Characteristics of clinical isolates of nontuberculous mycobacteria in Java-Indonesia: A multicenter study.
Characteristics of clinical isolates of nontuberculous mycobacteria in Java-Indonesia: A multicenter study.
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DOI：
10.1371/journal.pntd.0011007
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发表时间：
2022-12
影响因子：
3.8
通讯作者：
中科院分区：
文献类型：
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非结核分枝杆菌（NTM）肺部感染是一个主要的公共卫生问题。由于其临床、微生物学和放射学特征与肺结核（TB）相似，诊断NTM-PD很困难，导致误诊。在物种一级进行鉴定对于诊断和确定治疗方法至关重要，但印度尼西亚的实验室目前并不经常进行这种鉴定。从2020年1月至2021年5月，从爪哇省的三个结核病转诊中心收集了94株NTM分离株。使用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）鉴定物质。进行测试以确定抗生素敏感性、生物膜形成能力、滑动运动特性以及粘附和侵入肺细胞的能力。通过对所有分离物的种属鉴定，我们发现了9组NTMs：M.偶然组51%（48/94），M.红腹小蠹38.3%（36/94）;胞内型3.1%（3/94）; neoaurum2.1%（2/94），M.龟类1.1%（1/94）;戈登氏菌1.1%（1/94），M. szulgai 1.1%（1/94），M. mucogenicum 1.1%（1/94）; arupense 1.1%（1/94）。阿米卡星是对M. forturists group和M.你好分枝偶然组的生物膜形成明显优于M.但两者具有相同的滑动运动能力。M.偶联组对肺泡上皮细胞的粘附和侵袭能力优于M. pesticessus的分离株数与M.偶然组的粘附和侵袭能力优于M.你好本研究表明，M. forturists group和M.在印度尼西亚的爪哇岛发现的最常见的NTM。分枝forturists group和M.脓肿对阿米卡星最敏感，因此，这是经验性治疗的选择。形成生物膜的能力与粘附和侵入肺细胞的能力成正比，但与易感性特征或滑动运动特性不成正比。非结核分枝杆菌（NTM）感染是一个严重的公共卫生问题，可引起各种临床表现的感染，包括非结核分枝杆菌-肺病（NTM-PD）。NTM-PD感染经常被误诊为肺结核，导致NTM感染的发病率被低估，特别是在结核病流行的国家。在印度尼西亚缺乏常规的实验室服务，在物种鉴定和易感性NTM是一个复杂的诊断和病人管理的因素。这些因素导致印度尼西亚缺乏关于NTM感染的充分信息。物种鉴定和药敏试验的研究对于帮助临床医生更好地管理NTM感染非常重要。本研究对爪哇省的94株NTM临床分离株进行了研究，这是印度尼西亚首次使用基质辅助激光解吸电离飞行时间质谱法在物种水平上鉴定NTM。最常见的物种是M。forturists group和M.你好M.革兰氏阴性杆菌对环丙沙星、阿米卡星、磺胺甲恶唑、多西环素耐药率较低。幸运集团阿米卡星是最有效的抗生素，可作为经验抗生素的选择。
Nontuberculous mycobacterial (NTM) lung infections are a major public health concern. Diagnosis of NTM-pulmonary disease (NTM-PD) is difficult because its clinical, microbiological, and radiological features resemble to those of pulmonary tuberculosis (TB), leading to misdiagnosis. Identification at the species level is essential for diagnosis and determination of therapy, which is currently not performed routinely in Indonesian laboratories. From January 2020 to May 2021, 94 NTM isolates were collected from three TB referral centers in Java Province. Species were identified using matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS). Tests were performed to determine antibiotic susceptibility, biofilm formation ability, sliding motility characteristics, and the ability to adhere to and invade pneumocytes. After identifying the species of all the isolates, we found nine groups of NTMs: M. fortuitum group 51% (48/94), M. abscessus 38.3% (36/94), M. intracellulare 3.1% (3/94), M. neoaurum 2.1% (2/94), M. chelonae 1.1% (1/94), M. gordonae 1.1% (1/94), M. szulgai 1.1% (1/94), M. mucogenicum 1.1% (1/94), and M. arupense 1.1% (1/94). Amikacin was the most effective antibiotic against M. fortuitum group and M. abscessus. The M. fortuitum group was significantly better at forming biofilms than M. abscessus, but both had the same sliding motility capability. The ability of the M. fortuitum group to adhere to and invade pneumocytes was better than that of M. abscessus, with the number isolates of the M. fortuitum group capable of superior adhesion and invasion to that of M. abscessus. This study shows that M. fortuitum group and M. abscessus were the most common NTM found in Java, Indonesia. The M. fortuitum group and M. abscessus were the most susceptible to amikacin; therefore, this was the empirical treatment of choice. The ability to form biofilms is directly proportional to the ability to adhere to and invade pneumocytes but not to the susceptibility profile or sliding motility characteristics. Nontuberculous mycobacterial (NTM) infection is a serious public health problem that can cause various clinical manifestations of infection, including NTM-pulmonary lung disease (NTM-PD). NTM-PD infections are often misdiagnosed as pulmonary tuberculosis, leading to underestimation of the incidence of NTM infections, particularly in countries where tuberculosis is endemic. The lack of routine laboratory services in Indonesia in terms of species identification and susceptibility to NTM is a factor complicating diagnosis and patient management. These factors have led to a lack of adequate information on NTM infections in Indonesia. Research on species identification and susceptibility testing is important to help clinicians better manage NTM infections. This study was conducted on 94 clinical isolates of NTM from Java Province, and it is the first study in Indonesia to identify NTM to the species level using matrix-assisted laser desorption ionization time-of-flight mass spectrometry. The most common species found were M. fortuitum group and M. abscessus. M. abscessus was more resistant to ciprofloxacin, moxifloxacin, amikacin, trimethoprim/sulfamethoxazole, and doxycycline than M. fortuitum group. Amikacin is the most effective antibiotic and can be used as the empirical antibiotic of choice.
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影响因子：
3.7
作者：
Byrne AS;Goudreau A;Bissonnette N;Shamputa IC;Tahlan K
通讯作者：
Tahlan K
影响因子：
2.1
作者：
Eijkelkamp, Bart A.;Stroeher, Uwe H.;Brown, Melissa H.
通讯作者：
Brown, Melissa H.
DOI：
10.1016/j.jctube.2021.100271
发表时间：
2021-12
影响因子：
2
作者：
Chindam A;Vengaldas S;Srigiri VR;Syed U;Kilaru H;Chenimilla NP;Kilaru SC;Patil E
通讯作者：
Patil E
影响因子：
3.7
作者：
Li G;Lian LL;Wan L;Zhang J;Zhao X;Jiang Y;Zhao LL;Liu H;Wan K
通讯作者：
Wan K
影响因子：
16.6
作者：
Chakraborty P;Bajeli S;Kaushal D;Radotra BD;Kumar A
通讯作者：
Kumar A