Ge Hu, Liang Xiongwei, Lu Qiuran, He Aixiang, Zhong Peiwen, Liu Jun, Yu Yan, Song Honglian
Changsha KingMed Center for Clinical Laboratory, Changsha, Hunan, China.
Rucheng County People's Hospital, Rucheng, Hunan, China.
Front Med (Lausanne). 2023 Oct 5;10:1265594. doi: 10.3389/fmed.2023.1265594. eCollection 2023.
The taxonomic group of non-tuberculous mycobacteria (NTM) encompasses more than 190 species and subspecies, some of which can cause pulmonary and extrapulmonary diseases across various age groups in humans. However, different subspecies exhibit differential drug sensitivities, and traditional detection techniques struggle to accurately classify NTM. Therefore, clinicians need more effective detection methods to identify NTM subtypes, thus providing personalized medication for patients.
We present the case of a 47-year-old female patient diagnosed with an intraabdominal infection caused by Despite computed tomography of the chest suggesting potential tuberculosis, tuberculosis infection was ruled out due to negative TB-DNA results for ascites fluid and sputum and limited improvement of lung lesions after treatment. Additionally, acid-fast staining and Lowenstein-Jensen culture results revealed the presence of mycobacterium in ascites fluid. Subsequent whole-genome sequencing (WGS) confirmed the DNA sequences of in colonies isolated from the ascites fluid, which was further corroborated by polymerase chain reaction and Sanger sequencing. Ultimately, the patient achieved a complete recovery following the treatment regimen targeting , which involved clarithromycin, ethambutol hydrochloride, pyrazinamide, rifampicin, and isoniazid.
This is the first reported case of infection in humans. was detected by WGS in this case, suggesting that WGS may serve as a high-resolution assay for the diagnosis of different subtypes of mycobacterium infection.
非结核分枝杆菌（NTM）的分类群包含190多个物种和亚种，其中一些可导致人类各年龄组的肺部和肺外疾病。然而，不同亚种表现出不同的药物敏感性，传统检测技术难以准确分类NTM。因此，临床医生需要更有效的检测方法来识别NTM亚型，从而为患者提供个性化用药。
我们报告一例47岁女性患者，诊断为腹腔感染，病因是 尽管胸部计算机断层扫描提示可能患有结核病，但由于腹水和痰液的结核DNA检测结果为阴性，且治疗后肺部病变改善有限，排除了结核感染。此外，抗酸染色和罗氏培养结果显示腹水中存在分枝杆菌。随后的全基因组测序（WGS）证实了从腹水中分离出的菌落中的DNA序列，聚合酶链反应和桑格测序进一步证实了这一点。最终，患者按照针对 的治疗方案实现了完全康复，该方案包括克拉霉素、盐酸乙胺丁醇、吡嗪酰胺、利福平及异烟肼。
这是首例人类感染 的报告病例。本病例通过WGS检测到 ，表明WGS可作为诊断分枝杆菌感染不同亚型的高分辨率检测方法。
