Tan Jiao, Wang Yachun, Li Zheng, Xia Shuang, Guo Zhen, Li Wenbo, Yuan Yingying, Gao Jingcai, Wang Wei
Medical Laboratory, Henan Provincial Chest Hospital, Zhengzhou University, Henan Province Clinical Medical Research Center for Infectious Diseases (Tuberculosis), Zhengzhou, 450000, Henan, China.
Heliyon. 2024 Mar 27;10(7):e28665. doi: 10.1016/j.heliyon.2024.e28665. eCollection 2024 Apr 15.
This study analyzed the laboratory diagnosis results and drug resistance of patients infected with (NTM).
We collected information on patients with positive indicators of NTM infection at the Henan Provincial Chest Hospital from 2020 to 2022. Acid-fast smear, mycobacterium culture, QB-SPOT assay, GeneXpert MTB/RIF assay, immunoglobulin E test, tuberculosis antibody test, and microplate method for drug sensitivity test were analyzed using strain identification as the gold standard.
The 242 cases of NTM infection were predominantly detected with slow-growing (a detection rate of 87.19%), among which (66.53%), (15.70%), and complex (11.16%) ranked the top three in terms of the isolation rate. Males patients accounted for a higher proportion (58.26%) than females (41.74%), and the majority of them were over 60 years (50.83%). Among laboratory tests for patients with NTM infection, mycobacterium culture showed a highest detected rate (87.20%) among laboratory tests. The results of the drug sensitivity test demonstrated that the resistance rate of NTM was generally high. Moreover, the complex with the highest isolation rate showed 100% resistant to doxycycline and minocycline, but exhibited relatively high sensitivity to moxifloxacin (a resistance rate of 7.89%) and rifabutin (a resistance rate of 13.16%). The complex was 100% resistant to doxycycline and relatively sensitive to cefoxitin (29.17%) and clarithromycin (37.50%).
The NTM species isolated by the Henan Provincial Chest Hospital is dominated by and the highest positive rate is detected by mycobacterium culture among laboratory tests. NTM infection generally exhibits a high rate of drug resistance. Accordingly, the accurate diagnosis of NTM diseases requires enhanced drug sensitivity testing to provide patients with targeted combination drug treatment.
本研究分析了非结核分枝杆菌（NTM）感染患者的实验室诊断结果及耐药情况。
收集2020年至2022年河南省胸科医院NTM感染指标阳性患者的信息。以菌株鉴定为金标准，分析抗酸染色涂片、分枝杆菌培养、QB-SPOT检测、GeneXpert MTB/RIF检测、免疫球蛋白E检测、结核抗体检测及药敏试验的微量板法。
242例NTM感染病例中，主要检测出缓慢生长型NTM（检出率87.19%），其中胞内分枝杆菌（66.53%）、脓肿分枝杆菌（15.70%）和龟分枝杆菌脓肿复合群（11.16%）的分离率位列前三。男性患者占比（58.26%）高于女性（41.74%），且大多数患者年龄超过60岁（50.83%）。在NTM感染患者的实验室检查中，分枝杆菌培养在各项实验室检查中检出率最高（87.20%）。药敏试验结果显示，NTM的耐药率普遍较高。此外，分离率最高的龟分枝杆菌脓肿复合群对多西环素和米诺环素耐药率达100%，但对莫西沙星（耐药率7.89%）和利福布汀（耐药率13.16%）表现出相对较高的敏感性。胞内分枝杆菌对多西环素耐药率为100%，对头孢西丁（29.17%）和克拉霉素（37.50%）相对敏感。
河南省胸科医院分离出的NTM菌种以胞内分枝杆菌为主，实验室检查中分枝杆菌培养阳性率最高。NTM感染普遍呈现较高的耐药率。因此，准确诊断NTM疾病需要加强药敏试验，为患者提供针对性的联合药物治疗。
