2011－2018年四川省自贡市分枝杆菌临床分离株鉴定分析

邓建平; 王斌; 白锐; 肖波; 张正东; 宁柱; 李群; 万康林

doi:10.3784/j.issn.1003-9961.2019.04.013

2011－2018年四川省自贡市分枝杆菌临床分离株鉴定分析

Identification of clinical Mycobacterium isolates in Zigong, Sichuan province, 2011–2018

摘要

摘要:
目的了解自贡市肺部感染分枝杆菌的菌种菌型特征，为临床分枝杆菌病的诊断和治疗及制定有效防控策略提供科学依据。
方法收集2011－2018年临床疑似结核病患者分离到的抗酸染色阳性培养物，经对硝基苯甲酸（PNB）和噻吩-2-羧酸肼（TCH）鉴别培养和多位点PCR鉴定为结核分枝杆菌和非结核分枝杆菌（NTM），再经rpoB和hsp65序列分析对NTM进行种的鉴定。
结果2 751株分枝杆菌临床分离株经PNB/TCH鉴别培养基和多位点PCR鉴定，结核分枝杆菌2 647株，占96.22%，非洲分枝杆菌Ⅰ型32株，占1.16%，NTM 72株，占2.62%。 72株NTM鉴定出11个种。
结论自贡市分枝杆菌肺部感染主要为结核分枝杆菌所致，感染致病的NTM种类较多，以脓肿分枝杆菌、胞内分枝杆菌、堪萨斯分枝杆菌和鸟分枝杆菌为主。外来分枝杆菌和奥巴涅分枝杆菌在国内为首次报道。

Abstract:
ObjectiveTo investigate Mycobacterial species characteristics of pulmonary Mycobacterium infection in Zigong, Sichuan province, China for providing a scientific basis of the clinical diagnosis and treatment, and effective control strategy of Mycobacterial diseases.
MethodsThe of acid-fast stain positive cultures collected from clinical patients suspected with pulmonary tuberculosis from 2011 to 2018 were identified to Mycobacterium tuberculosis (MTB) and nontuberculosis Mycobacterium (NTM) by differential culture method with Nitrobenzene acid(PNB) and Thiophene -2- carboxylic acid hydrazine (TCH) (PNB/TCH method). Then, the strains of NTM were identified to species levelby multilocus sequence analysis (MLSA) with rpoB and hsp65 gene sequences.
ResultsA total of 2 751 clinical Mycobacterium isolates were collected and identified with PNB/TCH method and multi loci PCR, of which there were 2 647 strains (96.22%) of MTB, 32(1.16%) M. africanum Ⅰ, and 72(2.62%) NTM. A total of 11 species were identified from 72 NTM strains.
ConclusionThe vast majority of pulmonary Mycobacterial infectionwere caused by MTB and there were lots of pathogenic NTM species caused pulmonary infectious disearses, of which the majoring species is M. abscessus, M. intracellulare, M. kansasii and M. avium in Zigong.

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