Maurya A K, Nag V L, Kant S, Kushwaha R A S, Kumar M, Singh A K, Dhole T N
Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan 342005, India.
Department of Pulmonary Medicine, King George Medical University, Lucknow, Uttar Pradesh 226003, India.
Biomed Res Int. 2015;2015:465403. doi: 10.1155/2015/465403. Epub 2015 Mar 26.
The reports of nontuberculous mycobacteria (NTM) associated with extrapulmonary diseases are increasing in tertiary care hospitals. Despite a significant increase in knowledge about NTM infections, they still represent a diagnostic and therapeutic challenge. The aim of this study is to know the prevalence of NTN among extrapulmonary tuberculosis cases in tertiary care centers in Northern India. A total of 227 culture positive isolates from 756 cases were tested for niacin production and catalase assay. BIO-LINE SD Ag MPT64 TB test and final identification and differentiation between MTBC and different species of NTM were further confirmed by GenoType Mycobacterium CM/AS assay. 71 cases (9.3%) were positive for AFB by ZN staining and 227 cases (30.1%) were positive for mycobacteria by culture. Niacin production and catalase activity were negative in 62/227 (27.4%) strains and after using a panel of different biochemicals and final confirmation by GenoType Mycobacterium CM assay. Out of 227 cultures tested, 165 (72.6%) strains were confirmed as M. tuberculosis complex, and 62 (27.4%) were confirmed as NTM. The most common NTM species identified were M. fortuitum 17 (27.5%) and M. intracellulare 13 (20.9%). The rapid identification of NTM species may help in targeted therapy and management of the diseases.
在三级医院中,与肺外疾病相关的非结核分枝杆菌(NTM)报告数量不断增加。尽管人们对NTM感染的了解有了显著增加,但它们仍然是诊断和治疗方面的挑战。本研究的目的是了解印度北部三级医疗中心肺外结核病例中NTM的患病率。对756例病例中的227株培养阳性分离株进行了烟酸生成检测和过氧化氢酶检测。通过BIO-LINE SD Ag MPT64结核检测以及GenoType分枝杆菌CM/AS检测进一步确认了MTBC与不同NTM菌种之间的最终鉴定和区分。ZN染色显示71例(9.3%)抗酸杆菌阳性,培养显示227例(30.1%)分枝杆菌阳性。在227株菌株中,62株(27.4%)的烟酸生成和过氧化氢酶活性为阴性,经过一系列不同生化检测并通过GenoType分枝杆菌CM检测进行最终确认。在检测的227份培养物中,165株(72.6%)被确认为结核分枝杆菌复合群,62株(27.4%)被确认为NTM。鉴定出的最常见NTM菌种为偶然分枝杆菌17株(27.5%)和胞内分枝杆菌13株(20.9%)。NTM菌种的快速鉴定可能有助于疾病的靶向治疗和管理。