福建省261株非结核分枝杆菌的菌种鉴定分析

doi:10.3969/j.issn.1000-6621.2021.06.012

摘要/Abstract

摘要：

目的通过对福建省261株非结核分枝杆菌(NTM)进行菌种鉴定,分析福建省NTM的菌种分布情况,为福建省NTM病的临床诊疗和流行病学研究提供科学依据。方法从福建省9个省级结核病耐药监测点和9个地市级疾病预防控制中心结核病实验室2016年6月至2019年12月开展常规培养的菌株中,收集到分枝杆菌菌株3355株,经对硝基苯甲酸(PNB)生长试验初步鉴定出261株NTM菌株,采用GenoType Mycobacterium CM试剂盒进行分枝杆菌的菌种鉴定,DNA测序或MeltPro Myco试剂盒进一步鉴定无法确定菌种的菌株。结果从261株被初步鉴定为NTM的菌株中,鉴定出213株(81.61%)NTM,NTM的分离率为6.35%(213/3355),其中,位列前三的NTM菌种分别是胞内分枝杆菌(65.73%,140/213)、脓肿分枝杆菌(17.37%,37/213)和堪萨斯分枝杆菌(4.22%,9/213);同时,发现了6种罕见的NTM,分别为M.arupense、M.peregrinum、M.phocaicum、M.sinense、M.vanbaalenii和M.dioxanotrophicus;还鉴定出了9株混合感染菌株,其中,8株为结核分枝杆菌复合群(MTBC)和胞内分枝杆菌的混合感染,1株为MTBC和鸟分枝杆菌的混合感染。结论三种NTM鉴定方法的联合使用,揭示了福建省最常见的3种NTM分别是为胞内分枝杆菌、脓肿分枝杆菌和堪萨斯分枝杆菌,还发现了6种罕见的NTM和9株混合感染菌株。

关键词: 分枝杆菌,非典型性, 细菌分型技术, 聚合酶链反应, 流行病学研究

Abstract:

Objective To identify non-tuberculous mycobacteria (NTM) strains and analyze their distributions in Fujian Province, so as to provide scientific evidence for clinical diagnosis, treatment and epidemiological research of NTM disease in Fujian Province. Methods A total of 3355 strains of mycobacterium were collected from nine drug-resistant tuberculosis surveillance sites and nine tuberculosis laboratories of municipal level Center for Disease Control and Prevention in Fujian Province from June 2016 to December 2019. A total of 261 NTM strains were identified by PNB growth test, and then tested with the GenoType Mycobacterium CM kit. DNA sequencing or MeltPro Myco kit were used for further identification of strains that could not be identified by the above method. Results Among 261 strains, 213 (81.61%) were NTM and the separation rate of NTM was 6.35% (213/3355). Among them, the top three species of all NTM were M.intracellulare (65.73%,140/213), M.abscessus (17.37%,37/213) and M.kansasii (4.22%,9/213). In this study, six rare species of mycobacteria were found-M.arupense, M.peregrinum, M.phocaicum, M.sinense, M.vanbaalenii and M.dioxanotrophicus. In addition, 9 mixed infection strains were identified, including 8 mixed infections of MTBC and M.intracellulare, and 1 mixed infection of MTBC and M.avium. Conclusion Three identification methods of NTM species were combined to reveal that the three most prevalent NTM species in Fujian were M.intracellulare, M.abscessus and M.kansasii, and 6 rare NTM and 9 mixed infection strains have been found.

Key words: Mycobacteria,atypical, Bacterial typing techniques, Polymerase chain reaction, Epidemiologic studies

林建, 赵永, 戴志松, 魏淑贞, 林淑芳. 福建省261株非结核分枝杆菌的菌种鉴定分析[J]. 中国防痨杂志, 2021, 43(6): 590-595. doi: 10.3969/j.issn.1000-6621.2021.06.012

LIN Jian, ZHAO Yong, DAI Zhi-song, WEI Shu-zhen, LIN Shu-fang. Identification and analysis of 261 strains of non-tuberculous mycobacteria in Fujian Province[J]. Chinese Journal of Antituberculosis, 2021, 43(6): 590-595. doi: 10.3969/j.issn.1000-6621.2021.06.012

图/表 2

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分枝杆菌菌种	数量(株)	构成比(%)
胞内分枝杆菌	132	50.57
脓肿分枝杆菌	37	14.18
堪萨斯分枝杆菌	9	3.45
偶然分枝杆菌	8	3.06
鸟分枝杆菌	4	1.53
戈登分枝杆菌	3	1.15
龟分枝杆菌	3	1.15
瘰疬分枝杆菌	2	0.77
混合感染	9	3.45
分枝杆菌属	6	2.30
不含分枝杆菌	18	6.90
MTBC	21	8.04
阴性	9	3.45
总计	261	100.00

分枝杆菌菌种	数量(株)	构成比(%)
胞内分枝杆菌	140	65.73
脓肿分枝杆菌	37	17.37
堪萨斯分枝杆菌	9	4.22
偶然分枝杆菌	8	3.75
鸟分枝杆菌	5	2.35
戈登分枝杆菌	3	1.41
龟分枝杆菌	3	1.41
瘰疬分枝杆菌	2	0.94
M.arupense	1	0.47
M.peregrinum	1	0.47
M.phocaicum	1	0.47
M.sinense	1	0.47
M.vanbaalenii	1	0.47
M.dioxanotrophicus	1	0.47
总计	213	100.00