Department of Laboratory Medicine, Seoul National University Bundang Hospital, 82, Gumiro, 173 Beongil, Bundanggu, Seongnam, Gyeonggido 463-707, Republic of Korea; Department of Laboratory Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongnogu, Seoul 110-744, Republic of Korea.
Tuberculosis (Edinb). 2013 Nov;93(6):642-6. doi: 10.1016/j.tube.2013.07.007. Epub 2013 Aug 7.
Many nontuberculous mycobacteria (NTM) species have clinical significance, and the rapid and reliable identification of Mycobacterium tuberculosis complex (MTBC) and NTM species is important. We evaluated the simultaneous detection of MTBC and NTM in respiratory specimens. MTBC and NTM were simultaneously detected and identified by laboratory-developed (LDT) real-time PCR, multiplex real-time PCR/melting curve analysis, rpoB PCR restriction fragment length polymorphisms and the AdvanSure Mycobacteria GenoBlot assay (LG Life Sciences). Eighty-five respiratory specimens from 69 patients showed simultaneous detection of MTBC and NTM. A line probe assay showed 70.6% concordance with LDT. Ten patients (14.5%) had a history of tuberculosis, and eight patients (11.6%) had been previously diagnosed with bronchiectasis. Mixed cultures were present one time in 57 patients (82.6%) and repeatedly in 12 patients (17.4%). MTBC was more frequent in 44 patients (63.8%), and NTM was isolated in seven patients (10.1%). The commonly detected NTM species in the mixed cultures were Mycobacterium intracellulare (29.0%) and Mycobacterium abscessus (29.0%). Co-isolation caused a failure of antitubercular drug susceptibility testing in 2 patients (2.9%). Molecular methods allow MTBC and NTM species to be simultaneously identified in respiratory specimens. NTM isolated with MTBC has clinical significance in some patients and should not be ignored.
许多非结核分枝杆菌（NTM）具有临床意义，快速可靠地鉴定结核分枝杆菌复合群（MTBC）和 NTM 菌种非常重要。我们评估了呼吸道标本中 MTBC 和 NTM 的同时检测。通过实验室开发的（LDT）实时 PCR、多重实时 PCR/熔解曲线分析、rpoB PCR 限制性片段长度多态性和 Advansure 分枝杆菌 GenoBlot 检测（LG Life Sciences）同时检测和鉴定 MTBC 和 NTM。85 份来自 69 名患者的呼吸道标本同时检测到 MTBC 和 NTM。线探针检测与 LDT 具有 70.6%的一致性。10 名患者（14.5%）有结核病病史，8 名患者（11.6%）曾被诊断为支气管扩张症。57 名患者（82.6%）出现一次混合培养，12 名患者（17.4%）反复出现混合培养。44 名患者（63.8%）MTBC 更为常见，7 名患者（10.1%）分离出 NTM。混合培养中常见的 NTM 菌种是胞内分枝杆菌（29.0%）和脓肿分枝杆菌（29.0%）。2 名患者（2.9%）共分离导致抗结核药物敏感性试验失败。分子方法可同时鉴定呼吸道标本中的 MTBC 和 NTM 菌种。与 MTBC 一起分离的 NTM 在一些患者中具有临床意义，不应忽视。
