Preliminary Study on Drug Susceptibility Profile and Resistance Mechanisms to Macrolides of Clinical Isolates of Non-tuberculous Mycobacteria from China

Objective Macrolide susceptibility and drug resistance mechanisms of clinical non-tuberculous mycobacteria（NTM） isolates were preliminarily investigated for more accurate diagnosis and treatment of the infection in China. Methods Four macrolides, including clarithromycin（CLAR）, azithromycin（AZM）, roxithromycin（ROX）, and erythromycin（ERY）, were used to test the drug susceptibility of 310 clinical NTM isolates from six provinces of China with the broth microdilution method. Two resistance mechanisms, 23 S r RNA and erm, were analyzed with nucleotide sequence analysis. Results Varied effectiveness of macrolides and species-specific resistance patterns were observed. Most Mycobacterium abscessus subsp. massiliense were susceptible and all M. fortuitum were highly resistant to macrolides. All the drugs, except for erythromycin, exhibited excellent activities against slow-growing mycobacteria, and drug resistance rates were below 22.2%. Only four highly resistant strains harbored 2,058/2,059 substitutions on rrl and none of other mutations were related to macrolide resistance. G2191 A and T2221 C on rrl were specific for the M. abscessus complex（MABC）. Seven sites, G2140 A, G2210 C, C2217 G, T2238 C, T2322 C, T2404 C, and A2406 G, were specifically carried by M. avium and M. intracellulare. Three sites, A2192 G, T2358 G, and A2636 G, were observed only in M. fortuitum and one site G2152 A was specific for M. gordonae. The genes erm（39） and erm（41） were detected in M. fortuitum and M. abscessus and inducible resistance was observed in relevant sequevar. Conclusion The susceptibility profile of macrolides against NTM was demonstrated. The well-known macrolide resistance mechanisms, 23 S r RNA and erm, failed to account for all resistant NTM isolates, and further studies are warranted to investigate macrolide resistance mechanisms in various NTM species.

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.

Misdiagnosis of tuberculosis and the clinical relevance of nontuberculous mycobacteria in Zambia

Objective:To determine the accuracy of TB diagnosis of TB in Zambia in the era of increasing HIV prevalence.Methods:Sputum of the clinically diagnosed TB cases was additionally subjected to liquid culture and molecular identification.This study distinguished between TB cases confirmed by positive Mycobacterium tuberculosis(M.tuberculosis) cultures and mycobacterial disease caused by non-tuberculous mycobacteria(NTM).Results:Only 49% of the 173 presumptively diagnosed TB cases was M.tuberculosis cultured,while in 13% (22) cases,a combination of M.tuberculosis and NTM was found.In 18% of the patients only NTM were cultured.In 28% ,no mycobacteria was cultivable.HIV positive status was correlated with the isolation of NTM(P【0.05).Conclusions:The diagnosis of tuberculosis based on symptoms, sputum smear and/or chest X-ray leads to significant numbers of false-positive TB cases in Zambia,most likely due to the increased prevalence of HIV.The role of NTM in tuberculosislike disease also seems relevant to the false diagnosis of TB in Zambia.

Routinely detected indicators in plasma have a predictive effect on the identification of HIV-infected patients with non-tuberculous mycobacterial and tuberculous infections

