快生长分枝杆菌软组织感染的鉴定及耐药性分析

doi:10.3969/j.issn.1673-8640.2020.03.003

检验医学 ›› 2020, Vol. 35 ›› Issue (3): 200-204.DOI: 10.3969/j.issn.1673-8640.2020.03.003

快生长分枝杆菌软组织感染的鉴定及耐药性分析

周佳¹, 金博¹, 肖楠²(), 黄磊¹, 孙立颖¹

1. 北京大学第一医院检验科,北京 100034
2. 北京清华长庚医院检验科,北京 102218

收稿日期:2018-09-12 出版日期:2020-03-30 发布日期:2020-04-17
通讯作者: 肖楠
作者简介:通信作者：肖楠,E-mail：xna01053@btch.edu.cn。
作者简介：周佳,1977年生,女,学士,主管技师,主要从事临床微生物检测及细菌耐药机制研究。金博,1985年生,男,博士,助理研究员,主要从事分子生物学研究。周佳与金博对本研究具有同等贡献,并列为第一作者。

Identification and drug resistance of rapidly growing Mycobacterium soft tissue infection

ZHOU Jia¹, JIN Bo¹, XIAO Nan²(), HUANG Lei¹, SUN Liying¹

1. Department of Clinical Laboratory,Peking University First Hospital,Beijing 100034,China
2. Department of Clinical Laboratory,Beijing Tsinghua Changgung Hospital,Beijing 102218,China

Received:2018-09-12 Online:2020-03-30 Published:2020-04-17
Contact: XIAO Nan

摘要/Abstract

摘要：

目的分析快生长分枝杆菌（RGM）的耐药性及RGM感染患者的临床特征,为临床进一步认识RGM提供参考。方法选取北京大学第一医院10年间分离到的3株RGM,分别采用电离解析飞行时间质谱（MALDI-TOF MS）和基因测序法进行菌种鉴定,并进行药物敏感性试验。同时,分析RGM感染患者的临床特征。结果 3株RGM均对阿米卡星、妥布霉素、亚胺培南和利奈唑胺敏感,对复方磺胺甲噁唑均耐药。临床分别使用左氧氟沙星、阿奇霉素和/或利福平进行经验治疗,感染鼻疽分枝杆菌和偶发分枝杆菌的患者痊愈出院,脓肿分枝杆菌感染患者病情稳定后带药出院。结论 RGM对大环内酯类抗菌药物耐药性较强,临床经验用药应避免使用此类抗菌药物。

关键词: 快生长分枝杆菌, 软组织感染, 药物敏感性

Abstract:

Objective To analyze the drug resistance of rapidly growing Mycobacterium（RGM） and the clinical characteristic of RGM infection patients,and to provide a reference for the further research of RGM. Methods Three isolates of RGM from soft tissue infection patients in Peking University First Hospital for the last 10 years were collected. The 3 RGM isolates were determined by matrix-assisted laser desorption ionization time-of-flight mass spectrometry（MALDI-TOF MS） and sequencing. Drug susceptibility test was performed. The clinical characteristic of RGM infection patients were analyzed. Results The 3 RGM isolates were sensitive to amikacin,tobramycin,imipenem and linezolid,and were resistant to sulfamethoxazole. Levofloxacin,azithromycin and/or rifampicin were used to treat these patients. The patients infected with Mycobacterium fortuitum and Mycobacterium farcinogenes were cured and discharged. The patient with Mycobacterium abscessus was discharged without being completely cured since being in stable condition. Conclusions RGM is resistant to macrolides,which should be avoided in clinical experience.

Key words: Rapidly growing Mycobacterium, Soft tissue infection, Drug susceptibility

中图分类号:

R446.5

周佳, 金博, 肖楠, 黄磊, 孙立颖. 快生长分枝杆菌软组织感染的鉴定及耐药性分析[J]. 检验医学, 2020, 35(3): 200-204.

ZHOU Jia, JIN Bo, XIAO Nan, HUANG Lei, SUN Liying. Identification and drug resistance of rapidly growing Mycobacterium soft tissue infection[J]. Laboratory Medicine, 2020, 35(3): 200-204.

图/表 4

参考文献 18

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快生长分枝杆菌软组织感染的鉴定及耐药性分析

Identification and drug resistance of rapidly growing Mycobacterium soft tissue infection

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Metrics

抗菌药物	菌株1		菌株2		菌株3
抗菌药物	鼻疽分枝杆菌/ （μg/mL）	判读结果	偶发分枝杆菌/ （μg/mL）	判读结果	脓肿分枝杆菌/ （μg/mL）	判读结果
阿米卡星	1.5	敏感	1	敏感	2	敏感
亚胺培南	0.38	敏感	0.38	敏感	4	敏感
妥布霉素	2	敏感	0.38	敏感	1.5	敏感
头孢西丁	≥256	耐药	3	敏感	16	敏感
复方磺胺甲噁唑	32	耐药	32	耐药	32	耐药
环丙沙星	0.049	敏感	0.049	敏感	32	耐药
利奈唑胺	0.25	敏感	0.25	敏感	0.5	敏感
克拉霉素	4	中介	4	中介	32	耐药
左氧氟沙星	0.125		0.25		16
利福平	16		4		8
阿奇霉素	≥256		1.5		1.5

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