Distribution Characteristics of Drug Susceptibility Test Results of Tuberculosis and Non-Tuberculous Bacilli in Patients with Opportunistic Infections of AIDS

Objective: To understand the distribution of drug susceptibility test results of opportunistic infections of tuberculosis and non-tuberculous bacilli in AIDS patients. Methods: The AIDS patients who were hospitalized in our hospital from January 2016 to June 2019 were collected as the research objects, and patients with opportunistic tuberculosis and non-tuberculous bacilli from AIDS patients were screened for drug susceptibility tests, and the distribution characteristics of drug susceptibility were analyzed. Results: 179 strains of tuberculosis and non-tuberculous mycobacteria were isolated from the specimens of AIDS patients, including 135 cases of tuberculosis mycobacteria and 44 cases of non-tuberculous mycobacteria. In the results of the drug susceptibility test, most strains of Mycobacterium tuberculosis showed sensitivity to commonly used drugs, and a few strains showed resistance;most strains of non-tuberculous mycobacteria showed resistance, and a few strains showed sensitivity. Conclusion: AIDS opportunistic infection of Mycobacterium tuberculosis and non-tuberculous mycobacteria have significant differences in drug sensitivity test results. Timely detection and analysis are of great significance to the diagnosis and treatment of the disease.

Lack of correlation between surface water area and infection with Pseudomonas aeruginosa and the non-tuberculous mycobacteria (NTMs) in patients with cystic fibrosis (CF)

Background People with cystic fibrosis(CF)may develop clinically significant chronic respiratory infections with Pseudomonas aeruginosa(PA)and non-tuberculous mycobacteria(NTM).Open water has been suggested to be an important source for continuous or intermittent exposure to these pathogens.To date,there has been a paucity of studies examining the relationship between chronic PA and NTM infection in CF patients and surfaces waters,including blue spaces.The aim of this study was therefore to examine the relationship between chronic pulmonary infection with PA and NTMs in children and adults with CF in European countries and area of surface waters,including blue spaces.Methods European CF registry data detailing incidence of chronic PA and NTM infection in adults and children with CF in Europe(n=41,486 in 24 European countries)was correlated with surface water area data from the same countries(approx.678,278 km2)employing Spearman coefficients.Results Correlation of chronic PA infection in children and adults and surface water area were not significant(p=0.0680 and p=0.8448,respectively),as was NTM infection(p=0.7371 and p=0.0712,respectively).Conclusions Acquistion of PA and its avoidance in people with CF is a complicated dynamic,not solely driven by close association with surface water,but through the integration of several other factors,including mitigations by people with CF to avoid high risk scenarios with surface water.This study was unable to demonstrate a correlation between PA and NTM infection in people with cystic fibrosis and surface water area at a national level.CF patients should continue to be vigilant about potential infection risks posed by water and take evidence-based decisions regarding their behaviour around water to protect them for acquiring these organisms from these sources.

Characterization of mycobacterium isolates from pulmomary tuberculosis suspected cases visiting Tuberculosis Reference Laboratory at Ethiopian Health and Nutrition Research Institute,Addis Ababa Ethiopia:a cross sectional study

Objective:To characterize mycobaclerium isolates from pulmomary tuberculosis suspected cases visiting National Tuberculosis Reference Laboratory at Ethiopian Health and Nutrition Research Institute,for diagnosis of pulmonary tuberculosis from January 4 to February 22.2010 with total samples of 263.Methods:Sputum specimens were collected and processed:the deposits were cultured.Por culturing Lowenstein Jensen medium(LJ) and Mycobacteria Growth Indicator Tube(BACTEC MGIT 960) were used.Capilia Neo was used for detecting NTM isolates from isolates of BACTEC MGIT960.In Armauer Hansen Research Institute,Addis Ababa Ethiopia,Deletion typing PCR method for species identification(from confirmed Mycobacterium tuberculosis complex(MTBC) isolates by Capilia Neo) uas done.Results:Out of 263 enrolled in the study.124 and 117 ol them were positive for mycobaeterium growth by BACTEC MGIT 960 and 1.1 culture method,respectively.From BACTEC MGIT 960 positive media of 124 isolates.117 were randomly taken to perform Capilia TB Neo lest.From these 7(6%) of them were found to be NTM and 110(94%) were MTBC.From these 110 MTBC isolates,81 of them were randomly taken and run by the deletion typing RD9 PCR method of molecular technique.Out of these 78(96.3%) were found to be species of Mycobacterium tuberculosis and 3(3.7%) were found to be not in the MTBC.Regarding the types of methods of culture media.Mycobacteria Growth Indicator Tube(BACTEC MGIT 960) method was found to have excellent agreement(with kappa value ol 0.78) with the routine method of LJ.Conclusions:Pulmonary tuberculosis suspected cases visiting the National Tuberculosis Reference Laboratory at EHNR1 that were confirmed to be pulmonary tuberculosis are caused by the species of Mycobacterium tuberculosis.hence treatment regimen including pyrazinamide can be applied to the patients as the first choice in the study area in Addis Ababa.Ethiopia.There is indication of the presence of NTM in patients visiting the tuberculosis reference laboratory and this is important because NTM is known lo cause pulmonary disease similar with sign and symptom ol pulmonary tuberculosis but different in treatment.BACTEC MGIT 960 has excellent agreement with LJ media but it has high tendency of having high contamination rale unless a better decontamination method is designed.

