[Bacteriological features of Mycobacterium haemophilum isolated from skin lesions in an immunodeficient patient].
[Bacteriological features of Mycobacterium haemophilum isolated from skin lesions in an immunodeficient patient].
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免疫缺陷患者皮损中分离的嗜血分枝杆菌的细菌学特征
DOI：
10.11150/kansenshogakuzasshi1970.78.389
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
N. Ishii
中科院分区：
文献类型：
--
作者：
H. Saito;K. Toda;I. Matsumoto;K. Matsuo;K. Nakanaga;N. Ishii
一名53岁的男性患者出现左脚后部中部疼痛。疼痛区域伴有24 × 18 mm的红色圆顶状肿胀，中央部分溃疡。组织学上，皮肤病变包括溃疡周围脓肿和肉芽肿，并观察到大量抗酸微生物。随后，左侧腹股沟区正下方的区域出现发红和肿胀，接近鹌鹑蛋大小。患者对利福平、左氧氟沙星和米诺环素治疗反应良好。患者免疫缺陷，但HIV-1和HIV-2抗体阴性，其免疫缺陷状态的病因尚不清楚。将皮肤组织或脓在37 ℃下在2%Ogawa和BBL MGIT上培养。MGIT在4 ~ 12天内可回收抗酸菌，而2%小川培养基不能回收抗酸菌。使用来自阳性MGIT管的生长物作为接种物，接种MycoBroth、7 H9肉汤、添加或不添加铁络合物的7H11.2% Ogawa和血琼脂，并在30和37 ℃下培养。用补充有7 H11和血琼脂以及补充有因子X的7 H11的MycoBroth、7 H9、氯化血红素（60 μ M）或柠檬酸铁铵（15 mg/ml）观察到在30 ℃和37 ℃下的生长。对于补充有7 H9和2%Ogawa的柠檬酸铁铵，仅观察到在30 ℃下的生长。一般来说，在所有培养基中，30 ℃下的生长优于37 ℃。在添加氯化血红素或X因子的2%Ogawa中，在两种温度下均未观察到生长。在生化特性方面，分离物对烟酸、硝酸盐还原、尿素酶、芳基硫酸酯酶、吐温80水解、过氧化氢酶、68 ℃过氧化氢酶、酸性磷酸酶和亚碲酸盐还原呈阴性，而对中性红试验呈强阳性。16 S rRNA基因测序显示分离株与嗜血分枝杆菌一致。根据复合特征，将分离物鉴定为M.嗜血菌这是第二例M.在日本的嗜血杆菌感染的文献。
A 53-year-old, male patient presented with pain in the middle area of the back of his left foot. The painful area was associated with a reddish dome-shaped swelling of 24 by 18 mm which had ulcerated in the center part. Histopathologically, the cutaneous lesion consisted of an ulcer surrounded by abscess and granuloma and numerous acid-fast organisms were observed. Subsequently, the area just below the left inguinal area developed redness and swelling approaching the size of a quail egg. The patient responded favorably with rifampicin, levofloxacin, and minocycline therapy. The patient was immunodeficient, but negative for HIV-1 and HIV-2 antibodies and the etiology of his immunodeficient state is unclear. Skin tissues or pus were cultured at 37 degrees C on 2% Ogawa and BBL MGIT. Acid-fast organisms were recovered on MGIT within 4 to 12 days, while 2% Ogawa medium failed to recover acid-fast bacteria. Using growth from the positive MGIT tube as inoculum, MycoBroth, 7H9 broth, 7H11.2% Ogawa supplemented with or without iron complexes, and blood agar were inoculated and cultured at 30 and 37 degrees C. Growth at 30 and 37 degrees C was seen with MycoBroth, 7H9, hemin (60 microM) or ferric ammonium citrate (15 mg/ml) supplemented 7H11 and blood agar as well as 7H11 supplemented with factor X. Growth at 30 degrees C only was observed for ferric ammonium citrate supplemented 7H9 and 2% Ogawa. Generally, growth at 30 degrees C was better than that at 37 degrees C in all media. No growth at either temperature was observed with hemin or factor X supplemented 2% Ogawa. With respect to the biochemical characterization, the isolate was negative for niacin, nitrate reduction, urease, arylsulfatase, Tween 80 hydrolysis, catalase, 68 degrees C catalase, acid phosphatase, and tellurite reduction, while strongly positive for neutral red test. Sequencing of the 16S rRNA gene showed the isolate to be consistent with Mycobacterium haemophilum. Based on the composite characterization, the isolate was identified as M. haemophilum. This is the second case report of M. haemophilum infection in Japan in the literature.