Cafri Uğur, Aslan Gönül, Direkel Sahin, Tarhan Gülnur, Ceyhan Ismail, Emekdaş Gürol
Mersin Üniversitesi Sağlık Bilimleri Enstitüsü, Tıbbi Mikrobiyoloji Anabilim Dalı, Mersin, Türkiye.
Mikrobiyol Bul. 2010 Jul;44(3):395-403.
Non-tuberculous mycobacteria (NTM) found frequently in tap water and environment cause important opportunistic infections in immunocompromised patients. The aim of this study was to isolate and identify non-tuberculous mycobacteria in soil, raw milk and water distribution system samples in Mersin (a province located at Mediterranean region of Turkey). A total of 101 water, 124 soil and 40 milk samples collected from the central part and suburban parts of Mersin during November 2003-May 2004 period were included in the study. Water samples were collected from 29 different water distribution systems; soil samples from different parks and gardens and milk samples from raw milks sold at different districts. After the samples were processed by homogenization and decontamination, acid-fast staining and culture into Löwenstein-Jensen medium were performed. Acid-fast bacilli isolated from culture medium were identified by using conventional methods, polymerase chain reaction (PCR)-RFLP (Restriction Fragment Length Polymorphism) and INNO-LIPA Mycobacteria methods. NTM were identified from 4.9% (5/101) of water samples and 0.8% (1/124) of soil samples by culture and PCR. No NTM were detected in the raw milk samples. Three of the NTM strains isolated from water samples were defined as Mycobacterium chelonae type III and two as Mycobacterium kansasii type II. One NTM strain isolated from soil was defined as Mycobacterium fortuitum. It was of note that two of the five NTM positive water samples were tap water samples collected from hospitals. It was concluded that NTM colonization/contamination of water and environment in the hospitals was a potential risk factor in terms of nosocomial infections. Thus surveillance cultures of the water systems and the medical devices in the hospital are necessary to fix the source of NTM, to identify and type the strains and to establish effective control measures such as sterilization, disinfection, maintenance and modernization of water systems.
非结核分枝杆菌（NTM）在自来水和环境中频繁出现，可导致免疫功能低下患者发生重要的机会性感染。本研究的目的是分离和鉴定梅尔辛（土耳其地中海地区的一个省份）土壤、生牛奶和供水系统样本中的非结核分枝杆菌。2003年11月至2004年5月期间从梅尔辛市中心和郊区收集的101份水样、124份土壤样本和40份牛奶样本被纳入研究。水样取自29个不同的供水系统；土壤样本取自不同的公园和花园，牛奶样本取自不同地区销售的生牛奶。样本经匀浆和去污处理后，进行抗酸染色，并接种到罗-琴培养基中培养。从培养基中分离出的抗酸杆菌采用传统方法、聚合酶链反应（PCR）-限制性片段长度多态性（RFLP）和INNO-LIPA分枝杆菌方法进行鉴定。通过培养和PCR从4.9%（5/101）的水样和0.8%（1/124）的土壤样本中鉴定出NTM。生牛奶样本中未检测到NTM。从水样中分离出的3株NTM菌株被鉴定为Ⅲ型龟分枝杆菌，2株为Ⅱ型堪萨斯分枝杆菌。从土壤中分离出的1株NTM菌株被鉴定为偶然分枝杆菌。值得注意的是，5份NTM阳性水样中有2份是从医院采集的自来水样本。得出的结论是，医院水和环境中的NTM定植/污染是医院感染的一个潜在危险因素。因此，有必要对医院的水系统和医疗设备进行监测培养，以确定NTM的来源，鉴定和分型菌株，并建立有效的控制措施，如水系统的灭菌、消毒、维护和现代化。
