Pedraza Gutiérrez F, San José Alemany C, Cobos Barroso N, Fernández Pérez F, Martín Casabona N
Servicio de Microbiología y Parasitología, Ciudad Sanitària i Universitària Vall d'Hebron, Barcelona.
An Esp Pediatr. 1996 Aug;45(2):157-60.
A prospective study to assess the incidence of mycobacterial infection in patients with cystic fibrosis in our geographical area was performed.
A monitored follow-up was carried out in 91 patients over a period of 20 months, during which time 522 respiratory samples were obtained. These were processed by standard techniques of decontamination with sodiumlaurylsulphate, cultured on Löwenstein-Jensen medium and identified by biochemical and cultural characteristics and hybridization by specific probes. At the same time, the clinical reports of the patients with positive culture were reviewed.
Positive cultures of mycobacteria were obtained from 4 patients. Environmental mycobacteria were isolated in three of them (M. xenopi, M. fortuitum and M. avium) and M. chelonei and later M. tuberculosis in the forth. None of the isolations of environmental mycobacteria were associated with deterioration of pulmonary function, while the isolation of M. tuberculosis in one of the patients coincided with an episode of decompensation in respiratory function. None of the patients presented sensitivity of the tuberculin skin test.
It is advisable to investigate the mycobacteria in the presence of exacerbation of the respiratory process, above all taking into account the high incidence of tuberculosis in our geographical area. The isolation of environmental mycobacteria was not associated with pulmonary deterioration, but they represent a potential danger as opportunist pathogens, affecting patients of which many are candidates for lung transplants.
开展一项前瞻性研究,以评估我们所在地理区域囊性纤维化患者分枝杆菌感染的发生率。
对91例患者进行了为期20个月的监测随访,在此期间获取了522份呼吸道样本。这些样本采用十二烷基硫酸钠去污的标准技术进行处理,在罗-琴培养基上培养,并通过生化和培养特性以及特异性探针杂交进行鉴定。同时,对培养阳性患者的临床报告进行了回顾。
4例患者分枝杆菌培养呈阳性。其中3例分离出环境分枝杆菌(偶发分枝杆菌、龟分枝杆菌和鸟分枝杆菌),第4例先分离出龟分枝杆菌,后来分离出结核分枝杆菌。环境分枝杆菌的分离均与肺功能恶化无关,而1例患者结核分枝杆菌的分离与呼吸功能失代偿发作同时发生。所有患者结核菌素皮肤试验均无敏感性。
在呼吸过程加重时,建议对分枝杆菌进行调查,尤其是考虑到我们所在地理区域结核病的高发病率。环境分枝杆菌的分离与肺部恶化无关,但作为机会性病原体,它们代表了一种潜在危险,会影响许多肺移植候选患者。