Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Central Public Health Laboratories (CPHL), Ministry of Health, Cairo, Egypt.
Infection. 2022 Dec;50(6):1557-1563. doi: 10.1007/s15010-022-01864-1. Epub 2022 Jun 18.
Surgical site infection (SSI) is a post-operative complication of high concern with adverse impact on patient prognosis and public health systems. Recently, SSI pathogens have experienced a change in microbial profile with increasing reports of non-tuberculous mycobacteria (NTM) as important pathogens.
of the study The study aimed to detect the prevalence of NTM among cases with SSIs and describe their species using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) and PCR-based microarray.
The study was conducted with 192 pus samples collected from patients with SSI. Mycobacterial investigations were done in the form of Ziehl-Neelsen (ZN) smears for acid-fast bacilli, automated mycobacterial culture to isolate mycobacteria, followed by immunochromatography test to predict NTM. NTM-positive cultures were tested by MALDI -TOF MS and PCR-based microarray to reach species-level identification.
Mycobacterial growth was found in 11/192 samples (5.7%) and identified as 4 NTM and 7 M. tuberculosis isolates with prevalence of 2.1% and 3.64%, respectively. The NTM species were described by MALDI-TOF as M. abscessus, M. porcinum, M. bacteremicum, and M. gordonae. Microarray agreed with MALDI-TOF in identifying one isolate (M. abscessus), while two isolates were classified as belonging to broad groups and one isolate failed to be identified.
The prevalence of NTM among SSI was found to be low, yet have to be considered in the diagnosis of mycobacteria. Employing advanced technologies in diagnosis is recommended to guide for appropriate treatment.
手术部位感染（SSI）是一种术后并发症，对患者预后和公共卫生系统有不良影响。最近，SSI 病原体的微生物谱发生了变化，越来越多的报告表明非结核分枝杆菌（NTM）是重要的病原体。
本研究旨在检测 SSI 病例中 NTM 的流行率，并使用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）和基于 PCR 的微阵列描述其种属。
本研究共收集了 192 例 SSI 患者的脓液样本。进行了分枝杆菌检测，包括抗酸杆菌 Ziehl-Neelsen（ZN）染色、自动化分枝杆菌培养以分离分枝杆菌，以及免疫色谱试验以预测 NTM。对 NTM 阳性培养物进行 MALDI-TOF MS 和基于 PCR 的微阵列检测，以达到种属水平的鉴定。
在 192 个样本中发现 11 个（5.7%）有分枝杆菌生长，鉴定为 4 株 NTM 和 7 株结核分枝杆菌，其流行率分别为 2.1%和 3.64%。MALDI-TOF 将 NTM 种属描述为脓肿分枝杆菌、猪分枝杆菌、血流分枝杆菌和戈登分枝杆菌。微阵列与 MALDI-TOF 一致，鉴定出 1 株（脓肿分枝杆菌），而 2 株被归类为广泛组，1 株未能鉴定。
SSI 中 NTM 的流行率较低，但在分枝杆菌的诊断中仍需考虑。建议采用先进的诊断技术，以指导适当的治疗。
