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疑似肺结核患者中的非结核分枝杆菌感染

Nontuberculous mycobacterial infections among patients suspected of pulmonary tuberculosis.

作者信息

Grubek-Jaworska H, Walkiewicz R, Safianowska A, Nowacka-Mazurek M, Krenke R, Przybyłowski T, Chazan R

机构信息

Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland.

出版信息

Eur J Clin Microbiol Infect Dis. 2009 Jul;28(7):739-44. doi: 10.1007/s10096-008-0694-0. Epub 2009 Feb 14.

Abstract

The purpose of this study was to present a retrospective analysis of the frequency of nontuberculous mycobacteria (NTM)-related pulmonary infections among the AFB-positive and/or culture-positive patients in the Warsaw region who were suspected of tuberculosis (TB) and hospitalized in the university hospital between 1999 and 2005. All the AFB-positive pulmonary samples were examined with a molecular method using the Amplicor MTB test (Roche) for detection of Mycobacterium tuberculosis complex, and all mycobacterial isolates were speciated by high performance liquid chromatography (HPLC) analysis of mycolic acids. Patients who met clinical, radiological, and bacteriological criteria of mycobacteriosis were classified according to the American Thoracic Society (ATS) guidelines for diagnosis of NTM related disease. Among the 445 smear-positive or/and culture-positive patients, 142 subjects (31.9%) were found to be infected with M. tuberculosis. Among 303 non-TB patients, mycobacteriosis was found in 27 (8.9%) subjects. The frequency of NTM-related lung disease as compared to the bacteriologically-confirmed lung TB was estimated at 1:5. The rapid, precise methods of NTM speciation are necessary for progress in diagnostics of NTM related diseases.

摘要

本研究旨在对1999年至2005年间在华沙地区疑似结核病(TB)并在大学医院住院的抗酸杆菌(AFB)阳性和/或培养阳性患者中,非结核分枝杆菌(NTM)相关肺部感染的频率进行回顾性分析。所有AFB阳性的肺部样本均采用Amplicor MTB检测(罗氏公司)的分子方法进行检测,以检测结核分枝杆菌复合群,所有分枝杆菌分离株均通过对分枝菌酸的高效液相色谱(HPLC)分析进行鉴定。符合分枝杆菌病临床、放射学和细菌学标准的患者,根据美国胸科学会(ATS)关于NTM相关疾病诊断的指南进行分类。在445例涂片阳性或/和培养阳性患者中,142例(31.9%)被发现感染结核分枝杆菌。在303例非TB患者中,27例(8.9%)发现有分枝杆菌病。与经细菌学确诊的肺结核相比,NTM相关肺部疾病的发生率估计为1:5。NTM快速、精确的鉴定方法对于NTM相关疾病诊断的进展至关重要。

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