Mertaniasih Ni Made, Kusumaningrum Deby, Koendhori Eko Budi, Kusmiati Tutik, Dewi Desak Nyoman Surya Suameitria
Department of Clinical Microbiology, Faculty of Medicine, Airlangga University, Dr. Soetomo Hospital; Institute of Tropical Disease, Airlangga University, Surabaya 60115, Indonesias.
Department of Pulmonology, Faculty of Medicine, Airlangga University, Dr. Soetomo Hospital, Surabaya 60131, Indonesias.
Int J Mycobacteriol. 2017 Jan-Mar;6(1):9-13. doi: 10.4103/2212-5531.201894.
OBJECTIVE/BACKGROUND: The aim of this study was to analyze the detection of nontuberculous mycobacterial (NTM) species derived from sputum specimens of pulmonary tuberculosis (TB) suspects. Increasing prevalence and incidence of pulmonary infection by NTM species have widely been reported in several countries with geographical variation.
Between January 2014 and September 2015, sputum specimens from chronic pulmonary TB suspect patients were analyzed. Laboratory examination of mycobacteria was conducted in the TB laboratory, Department of Clinical Microbiology, Dr. Soetomo Hospital, Surabaya. Detection and identification of mycobacteria were performed by the standard culture method using the BACTEC MGIT 960 system (BD) and Lowenstein-Jensen medium. Identification of positive Mycobacterium tuberculosis complex (MTBC) was based on positive acid-fast bacilli microscopic smear, positive niacin accumulation, and positive TB Ag MPT 64 test results (SD Bioline). If the growth of positive cultures and acid-fast bacilli microscopic smear was positive, but niacin accumulation and TB Ag MPT 64 (SD Bioline) results were negative, then the isolates were categorized as NTM species. MTBC isolates were also tested for their sensitivity toward first-line anti-TB drugs, using isoniazid, rifampin, ethambutol, and streptomycin.
From 2440 sputum specimens of pulmonary TB suspect patients, 459 isolates (18.81%) were detected as MTBC and 141 (5.78%) as NTM species.
From the analyzed sputum specimens, 18.81% were detected as MTBC and 5.78% as NTM species. Each pulmonary TB suspect patient needed clinical settings to suspect causative agents of MTBC and/or NTM species; clinicians have to understand the local epidemiological data for the evaluation of causes of lung infection to determine appropriate therapy.
目的/背景：本研究旨在分析对肺结核疑似患者痰液标本中分枝杆菌属非结核分枝杆菌（NTM）菌种的检测情况。多个国家广泛报道了NTM菌种导致肺部感染的患病率和发病率呈上升趋势，且存在地域差异。
2014年1月至2015年9月期间，对慢性肺结核疑似患者的痰液标本进行了分析。分枝杆菌的实验室检测在泗水苏托莫医院临床微生物科的结核病实验室进行。分枝杆菌的检测和鉴定采用标准培养方法，使用BACTEC MGIT 960系统（BD公司）和罗氏培养基。结核分枝杆菌复合群（MTBC）阳性的鉴定依据为抗酸杆菌显微镜涂片阳性、烟酸积累试验阳性以及结核抗原MPT 64检测结果阳性（SD Bioline公司）。如果阳性培养物生长且抗酸杆菌显微镜涂片阳性，但烟酸积累试验和结核抗原MPT 64（SD Bioline公司）结果为阴性，则分离株归类为NTM菌种。MTBC分离株还使用异烟肼、利福平、乙胺丁醇和链霉素进行了一线抗结核药物敏感性测试。
在2440份肺结核疑似患者的痰液标本中，459株（18.81%）被检测为MTBC，141株（5.78%）被检测为NTM菌种。
在所分析的痰液标本中，18.81%被检测为MTBC，5.78%被检测为NTM菌种。每位肺结核疑似患者都需要临床评估来确定MTBC和/或NTM菌种的致病原；临床医生必须了解当地的流行病学数据，以评估肺部感染的病因，从而确定合适的治疗方案。