Background:It is difficult to quickly distinguish non-tuberculous mycobacterial(NTM)infection from tuberculosis(TB)infection in human immunodeficiency virus(HIV)-infected patients because of many similarities between these diseases.A simple and effective way to determine the differences using routine blood tests is necessary in developing countries.Methods:A retrospective cohort study was conducted to recruit HIV-infected patients with either NTM infection or TB infection diagnosed for the first time according to mycobacterial culture and microscopic identification from May 2010 to March 2016.These data included the analysis of blood cells,liver function,renal function,C-reactive protein(CRP),and erythrocyte sedimentation rate(ESR),and were compared between the HIV/TB and HIV/NTM groups.Results:A total of 240 patients were enrolled.The number of HIV/TB and HIV/NTM patients was 113 and 127,respectively.There were no significant differences in the CD4 T-cell count,age,sex,percentage of patients initiating antiretroviral therapy(ART)before the explicit diagnosis of TB or NTM infection.NTM infection was more likely to be restricted in the pulmonary while TB infection also involves extra-pulmonary sites.Both the leukocyte count(5.60×109/L)and the proportion of neutrophils in the leukocyte count(76.70%)in the HIV/TB group were significantly higher than those in the HIV/NTM group(4.40×10^(9)/L[P=0.0014]and 69.30%[P<0.001].The analysis of liver function markers indicated that the concentration of albumin but not ALT and AST was significantly lower in the HIV/TB group than in the HIV/NTM group(P<0.001).The creatinine and urea levels were not significantly different between the two groups.The ESR(84.00 mm/h)and the concentration of CRP(59.60 mg/L)were significantly higher in the HIV/TB group than in the HIV/NTM group(52.00 mm/h and 19.60 mg/L,respectively)(P<0.001).To distinguish TB infection from NTM infection,the best cut-off value was 69.5 mm/h for ESR,with a positive predictive value(PPV)of 0.740 and negative predictive value(NPV)of 0.721,and 48.8 mg/L for CRP,with a PPV of 0.676 and NPV of 0.697.Conclusion:The dissemination character as well as stronger immune response characterized by higher inflammation markers(e.g.WBC,ESR,CRP)can help distinguish TB from NTM infection in HIV-infected patients who need empirical therapy or diagnostic therapy immediately in low-income areas.

Thoracoscopic management for bronchiectasis with non-tuberculous mycobacterial infection

Background Non-tuberculous mycobacteria （NTM） have emerged as important opportunistic pathogens of the human being in recent years. Patients with pre-existing bronchiectasis are susceptible to NTM. However, information about its occurrence among bronchiectatic patients in Shenzhen, China is lacking and its impact on the course of bronchiectasis following surgical intervention is unknown. This preliminary study aimed to investigate the prevalence of NTM in bronchiectasis that required surgery in our center, evaluate the role of intraoperative routine screening for NTM, and summarize our initial experience in thoracoscopic management for bronchiectatic patients with NTM. Methods A retrospective analysis of clinical, microbiological data of our bronchiectatic patients with NTM over 5 years was made and 40 patients with bronchiectasis were studied to determine the role of intraoperative routine screening for NTM. Results The prevalence of NTM in this population of patients with bronchiectasis in our center was 6.7% （7/105）. The diagnostic yield of the 40 intraoperative specimens was 7.5% （3/40）. Of the 7 patients with bronchiectasis and NTM, 3 patients developed postoperative wound infections. All were cured with chemotherapy for 8-12 months along with vigorous surgical debridement. Another patient had a slow growth of mycobacteria involving double lungs and the right thoracic cavity and recovered after chemotherapy for nearly 14 months and tube drainage. The affected tissue was completely resected in the remaining 3 patients with no operative mortality and postoperative morbidity, and routine intraoperative screening for NTM was initiated in these patients. Conclusions NTM is not uncommon in bronchiectatic patients which deserves surgeons＇ utmost attention. Routine intraoperative screening for NTM identified otherwise unsuspected patients has shown favorable outcomes. Thoracoscopic management for bronchiectasis with NTM is technically feasible although its role remains to be defined.