反复误诊的偶发分枝杆菌感染一例

医源性偶发分枝杆菌感染多与手术伤口、器官移植、透析和注射等有关。本文报道注射后发生的偶发分枝杆菌感染一例,曾多次被误诊为“软组织感染、坏疽性脓皮病”等,最终通过病理、培养和PCR测序确诊,并对分离菌株体外药敏试验。患者经亚胺培南西司他丁钠、阿米卡星、环丙沙星等药物治疗后痊愈,随访5年,患儿无不良反应发生。

66例非结核分支杆菌肺病的临床分析

目的 了解非结核分支杆菌 (NTM )肺病的临床特征。方法 对 1998— 2 0 0 2年 4年间广州地区 4 12 9例分支杆菌培养阳性的病例中 ,经菌型鉴定而确诊为NTM肺病的资料完整的 6 6例病例进行分析。结果 6 6例NTM肺病中 ,快速生长型感染的有 4 0例 ,其中脓肿分支杆菌 2 9例 ,龟分支杆菌 7例 ,耻垢分支杆菌 3例和偶然分支杆菌 1例 ;慢速生长型感染的有 2 6例 ,其中鸟分支杆菌 18例 ,胞内分支杆菌 6例 ,蟾分支杆菌和海分枝杆菌各 1例。分枝杆菌混合感染的有 10例 ;新发现病例16例 ,病程在 1～ 10年的有 31例 ,11～ 2 5年 11例 ,30年以上的有 8例 ;主要症状依次为咳嗽、咳白粘痰、咯血和发热 ;X线胸片示两侧受累者达 6 9.7% ,右侧 2 1.2 % ,左侧仅有 4 .5 % ,无病灶者占4 .5 % ;出现胸腔积液的有 7例 ;NTM对抗结核药物呈现高度的原始耐受性 ,但对喹诺酮类、大环内脂类和氨基糖甙类的耐药率相对较低。结论 NTM肺病的临床特征无特异性 ,病程长 ,常规的抗结核治疗效果差。

应用多重PCR方法检测石蜡包埋组织标本中的分枝杆菌DNA

应用多重PCR方法检测并鉴别石蜡包埋组织中的结核分枝杆菌复合体与非结核分枝杆菌DNA扩增片段类型 ,为结核分枝杆菌复合体感染与非结核分枝杆菌感染的病理学诊断提供一种补充的鉴别诊断方法。应用三对具有特异性的寡核苷酸引物 ,进行多重PCR扩增。这三对引物分别对应于分枝杆菌 6 5kD表面抗原、结核分枝杆菌插入序列IS6 1 1 0及人类β 珠蛋白基因的部分序列 ,其扩增产物分别为 3 83bp、1 2 3bp和 2 6 8bp。此种多重PCR方法检测的灵敏度为 0 6pg。经多重PCR扩增后进行凝胶电泳 ,结核分枝杆菌复合体 (结核分枝杆菌、牛型结核分枝杆菌、BCG)均可见 3 83bp、1 2 3bp片段 ,而非结核分枝杆菌 (鸟、龟、瘰疬、蟾蜍、堪萨斯、胞内、耻垢分枝杆菌 )仅见 3 83bp片段 (猿猴分枝杆菌与结核分枝杆菌复合体相同 )。与上述相比 ,分枝杆菌感染的临床标本分别增加了一条 2 6 8bp片段。对 2 0 9例临床初步诊断为淋巴结结核病人的石蜡包埋组织标本进行了多重PCR检测 ,1 93例病理诊断为淋巴结结核、结核性肉芽组织、结核性肉芽肿性炎症病人的标本 ,检测结果符合结核分枝杆菌复合体感染。1 6例病理诊断为可疑淋巴结结核病人的标本 ,1 5例检测结果符合结核分枝杆菌复合体感染 ,1例符合非结核分枝杆菌感染。此种多重PCR方法可?

