Metaxa-Mariatou V, Ikonomou A, Tzortzi A, Mihalatos M, Vakalis N, Nasioulas G
Molecular Biology Research Center, HYGEIA Antonis Papayiannis, Kifissias Ave. & 4 Erythrou Stavrou Str., 151 23 Maroussi, Athens, Greece.
In Vivo. 2003 Jul-Aug;17(4):365-7.
Bacterial lung infections are common causes of ARDS and, despite intensive research for decades, the mortality rate remains very high. Only two reports suggest the co-existence of Legionnaires' disease and pulmonary tuberculosis based mainly on clinical presentation and serologic results for Legionella and positive cultures for Mycobacterium tuberculosis (M. tuberculosis).
A variety of specimens from a 61-year-old man was used for detection of Legionella pneumophila (L. pneumophila) and M. tuberculosis by PCR. Further identification of the pathogens was carried out by sequence analysis.
L. pneumophila region mip was detected in bronchial washings, bronchoalveolar lavage and urine specimens of the patient. M. tuberculosis regions IS6110 and mtp40 were detected in endo-bronchial secretions and bronchoalveolar lavage.
By using polymerase chain reaction (PCR) and DNA sequencing we documented L. pneumophila and M. tuberculosis co-existence, in multiple specimens of a patient presenting with acute respiratory distress syndrome (ARDS). Furthermore, the efficacy of the specific antibiotic treatment, based on the PCR results, suggest the co-existence of these two pathogens.
细菌性肺部感染是急性呼吸窘迫综合征（ARDS）的常见病因，尽管经过数十年的深入研究，死亡率仍然很高。仅有两份报告提示退伍军人病和肺结核并存，主要依据临床表现、嗜肺军团菌血清学检测结果及结核分枝杆菌培养阳性。
采集一名61岁男性的多种标本，采用聚合酶链反应（PCR）检测嗜肺军团菌（L. pneumophila）和结核分枝杆菌。通过序列分析对病原体进行进一步鉴定。
在该患者的支气管冲洗液、支气管肺泡灌洗液及尿液标本中检测到嗜肺军团菌mip区域。在支气管内分泌物及支气管肺泡灌洗液中检测到结核分枝杆菌IS6110和mtp40区域。
通过聚合酶链反应（PCR）及DNA测序，我们在一名急性呼吸窘迫综合征（ARDS）患者的多个标本中证实了嗜肺军团菌和结核分枝杆菌并存。此外，基于PCR结果的特异性抗生素治疗的有效性提示这两种病原体并存。