结核/非结核分枝杆菌核酸检测对结核性脑膜炎的诊断价值

目的探讨脑脊液中结核/非结核分枝杆菌(mycobacterium tuberculosis/nontuberculous mycobacteria,MTB/NTM)核酸检测诊断结核性脑膜炎(tuberculous meningitis,TBM)的临床价值。方法收集120例TBM患者的临床资料,采用随机数字表法将患者分为TBM A组(n=67,进行脑脊液常规、生化、罗氏培养、涂片查抗酸菌、MTB/NTM核酸检测)和TBM B组(n=53,进行脑脊液常规、生化、罗氏培养、涂片查抗酸菌、GeneXpert MTB/RIF检测),另收集其他中枢神经系统感染患者脑脊液18例为对照组(C组,进行脑脊液常规、生化、罗氏培养、涂片查抗酸菌、MTB/NTM核酸检测、GeneXpert MTB/RIF检测)。结果TBM A组脑脊液罗氏培养、涂片查抗酸菌、MTB/NTM核酸检测阳性率分别为13.43%(9/67)、10.45%(7/67)、46.27%(31/67);TBM B组脑脊液罗氏培养、涂片查抗酸菌、GeneXpert MTB/RIF检测阳性率分别为15.09%(8/53)、11.32%(6/53)、47.17%(25/53),GeneXpert MTB/RIF检测阳性病例中利福平耐药基因检测阳性2例。C组脑脊液罗氏培养、涂片查抗酸菌、MTB/NTM核酸检测和GeneXpert MTB/RIF检测均为阴性。结论MTB/NTM核酸检测与GeneXpert MTB/RIF检测均可辅助早期诊断TBM,相较于后者更经济,并能鉴别非结核分枝杆菌(nontuberculous mycobacteria,NTM)感染,及时减少NTM病误诊、误治,值得临床推广。

2013-2018年徐州市非结核分枝杆菌感染分布和感染危险因素分析

目的探究2013-2018年徐州市非结核分枝杆菌(non-tuberculous mycobacteria,NTM)感染分布和感染危险因素。方法选取2013年1月至2018年12月徐州地区各医疗机构所有疑似NTM病而转诊至徐州市传染病医院并被确诊的患者97例,作为感染组,分离出NTM菌株97株,对标本进行抗酸染色,PCR-反向点杂交,行分枝杆菌培养,并进行菌群菌种鉴定。分析NTM感染患者的性别、治疗史和户籍类型分布。选取同时期诊断为结核分支杆菌感染者136例,作为对照组。对NTM感染者进行单因素分析和非条件logistic回归分析。结果确诊NTM感染97例,分离出7种分枝杆菌,感染率分别为胞内分枝杆菌40.2%、鸟分枝杆菌24.7%、堪萨斯分枝杆菌12.4%、龟分枝杆菌10.3%、脓肿分枝杆菌8.2%、浅黄分枝杆菌3.1%和戈登分枝杆菌1.0%。男性鸟分枝杆菌感染率(17.5%比7.2%)和堪萨斯分枝杆菌感染率(10.3%比2.1%)均显著高于女性,差异均有统计学意义(P<0.05)。近一年化疗患者胞内分枝杆菌和鸟分枝杆菌感染率均显著高于有抗菌药物史和长期服用免疫抑制剂的患者,差异均有统计学意义(P<0.05)。各分枝杆菌在城镇和农村户籍之间差异无统计学意义(P>0.05)。单因素分析和非条件logistic回归分析结果显示,农村户籍(OR=4.67,95%CI:2.66~8.20)、支气管扩张(OR=5.59,95%CI:3.19~12.33)、薄壁空洞(OR=4.16,95%CI:2.10~8.22)、吸烟史10~20年(OR=3.38,95%CI:1.76~6.47)、吸烟史>20年(OR=3.23,95%CI:1.68~6.19)、结核菌素纯蛋白衍生物(purified protein derivative,PPD)试验弱阳性(OR=6.56,95%CI:3.59~11.99)、化疗史(OR=7.52,95%CI:2.46~23.02)、抗菌药物史(OR=2.96,95%CI:1.70~5.13)、长期服用免疫抑制剂(OR=5.11,95%CI:2.35~11.15)、饮用生水(OR=1.99,95%CI:1.09~3.61)和接触禽类史(OR=4.31,95%CI:2.47~7.51)是NTM感染的危险因素(P<0.05)。结论NTM感染者中,男性和化疗患者更易感染胞内分枝杆菌和鸟分枝杆菌,且农村户籍、薄壁空洞、吸烟史(>10年)、PPD弱阳性、化疗史、抗菌药物史、长期服用免疫抑制剂、饮用生水和接触禽类史是NTM感染的危险因素。

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?