非结核分枝杆菌的临床检测研究进展

非结核分枝杆菌(NTM)是指除结核分枝杆菌复合群和麻风分枝杆菌之外的其他分枝杆菌。近年来,随着艾滋病的流行、器官移植以及免疫抑制剂应用的增多,NTM感染患病率不断上升。目前,NTM鉴定常用方法有抗酸染色、培养、PNB(对硝基苯甲酸)生长实验等传统检测法,PCR、qPCR等分子生物学鉴定法,免疫学鉴定和药敏学方法等。本文现将非结核分枝杆菌检测方法的国内外研究进展以及每种方法的特点进行综述,以期为NTM感染性疾病的菌株鉴定提供借鉴。

抗分枝杆菌植物天然产物研究进展

由分枝杆菌引起的感染是人类健康的巨大威胁。目前,多种结核分枝杆菌和非结核分枝杆菌对临床抗分枝杆菌药物具有较高的耐药性。中药治疗分枝杆菌感染具有悠久历史。例如,中药材狼毒已应用于抗结核分枝杆菌的治疗。非中药来源的植物中,也蕴含丰富的抗分枝杆菌成分。这些植物来源的天然产物具有较好的结构多样性,是开发抗分枝杆菌药物的潜在来源。本文综述了近年来在中药和其他非中药来源植物中发现的,具有良好抗分枝杆菌活性的化合物或提取物,并介绍了它们的作用机制。这些活性植物天然产物为新抗分枝杆菌药物的发现提供了化合物库。同时,这些植物天然产物结构与现有抗分枝杆菌药物具有显著的差别,研究其作用机制,也可发现新的抗分枝杆菌靶标。

基于熔解曲线法对肺部感染分枝杆菌菌种的研究

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。

自体脂肪移植隆乳后非结核分枝杆菌感染的救治策略

目的:观察彻底清创联合药物治疗对自体脂肪移植隆乳后非结核分枝杆菌(Non-tuberculous mycobacterium,NTM)感染的治疗效果,探讨其有效的救治策略。方法:2018年4月-2020年12月医院收治10例自体脂肪移植隆乳后NTM感染患者,经小切口多次彻底清创、持续封闭负压吸引,静脉联合口服多种抗生素治疗。结果:7例患者经上述联合治疗,伤口愈合,乳房形态满意;1例患者多重药物过敏,经脱敏治疗后痊愈;2例患者后期病灶局限,经再次手术清创后痊愈。10例患者出院后随访1~2年,无复发,经微等离子射频治疗后,切口瘢痕得到进一步改善。结论:对自体脂肪移植隆乳后NTM感染患者,采用彻底手术清创联合药物治疗策略具有较好疗效,值得临床推广。

63例非结核分枝杆菌肺病的临床分析

目的研究63例非结核分枝杆菌(NTM)肺病住院患者的临床特点、影像学特征,治疗方案及转归。希望通过对非结核分枝杆菌肺病的临床特点的探讨,使医务人员对该病症临床特征的认识加深,并对影像学特征及治疗方案有更深入了解。方法将某院2016年1月~2017年12月住院患者中63例NTM肺病患者作为研究对象,对患者的年龄、性别、基础疾病、症状及胸部CT特点、治疗方案及转归进行回顾性分析。结果NTM肺病在各组人群中分布差异无统计学意义(χ^2=0.967,P=0.617),半数以上(63.5%)合并基础疾病,其中肺部基础疾病如COPD、支气管扩张、尘肺、肺结核较多见,63例病例中其中既往有肺结核病史者22例(占34.9%),住院后同时结核培养阳性且菌种鉴定结核分枝杆菌复合群或X-pert、线性探针阳性16例(占25.4%)。非结核分枝杆菌肺病的主要临床表现有咳嗽咳痰、咯血、气促、胸闷胸痛、发热,影像学表现主要累及双肺。除未抗NTM治疗的有15例患者,其余48例患者治疗时间≥3年者4例;2~3年者3例;1~2年者20例;<1年者22例,其中<6个月者9例。结论非结核分枝杆菌肺病的发病率呈上升趋势,常发生于有肺病基础疾病如COPD、支气管扩张、尘肺等患者并部分合并肺结核。临床表现与肺结核极其相似,影像学表现有很多共同点,故误诊率高。NTM对常用抗结核药耐药率高、治疗难度大、治疗时间长。长期随访失访率高。

Pulmonary cavitary disease due to Mycobacterium xenopi

Non-tuberculous mycobacteria are a significant cause of pulmonary infections worldwide and can be clinically challenging.Mycobacterium xenopi(M.xenopi)has a low pathogenicity and usually requires immunosuppression or lung diseases.We describe herein a scarce case of pulmonary cavitary disease attributed to M.xenopi in a 57-year-old Caucasian patient with underlying structural lung disease successfully treated with rifampicin,ethambutol,clarithromycin,and amikacin.

