长期广泛耐药结核分枝杆菌（XDR-TB）与非结核分枝杆菌合并感染：一例报告。

Co-infection of long-standing extensively drug-resistant Mycobacterium tuberculosis (XDR-TB) and non-tuberculosis mycobacteria: A case report.

作者信息

Izadi Nafiseh, Derakhshan Mohammad, Samiei Amin, Ghazvini Kiarash

机构信息

Antimicrobial Resistance Research Center, Buali Research Institute, Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Center for Disease Control, Tuberculosis and Leprosy Branch, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Respir Med Case Rep. 2014 Dec 16;15:12-3. doi: 10.1016/j.rmcr.2014.11.006. eCollection 2015.

DOI:10.1016/j.rmcr.2014.11.006

PMID:26236585

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4501442/

Abstract

We report a 69-years-old Iranian HIV negative male patient, with long-standing pulmonary tuberculosis (eleven years) co-infected with non-tuberculosis mycobacteria. Despite of initiation of first line anti-tuberculosis therapy after diagnosis the patient poorly respond because of low compliance with anti-TB treatment. After several incomplete treatments the smear was still positive and thus drug susceptibility tests were performed on isolated organism which revealed that the organisms was resistant not only against isoniazid and rifampin but also against Ofloxacin (OFX), Capreomycin (CAP), p-aminosalicylic acid (PAS), ethionamide (ETH), Kanamycin (KAN), ciprofloxacin (Cip), amikacin (AMK) and cycloserine (CYC). Persistence and resistance of infection had led us to do more investigation using molecular methods, which revealed co-infection with Non-tuberculosis mycobacteria (NTM). The patient is still alive with cough and shortness of breath.

摘要

我们报告了一名69岁的伊朗男性患者，HIV阴性，患有长期肺结核（11年），并合并非结核分枝杆菌感染。尽管诊断后开始了一线抗结核治疗，但由于患者对抗结核治疗的依从性低，治疗效果不佳。经过几次不完整的治疗后，涂片仍为阳性，因此对分离出的菌株进行了药敏试验，结果显示该菌株不仅对异烟肼和利福平耐药，而且对氧氟沙星（OFX）、卷曲霉素（CAP）、对氨基水杨酸（PAS）、乙硫异烟胺（ETH）、卡那霉素（KAN）、环丙沙星（Cip）、阿米卡星（AMK）和环丝氨酸（CYC）也耐药。感染的持续性和耐药性促使我们使用分子方法进行更多调查，结果显示合并非结核分枝杆菌（NTM）感染。该患者仍存活，有咳嗽和气短症状。