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[龟分枝杆菌烟酸基因变种引起的医院感染暴发及其传播原因]

[The outbreak of nosocomial infection by Mycobacterium chelonae chemovar niacinogenes and the cause of its spread].

作者信息

Kazumi Yuko, Murase Yoshiro, Ishii Kazue, Maeda Shinji

机构信息

Molecular Epidemiology and Genetic Identification Division, Department of Mycobacteria References and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association.

出版信息

Kansenshogaku Zasshi. 2013 Jul;87(4):424-30. doi: 10.11150/kansenshogakuzasshi.87.424.

Abstract

Mycobacteria consist of 2 large groups: one is the tuberculosis complex, and the other is nontuberculous mycobacterium (NTM). Most of the NTM are generally non-virulent bacteria, but some NTMs have pathogenicity to humans. There are many reports of nosocomial infection cases caused by common bacteria such as multidrug-resistant Pseudomonas aeruginosa. Also, some cases of in-hospital infection due to NTM were reported. Unlike common bacteria, detection of mycobacteria is affected by various factors, such as stainability, time for colony forming, temperature and nutrition Mycobacterium chelonae chemovar niacinogenes was isolated from 5 patients in 73 nosocomial infection cases (60 patients and 13 suspected cases) at a certain hospital during the period from March 2007 until January 2009. One of the reasons for the expansion of infection and difficulty in identification of the bacteria was the properties of this mycobacterium. This bacterium was very faintly stained with Gram-staining. Therefore, this mycobacterium could only be detected at a hospital when Ziehl-Neelsen stain and the cultivation at 28 degrees C for more than 5 days were performed. MICs for Cefmenoxime and Tosufloxacin of the isolates were more than 128 microg/mL. The isolates and type strasin of M. chelonae chemovar niacinogenes were also resistant to other drugs.

摘要

分枝杆菌分为两大类

一类是结核分枝杆菌复合群,另一类是非结核分枝杆菌(NTM)。大多数NTM通常是无毒细菌,但有些NTM对人类具有致病性。有许多关于由多重耐药铜绿假单胞菌等常见细菌引起的医院感染病例的报道。此外,也有一些因NTM导致医院内感染的病例报道。与常见细菌不同,分枝杆菌的检测受到多种因素的影响,如可染性、菌落形成时间、温度和营养等。在2007年3月至2009年1月期间,某医院的73例医院感染病例(60例确诊患者和13例疑似病例)中有5例分离出了烟酸产色龟分枝杆菌。感染扩大和细菌鉴定困难的原因之一是这种分枝杆菌的特性。该菌革兰氏染色很浅。因此,只有在进行萋-尼氏染色并在28℃培养5天以上时,才能在医院检测到这种分枝杆菌。分离株对头孢甲肟和妥舒沙星的最低抑菌浓度(MIC)均大于128μg/mL。烟酸产色龟分枝杆菌的分离株和标准菌株对其他药物也耐药。

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