HAIN基因分型试剂盒鉴定临床非结核分枝杆菌的应用研究

目的采用HAIN基因分型试剂盒鉴定临床非结核分枝杆菌，评价其优缺点。方法收集浙江、安徽等地74株临床非结核分枝杆菌，采用HAIN基因分型试剂盒鉴定临床非结核分枝杆菌，并用16SrRNA基因测序方法对其进行比较和评价。结果74株非结核分枝杆菌HAIN基因分型试剂盒鉴定结果为：31株胞内分枝杆菌，12株脓肿分枝杆菌，8株偶发分枝杆菌，6株堪萨斯分枝杆菌，5株鸟分枝杆菌，3株耻垢分枝杆菌，2株草分枝杆菌，2株瘰疬分枝杆菌，1株戈登分枝杆菌，另外有4株菌株只能鉴定为分枝杆菌属，不能鉴定到种。8株结核分枝杆菌鉴定准确。与16S rRNA基因测序相比较，HAIN基因分型试剂盒除了4株菌株只能鉴定为分枝杆菌属以外，其余70株非结核分枝杆菌均能鉴定到种，鉴定符合率为94．59％；并且它能进一步区分脓肿分枝杆菌和龟分枝杆菌，以及堪萨斯分枝杆菌和胃分枝杆菌。如果单纯鉴定HAIN基因分型试剂盒菌株范围之内的临床最常见非结核分枝杆菌菌株，鉴定符合率为100％。结论HAIN基因分型试剂盒鉴定临床非结核分枝杆菌时间短、操作简单、结果准确，可在临床推广使用。

结核病实验室诊断中常见干扰型非结核分枝杆菌的监测分析

目的掌握常见干扰结核病(TB)实验室诊断的非结核分枝杆菌(NTM)菌种组成及生长特性,以提高TB实验室诊断水平。方法采用分子线性探针(LPA)法对139株经实验室初步鉴定为NTM进行快速分型检测,回顾性对照分析其传统细菌学生长特性。结果脓肿、戈登、偶发、胞内、堪萨斯、鸟、瘰疠和外来分枝杆菌分别占41.01%、20.14%、13.67%、12.95%、5.76%、4.32%、1.44%和0.72%。2例NTM与结核分枝杆菌(MTB)混合培养阳性菌分别为戈登与脓肿分枝杆菌。脓肿分枝杆菌为TB复诊样本中常见干扰型NTM。结论综合分析常见干扰TB诊断的NTM的分子分型与细菌学生长特性,可提高TB实验室鉴别诊断准确率。

快速检测手部非结核分枝杆菌感染的多重聚合酶链反应的方法建立

目的建立一种可快速检测手部常见非结核分枝杆菌感染的具有特异、敏感度高的多重聚合酶链反应（PCR）方法。方法应用引物设计软件以海、鸟、堪萨斯、偶发分枝杆菌的特异靶序列构建多重PCR方法，用上述非结核分枝杆菌标准菌株的DNA检测每一细菌的单一PCR和构建的多重PCR特异性，并测序对比评估验证多重PCR引物的特异性。用该方法鉴定26份临床标本。结果检测26例临床标本，阳性检出达7／8以上，鉴定时间较传统方法短。结论本研究方法可快速、特异、敏感有效的检测出常见手部非结核分枝杆菌感染，可用于临床非结核分枝杆菌感染的鉴定。

2016–2021年四川地区非结核分枝杆菌感染临床特点分析

目的分析四川地区非结核分枝杆菌(NTM)感染的菌种分布、临床特点及药敏数据,为非结核分枝杆菌病的防治提供诊治依据。方法收集2016年7月–2021年7月在成都市公共卫生临床医疗中心就诊的NTM感染病例的临床资料,回顾性分析患者感染特点。结果最终纳入分析病例264例,其中173例进行NTM药敏试验。四川地区NTM感染具有性别、年龄和基础疾病差异,其中AIDS以20~40岁中青年男性易感,肺部疾病以>60岁老年男性易感,支气管扩张以>40岁中老年女性易感。呼吸道是NTM感染的主要途径。四川地区NTM优势菌种是龟/脓肿分枝杆菌。鸟、龟/脓肿分枝杆菌耐药率较高。结论不同人口学特点及基础疾病患者NTM感染时其感染部位、菌种、耐药性等特点均不同。明确病原学诊断是NTM感染治疗中的关键,应重视不同的NTM感染时采用个性化的治疗方案。