2021-2022年天津市某中心非结核分枝杆菌菌种鉴定
Identification of non-tuberculous mycobacteria from 2021 to 2022 in a center of Tianjin
赵慧 1巨韩芳 1王志锐 1江丽娜 1孙蕊 1张国钦 1李晓蓉 1王春花1
作者信息
- 1. 天津市结核病控制中心,天津市传染病病原微生物重点实验室,天津 300011
- 折叠
摘要
目的 通过对肺部感染患者的非结核分枝杆菌(NTM)进行菌种鉴定分析,探讨NTM菌种类型和分布情况.方法 收集2021年1月-2022年12月期间就诊于天津市结核病控制中心门诊,疑似肺结核患者的呼吸道标本14 414例进行分枝杆菌培养(BACTEC MGIT 960和改良罗氏法),纳入1 838例培养阳性标本,采用结核分枝杆菌抗原MPT64胶体金法进行菌群鉴定,对MPT64检测阴性或MPT64结果阳性但有质疑的样本,进行罗氏培养基转种,抗酸染色初筛后,采用DNA微阵列芯片技术进行分枝杆菌菌种鉴定,无法确定的菌株进一步采用基质辅助激光解析电离飞行时间质谱(MALDI-TOF MS)鉴定.对剔除重复后的NTM菌株在不同年龄、性别、以及NTM不同类菌株的分布特征进行回顾性分析.结果 2021-2022年分离培养的分枝杆菌中,剔除重复菌株,共有1 289例标本分枝杆菌培养阳性.通过4种方法联合使用,剔除重复后,确定从313例标本中分离出315株NTM菌株,NTM分离率为24.44％(315/1 289).NTM分离株中,构成比占前4位者依次为胞内分枝杆菌26.03％(82/315)、慢生黄分枝杆菌20.00％(63/315)、脓肿分枝杆菌16.19％(51/315)、堪萨斯分枝杆菌10.79％(34/315).男性NTM感染者190例,女性123例,比例为1.54:1.4种NTM优势菌株的年龄分布中,脓肿分枝杆菌偏向于年轻患者,胞内分枝杆菌老年患者偏多.结论 本中心NTM分离率较高,NTM分布种类多样,优势菌株以胞内分枝杆菌、慢生黄分枝杆菌、脓肿分枝杆菌和堪萨斯分枝杆菌为主.
Abstract
Objective To investigate the species and distributions of non-tuberculous mycobacteria(NTM)among outpatients with pulmonary infection,explore the type and distribution of NTM species.Methods A total of 14 414 respiratory specimens from suspected pulmonary tuberculosis patients who visited the outpatient clinic of the Tianjin Tuberculosis Control Center from January 2021 to December 2022 were collected for mycobacterial culture(BACTEC MGIT 960 and modified Roche method),and 1 838 culture-positive specimens were included.Mycobacterium tuberculosis antigen MPT64(colloidal gold method)was used for bacterial strain identification.For samples with negative MPT64 test results or positive but questionable MPT64 results,Roche medium was used for inoculation.After initial screening with acid-fast staining,DNA microarray chip technology was used for mycobacterial species identification.Undetermined strains were further identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS).The distribution characteristics of NTM strains in different ages,genders,and different types of NTM strains after excluding duplicates were retrospectively analyzed.Results Among 1 838 positive cultures in 2021-2022,there were 1 289 non-repeated positive isolates(excluding repeated cultures).With using four identification methods,315 NTM isolates were isolated from 313 specimen and then the NTM rate was 24.44％(315/1 289).Among the NTM isolates,the top four constituent ratios were Mycobacterium intracellulare 26.03％(82/315),Mycobacterium lentiflavum 20.00％(63/315),Mycobacterium abscessus 16.19％(51/315),and Mycobacterium kansasii 10.79％(34/315).There were 190 male NTM-infected patients and 123 female NTM-infected patients,with a ratio of 1.54:1.Among the age distribution of four major NTM isolates,M.abscessus isolates were common among young patients while M.intracellulare isolates were common among old patients.Conclusions The NTM isolation rate in our center was high,and the distribution of NTM was diverse.The dominant strains were mainly Mycobacterium intracellulare,Mycobacterium lentiflavum,Mycobacterium abscessus,and Mycobacterium kansasii.
关键词
非结核分枝杆菌/菌种鉴定/胞内分枝杆菌/慢生黄分枝杆菌Key words
Non-tuberculous mycobacteria/Species identification/Mycobacterium intracellulare/Mycobacterium lentiflavum引用本文复制引用
出版年
2024
NETL
NSTL
万方数据