Wang Tao, Zhang Yuan-yuan, Qin Xue-bing, Li Xiao-liang, Zhao Xiu-qin, Liu Zhi-guang, Wan Kang-lin
The 1st Ambulant Clinic Bureau, Management and Security Military Upper Command, Beijing, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2011 Aug;34(8):571-4.
To analyze the clinical features and differential diagnosis of pulmonary infection with Mycobacterium massiliense (M. massiliense).
The clinical manifestations and laboratory test results of our patient were analyzed and the strain isolated from the patient was tested by bacteriological and molecular methods. The partial gene fragments of rpoB and hsp65 were amplified by PCR, sequenced and compared with GeneBank database in NCBI for identification of Mycobacterium species.
The patient was a 72 year old female, who had been admitted to hospital several times because of recurrent respiratory symptoms which had failed to improve upon treatment. This time, pulmonary infection with M. massiliense was confirmed by clinical manifestation and laboratory results. M. massilence isolated from the sputum of our patient was confirmed by bacteriological and molecular methods. The results of specific segments of rpoB and hsp65 tested by PCR and sequence analysis, and compared with that of mycobacterium in NCBI, showed that the DNA homology was 100% and 99% respectively. The results of drug sensitivity test showed that this strain was resistant to multiple drugs. According to the results of drug susceptibility tests and the condition of the patient, therapy with cefoxitin sodium and amikacin was used and the drugs were effective.
The clinical manifestations and the chest imaging of pulmonary infection with M. massiliens were similar to those of Mycobacterium tuberculosis, which can be differentiated by laboratory tests.
分析马赛分枝杆菌肺部感染的临床特征及鉴别诊断。
分析患者的临床表现及实验室检查结果，并对从患者分离出的菌株进行细菌学和分子学检测。采用聚合酶链反应（PCR）扩增rpoB和hsp65的部分基因片段，进行测序，并与美国国立生物技术信息中心（NCBI）的基因库数据库进行比较，以鉴定分枝杆菌种类。
患者为一名72岁女性，因反复出现呼吸道症状且治疗后未改善而多次入院。此次，根据临床表现及实验室结果确诊为马赛分枝杆菌肺部感染。通过细菌学和分子学方法确认从患者痰液中分离出的为马赛分枝杆菌。经PCR及序列分析检测rpoB和hsp65的特定片段，并与NCBI中的分枝杆菌进行比较，结果显示DNA同源性分别为100%和99%。药敏试验结果显示该菌株对多种药物耐药。根据药敏试验结果及患者情况，使用头孢西丁钠和阿米卡星进行治疗，药物有效。
马赛分枝杆菌肺部感染的临床表现及胸部影像学表现与肺结核相似，可通过实验室检查进行鉴别。
