Truden Sara, Žolnir-Dovč Manca, Sodja Eva, Starčič Erjavec Marjanca
University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
Infect Genet Evol. 2020 Aug;82:104311. doi: 10.1016/j.meegid.2020.104311. Epub 2020 Apr 2.
The burden of tuberculosis (TB) in Slovenia is low due to good ongoing preventive measures. However, analysis of data obtained from the Registry for Tuberculosis and National Reference Laboratory for Mycobacteria at University Clinic of Respiratory and Allergic Diseases Golnik from January 2000 to December 2017 revealed that the number of nontuberculous mycobacterial (NTM) isolates is increasing. A group of slowly growing NTM and a common cause of NTM disease among humans is the Mycobacterium avium complex, the taxonomy of which is rapidly changing. M. intracellulare and M. chimaera are part of the Mycobacterium avium complex, and together represent 19.6% of all isolated NTM species in Slovenia. Due to the high genotypic and phenotypic similarity between M. intracellulare and M. chimaera species, both species are difficult to differentiate. A method that can be used to successfully distinguish between M. intracellulare and M. chimaera is the molecular assay GenoType NTM-DR. Mutations in the rrl and rrs genes that are associated with macrolide and aminoglycoside resistance, respectively, can also be detected with this method. Overall, 222 clinical isolates were tested, and the nationwide study showed that 44.6% of the previously identified M. intracellulare species were actually M. chimaera. Further, this study showed that none of the tested M. intracellulare and M. chimaera isolates harboured mutations in the rrl and rrs genes. The genotyping result that no isolates were resistant to macrolides or aminoglycosides was also confirmed phenotypically with the broth microdilution method. Among isolates from the Slovenian Mycobacterial Isolates Collection all these tested strains (n = 222) were sensitive to macrolides and aminoglycosides.
由于持续采取了有效的预防措施，斯洛文尼亚的结核病负担较低。然而，对2000年1月至2017年12月期间从戈尔尼克呼吸与过敏性疾病大学诊所的结核病登记处和国家分枝杆菌参考实验室获得的数据进行分析后发现，非结核分枝杆菌（NTM）分离株的数量正在增加。鸟分枝杆菌复合体是一组生长缓慢的NTM，也是人类NTM疾病的常见病因，其分类正在迅速变化。胞内分枝杆菌和嵌合体分枝杆菌是鸟分枝杆菌复合体的一部分，在斯洛文尼亚所有分离出的NTM物种中占19.6%。由于胞内分枝杆菌和嵌合体分枝杆菌在基因型和表型上高度相似，这两个物种很难区分。一种可用于成功区分胞内分枝杆菌和嵌合体分枝杆菌的方法是分子检测GenoType NTM-DR。该方法还可检测分别与大环内酯类和氨基糖苷类耐药相关的rrl和rrs基因中的突变。总体而言，共检测了222株临床分离株，全国性研究表明，先前鉴定为胞内分枝杆菌的物种中，有44.6%实际上是嵌合体分枝杆菌。此外，该研究表明，所检测的胞内分枝杆菌和嵌合体分枝杆菌分离株均未在rrl和rrs基因中发生突变。肉汤微量稀释法在表型上也证实了基因分型结果，即没有分离株对大环内酯类或氨基糖苷类耐药。在斯洛文尼亚分枝杆菌分离株库的分离株中，所有这些检测菌株（n = 222）对大环内酯类和氨基糖苷类均敏感。
