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城市地区非色素沉着快速生长分枝杆菌所致感染的流行病学

Epidemiology of infections due to nonpigmented rapidly growing mycobacteria diagnosed in an urban area.

作者信息

Esteban J, Martín-de-Hijas N Z, Fernandez A-I, Fernandez-Roblas R, Gadea I

机构信息

Department of Clinical Microbiology, Fundación Jiménez Díaz-UTE, Av. Reyes Católicos 2, 28040, Madrid, Spain.

出版信息

Eur J Clin Microbiol Infect Dis. 2008 Oct;27(10):951-7. doi: 10.1007/s10096-008-0521-7. Epub 2008 May 6.

Abstract

The objective was to determine the incidence, clinical significance, and epidemiology of the isolates of nonpigmented, rapidly growing mycobacteria (NPRGM) in Madrid, Spain. Patients with new isolates of NPRGM during 2005 were selected prospectively for review of clinical charts. Clinical significance was analyzed according internationally accepted criteria. Randomly amplified polymorphic DNA (RAPD) was used for the genotyping of the isolates. NPRGM were identified in 70 patients (1.51 cases/100,000 inhabitants). The species were M. abscessus (in 5 patients), M. chelonae (in 9), M. fortuitum (in 40), M. peregrinum (in 9), M. mageritense (in 5), M. mucogenicum (in 2), and M. alvei (in 1 patient). The isolates were clinically significant in 17 cases (24.3%, 0.39 cases/100,000 inhabitants): in 4 cases of M. abscessus, in 5 of M. chelonae, and in 9 of M. fortuitum. Only 10.7% of the respiratory isolates were significant, whereas 75% of the nonrespiratory ones were significant (p < 0.001). RAPD analysis showed no relationship among the 74 strains available for the study. No characteristic resistance pattern could be found, although 4 strains appeared to be resistant to amikacin. Significant isolates were mainly nonrespiratory ones. The most significant species was M. abscessus. No relationship between the various isolates was detected, ruling out interhuman transmission between these cases.

摘要

目的是确定西班牙马德里非色素沉着、快速生长分枝杆菌(NPRGM)分离株的发病率、临床意义及流行病学特征。前瞻性选取了2005年有NPRGM新分离株的患者,对其临床病历进行回顾。根据国际公认标准分析临床意义。采用随机扩增多态性DNA(RAPD)对分离株进行基因分型。在70例患者中鉴定出NPRGM(1.51例/10万居民)。菌种包括脓肿分枝杆菌(5例)、龟分枝杆菌(9例)、偶然分枝杆菌(40例)、 Peregrinum分枝杆菌(9例)、马格里特分枝杆菌(5例)、产黏液分枝杆菌(2例)和蜂房分枝杆菌(1例)。17例分离株具有临床意义(24.3%,0.39例/10万居民):脓肿分枝杆菌4例,龟分枝杆菌5例,偶然分枝杆菌9例。仅10.7%的呼吸道分离株具有临床意义,而非呼吸道分离株有75%具有临床意义(p<0.001)。RAPD分析显示,可用于该研究的74株菌株之间无相关性。尽管有4株菌株似乎对阿米卡星耐药,但未发现特征性耐药模式。有临床意义的分离株主要是非呼吸道分离株。最具临床意义的菌种是脓肿分枝杆菌。未检测到不同分离株之间的相关性,排除了这些病例之间的人际传播。

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