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从临床样本中分离出的快速生长分枝杆菌(RGM)菌种模式:在孟加拉国一家三级护理医院进行的一项10年回顾性研究。

Pattern of rapidly growing mycobacteria (RGM) species isolated from clinical samples: A 10-year retrospective study in a tertiary care hospital of Bangladesh.

作者信息

Barai Lovely, Saha Mili Rani, Rahman Tanjila, Sukanya Marium, Ferdous Jannatul, Khanduker Adeeba, Hasan Rokibul, Nova TasfiaTasnim

机构信息

Department of Microbiology, BIRDEM General Hospital, 122 Kazi Nazrul Islam Avenue, Shahbagh, Dhaka, 1000, Bangladesh.

Department of Microbiology, BIRDEM General Hospital, Shahbagh, Dhaka, Bangladesh.

出版信息

Indian J Med Microbiol. 2025 Jan-Feb;53:100756. doi: 10.1016/j.ijmmb.2024.100756. Epub 2024 Dec 5.

DOI:10.1016/j.ijmmb.2024.100756
PMID:39550067
Abstract

PURPOSE

Infections caused by rapidly growing mycobacteria (RGM) are increasing worldwide. The study was conducted in a microbiological laboratory of Bangladesh to determine the pattern of detection of RGM from clinical samples.

METHODS

All laboratory culture records of RGM from 2012 to 2022 were collected retrospectively and analyzed.

RESULTS

A total 62 RGM infected patients with surgical site infection (74.1 %), injection site and skin abscess (9.7 %), septicaemia (4.8 %) and UTI (1.6 %) were identified. The annual isolation frequency of RGM increased 4.8 %-29.1 % in between year 2012 and 2022. RGM infected patients (14.5 %) were mistakenly treated with first line anti tubercular drug before correct microbiological diagnosis (median, IQR; 3, 2-5 months). Out of 23 RGM isolates, 86.9 % were M. abscessus and rest 13.1 % were M. fortuitum. Most of them (≥95 %) were sensitive to amikacin, linezolid, clarithromycin where as 27.1 % to imipenem and ciprofloxacin, 40 % to cefoxitin, 35.3 % and 1.7 % to doxycycline and co-trimoxazole respectively.

CONCLUSION

Misdiagnosis or delay in diagnosis and erroneous treatment with first line anti tubercular drug may cause prolong morbidity and therapeutic failure to patients with RGM infection. So, early and appropriate diagnosis is crucial for successful outcome.

摘要

目的

由快速生长分枝杆菌(RGM)引起的感染在全球范围内呈上升趋势。本研究在孟加拉国的一个微生物实验室进行,以确定临床样本中RGM的检测模式。

方法

回顾性收集并分析了2012年至2022年所有RGM的实验室培养记录。

结果

共鉴定出62例RGM感染患者,其中手术部位感染(74.1%)、注射部位和皮肤脓肿(9.7%)、败血症(4.8%)和尿路感染(1.6%)。2012年至2022年间,RGM的年度分离频率从4.8%增至29.1%。14.5%的RGM感染患者在正确的微生物学诊断之前(中位数,IQR;3,2 - 5个月)被错误地用一线抗结核药物治疗。在23株RGM分离株中,86.9%为脓肿分枝杆菌,其余13.1%为偶然分枝杆菌。它们中的大多数(≥95%)对阿米卡星、利奈唑胺、克拉霉素敏感,而对亚胺培南和环丙沙星敏感的占27.1%,对头孢西丁敏感的占40%,对多西环素和复方新诺明敏感的分别占35.3%和1.7%。

结论

误诊或诊断延迟以及用一线抗结核药物进行错误治疗可能会导致RGM感染患者的发病率延长和治疗失败。因此,早期和适当的诊断对于成功治疗至关重要。

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