肺病常伴有慢性肺部疾病,CT表现具有一定特征性,CT检查对该病诊断具有重要价值。

邻苯二甲醛对细菌芽孢和分枝杆菌杀灭效果研究

目的观察某邻苯二甲醛消毒液对细菌芽孢和分枝杆菌的杀灭效果及连续使用稳定性。方法采用悬液定量杀菌试验,对该邻苯二甲醛消毒液杀灭枯草杆菌黑色变种芽孢和龟分枝杆菌脓肿亚种的效果进行观察。结果浓度为4 800 mg/L的该消毒液作用14 h,对龟分枝杆菌脓肿亚种作用5 min杀灭对数值为4. 60;浓度为3 000 mg/L的该邻苯二甲醛消毒液的稀释液作用14 h,对悬液内枯草杆菌黑色变种芽孢的杀灭对数值为7. 65,杀灭对数值为4. 02,作用5 min对龟分枝杆菌脓肿亚种的杀灭对数值仅为2. 88。该消毒液经医疗器械浸泡连续使用14 d的稳定性实验结果证明,杀菌效果不变。该消毒液在内镜清洗机内连续使用14 d共处理80条模拟内镜后,杀菌效果未达到高效消毒要求。结论该邻苯二甲醛消毒液所设定的剂量不适用于医疗器械的高水平消毒。

三氯异氰尿酸对龟分枝杆菌杀菌效果及影响因素研究

目的研究三氯异氰尿酸杀灭龟分枝杆菌的效果及其影响因素。方法采用悬液定量杀菌试验方法进行了实验室观察。结果以含有效氯500 mg/L三氯异氰尿酸溶液作用5 min,对悬液内龟分枝杆菌脓肿亚种杀灭对数值为4.46。随有效氯浓度增加,三氯异氰尿酸对龟分枝杆菌杀灭效果增加;随作用温度的升高,该消毒剂杀菌作用增强;随有机物浓度增加或pH值升高,该消毒剂杀菌作用降低。结论三氯异氰尿酸对龟分枝杆菌脓肿亚种的杀灭效果较好,其杀菌作用受作用温度、有机物和pH值等因素的影响。