检验医学 ›› 2025, Vol. 40 ›› Issue (6): 540-544.DOI: 10.3969/j.issn.1673-8640.2025.06.004

• 论著 • 上一篇    下一篇

上海市某三级甲等医院快生长分枝杆菌临床分离株菌种分布和耐药性

鲍容1, 沈佳瑾1, 姚雨濛2, 缪青2, 王蓓丽1, 潘柏申1, 郭玮1(), 胡必杰2()   

  1. 1.复旦大学附属中山医院检验科,上海 200032
    2.复旦大学附属中山医院感染性疾病科,上海 200032
  • 收稿日期:2023-10-25 修回日期:2024-10-25 出版日期:2025-06-30 发布日期:2025-07-01
  • 通讯作者: 郭玮,胡必杰
  • 作者简介:郭 玮,E-mail:guo.wei@zs-hospital.sh.cn
    胡必杰,E-mail: hu.bijie@zs-hospital.sh.cn
    鲍 容,女,1985年生,学士,主管技师,主要从事病原微生物检测和耐药机制研究。
  • 基金资助:
    上海市临床重点专科建设项目(shslczdzk03302);上海申康医院发展中心重大临床研究项目(SHDC2020CR2031B);复旦大学附属中山医院临床研究专项(ZSLCYJ202309)

Distribution and drug resistance of clinical rapidly growing Mycobacterium in a Grade 3 Class A hospital

BAO Rong1, SHEN Jiajin1, YAO Yumeng2, MIAO Qing2, WANG Beili1, PAN Baishen1, GUO Wei1(), HU Bijie2()   

  1. 1. Department of Clinical Laboratory,Zhongshan Hospital,Fudan University,Shanghai 200032,China
    2. Department of Infectious Diseases,Zhongshan Hospital,Fudan University,Shanghai 200032,China
  • Received:2023-10-25 Revised:2024-10-25 Online:2025-06-30 Published:2025-07-01
  • Contact: GUO Wei,HU Bijie

摘要:

目的 分析复旦大学附属中山医院临床分离快生长分枝杆菌(RGM)菌种分布及其耐药性,为临床抗感染治疗提供参考。方法 收集2019年1月—2022年12月复旦大学附属中山医院非结核分枝杆菌(NTM)感染患者RGM临床分离株。采用质谱技术进行菌种鉴定,采用微量肉汤稀释法分析鉴定所得RGM临床分离株对常用抗菌药物的耐药性。收集感染患者相关临床资料,分析患者临床特征。结果 共收集103株RGM,其中脓肿分枝杆菌89株(86.4%)、偶发分枝杆菌13株(12.6%)、龟分枝杆菌1株(1.0%)。RGM感染患者年龄为(54.0±16.2)岁,女性占66.0%(68/103)。咳嗽、咳痰是最常见的临床表现,占69.9%(72/103);其次是发热、咯血。RGM对阿米卡星高度敏感(100.0%),对多西环素的耐药率最高(82.5%)。脓肿分枝杆菌对多种抗菌药物高度耐药,对诱导型克拉霉素的耐药率为49.4%。偶发分枝杆菌对复方磺胺甲噁唑、利奈唑胺、莫西沙星和环丙沙星的敏感率为90.0%~100.0%,对多西环素、克拉霉素和亚胺培南的耐药率分别为53.8%、53.8%和30.8%。结论 RGM对不同抗菌药物的敏感性差异较大,临床应根据体外药物敏感性试验结果合理使用抗菌药物。

关键词: 非结核分枝杆菌, 快生长分枝杆菌, 脓肿分枝杆菌, 菌种, 耐药性

Abstract:

Objective To analyze the distribution and drug resistance of clinical rapidly growing Mycobacterium(RGM). Methods The clinical isolates of the patients infected with nontuberculous Mycobacterium(NTM) from January 2019 to December 2022 were collected. All the isolates were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry,and the antimicrobial susceptibility was determined using a broth microdilution method. The related clinical data of patients were analyzed retrospectively. Results A total of 103 RGM isolates were isolated,including Mycobacterium abscessus(89 isolates,86.4%),Mycobacterium fortuitum(13 isolates,12.6%) and Mycobacterium chelonae(1 isolate,1.0%). The average age of patients was(54.0±16.2) years old,with 66.0%(68/103) females. Cough and expectoration(69.9%,72/103) were the most common clinical symptoms,followed by fever and hemoptysis. RGM isolates were all sensitive to amikacin(100.0%) and highly resistant to doxycycline(82.5%). Mycobacterium abscessus was highly resistant to a variety of antibiotics. The resistance rate of induced clarithromycin was 49.4%. Mycobacterium fortuitum showed high sensitive rates to trimethoprim/sulfamethoxazole,linezolid,moxifloxacin and ciprofloxacin(90.0%-100.0%),but resistant to doxycycline(53.8%),clarithromycin(53.8%) and imipenem(30.8%). Conclusions The susceptibility of RGM to antibiotics varies. Species identification and drug susceptibility testing are necessary to ensure appropriate treatment regimens for patients.

Key words: Nontuberculous Mycobacterium, Rapidly growing Mycobacterium, Mycobacterium abscessus, Species, Drug resistance

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