非结核分枝杆菌肺病需要更多关注

非结核分枝杆菌肺病(NTM-PD)是最常见的非结核分枝杆菌感染性疾病,但误诊率高。近年来的研究报道显示,NTM-PD发病率和患病率都呈现逐渐上升趋势。NTM-PD症状和体征无特异性。CT检查主要表现肺部支气管扩张、结节、空洞和实变,常常多种CT表现形式同时存在。由于非结核分枝杆菌在自然界中普遍存在,易污染标本和定植在人呼吸道,单次呼吸道标本分离非结核分枝杆菌阳性不能作为确诊NTM-PD的依据。目前,NTM-PD诊断标准仍采用2007年美国胸科学会/美国感染性疾病学会发布的指南性文件,即呼吸道症状、肺CT表现和微生物学检查三项条件符合诊断要求。该文对NTM-PD的研究进展进行综述。

抗痨颗粒辅助抗结核药物对患者非结核分枝杆菌性肺病的疗效及其对T细胞亚群的影响

目的:探究抗痨颗粒辅助抗结核药物对非结核分枝杆菌性肺病的临床疗效及其对T细胞亚群改善的影响。方法:选取2017年1月—12月期间诊治的非结核分枝杆菌性肺病患者70例资料,按治疗用药的不同将其分为治疗组和对照组,每组35例;其中对照组患者给予抗结核分枝杆菌药物治疗,治疗组患者在对照组基础上加用中药抗痨颗粒治疗;观察两组患者用药治疗前和治疗3月的临床疗效(分枝杆菌转阴率、CT影像学好转率)、临床症状评分值以及T细胞亚群各指标的变化情况。结果:治疗组患者治疗后的中医症状(咳嗽咳痰、盗汗、食欲症状改善情况)评分值均低于对照组(P<0.01);两组患者治疗前CD4、CD8、CD4/CD25测得值经组间比较其差异均无统计学意义(P>0.05);治疗组患者治疗后CD4测得值优于对照组(P<0.01);而CD8、CD4/CD25测得值两组间无统计学意义(P>0.05)。结论:采用抗痨颗粒辅助抗结核药物治疗非结核分枝杆菌性肺病患者,有效改善了CD4水平,其机制可能与调节CD4 T细胞水平有关。

非结核分支杆菌肺病24例临床分析

目的总结非结核分支杆菌(NTM)肺病的临床特点。方法回顾性分析我所1994年至2004年间收治的24例NTM肺病的临床特点。结果本组NTM肺病以老年患者多见,症状较轻,肺部病变范围广,耐药率高,治疗效果差,部分患者持续菌阳。结论NTM肺病治疗方案有待探讨。

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。

非结核分枝杆菌肺病的研究进展

近年来,全球非结核分枝杆菌肺病的患病率呈上升趋势,已成为常见病,且对人类健康造成了威胁。非结核分枝杆菌(NTM)主要累及肺脏,NTM肺病缺乏特异性临床表现和体征,与其他疾病鉴别困难。很多临床医师常忽略NTM肺病的存在,常出现误诊或者漏诊。该文从NTM肺病的定义、流行病学特征及危险因素、发病机制及病理变化、诊治及预防等方面作一综述。

成批妇产科切口非结核分支杆菌感染

目的 探讨龟型非结核分支杆菌感染的妇产科切口的临床特点 ,总结治疗方法及效果 ,并提出新的临床分类 ,以指导治疗。方法 :据 139例感染切口的临床特点 ,分四型 (1)混合溃疡型 :118例 (84 9% ) ,(2 )单纯硬结型 :5例 (3 6 % ) ,(3)脓肿型 ,6例 (4 3% ) ,(4)淋巴结炎型 ,10例 (7 2 % )。切口感染潜伏期 10～ 5 0天最多。治疗 抗生素联用 ,分别以克拉霉素 ,丁胺卡那 ,阿奇霉素 ,泰能为主的 2～ 3联组合应用 4～ 6个月 ,切口愈合 ,B超二次检查(间隔 1个月 )切口正常后可停药 ;病灶切除术的 83例 ,仅以抗生素治疗的 5 0例 ,及未用任何药的 6例 ,切口全部治愈。结果 全部病例在 2～ 4个月内伤口愈合 ,停药后随访两个月 ,每月检查一次 ,伤口无硬结 ,积液 ,脓肿再发者为治愈。结论 成批龟型非结核性分支杆菌切口感染极为罕见 ,较难治疗 ,重在预防。

两株鼻疽诺卡菌临床分离株的鉴定

目的应用基因测序方法对2株疑似非结核分枝杆菌的菌株进行初步菌种鉴定,指导临床用药治疗。方法将2株临床分离菌株1520、4108分别接种于罗氏培养基,观察其菌落生长状况;取生长对数期菌落,抽提菌株DNA;PCR扩增16SrDNA基因序列,对其PCR产物进行测序和NCBI网站Blast同源性比对,以进行菌株的初步鉴定。结果编号为1520、4108两株菌株,在罗氏培养基上生长迅速,均可见淡黄色粗颗粒样小菌落,疑似非结核分枝杆菌;以PCR扩增两株菌的16SrDNA基因序列,结果与鼻疽诺卡菌(Nocardia farcinica)同源性极高,比例均达到99%。结论从肺科急诊患者体内分离到的菌株1520、4108为鼻疽诺卡菌,而不是非结核分枝杆菌,为临床在治疗方案上提供了有力的证据。同时,DNA测序分析能够快速、简便、准确地鉴定到菌种,为实验室疑难菌型鉴定提供了技术保障。

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.

胸部CT在AIDS合并非结核分枝杆菌肺病与合并肺结核中的影像特征

目的分析胸部CT在艾滋病(AIDS)合并非结核分枝杆菌(NTM)肺病与合并肺结核(TB)中的影像特征。方法选取2016年12月至2017年12月我院50例AIDS合并TB患者作为对照组,同期的50例AIDS合并NTM肺病患者作为研究组,所有患者均行胸部CT检查,采用Fisher确切概率法比较两组的影像学特征。结果对照组的上叶侵犯率显著高于研究组(P<0.05);研究组患者条索影、结节、斑片影、支气管扩张、类圆形GGO占比显著高于对照组(P<0.05);两组粟粒、胸部积液占比及胸腔增大淋巴结分布比较,差异显著(P<0.05)。结论胸部CT检查在AIDS合并TB与AIDS合并NTM肺病诊断鉴别中具有较高的应用价值。

非结核分枝杆菌感染性乳腺炎临床病理学特征分析

目的探讨非结核分枝杆菌(nontuberculous mycobacteria,NTM)感染性乳腺炎的病理学特征,以期提高对这一罕见疾病临床病理学上的认识。方法回顾性分析13例NTM感染性乳腺炎的病理切片,并运用金胺O染色、抗酸染色及结核/非结核荧光定量PCR进一步明确诊断。结果特殊染色结果显示13例确诊患者中11例金胺O染色阳性(84.6%),3例抗酸染色阳性(23.1%)。荧光定量PCR检出7例非结核分枝杆菌(63.6%),所有病例均未检出结核分枝杆菌。结论非结核分枝杆菌感染性乳腺炎光镜下主要表现为以乳腺小叶为中心,多灶性分布的肉芽肿性病变,典型病变表现为弥漫性炎症背景中或脓肿边缘出现结节性病变,结节中或其周围可伴有少量巨细胞浸润。结合光镜特征、金胺O染色及PCR检测对于乳腺NTM感染的诊断具有重要价值。

HIV/AIDS合并NTM病的研究进展

近年来,非结核分枝杆菌(Non-tuberculosis mycobacteria,NTM)病在全球的患病率呈快速增长的趋势,且随着HIV/AIDS患者的出现,由非结核分枝杆菌引起的疾病的发生率升高,同时也使人们认识到非结核分枝杆菌病的重要性。HIV/AIDS患者免疫力低下,死亡率高,更容易被NTM感染,从而加速HIV/AIDS患者死亡。因此,尽快对非结核分枝杆菌进行诊断,不仅具有流行病学的意义,而且对降低HIV/AIDS患者的死亡率具有重要意义。本文就近几年关于HIV/AIDS合并NTM病的研究进展做一综述。