Distribution of Nontuberculous Mycobacteria by Multigene Sequence-Based Typing and Clinical Significance of Isolated Strains
Distribution of Nontuberculous Mycobacteria by Multigene Sequence-Based Typing and Clinical Significance of Isolated Strains
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DOI：
10.1128/jcm.03053-13
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发表时间：
2014-04-01
影响因子：
9.4
通讯作者：
Lee, Nam Yong
中科院分区：
文献类型：
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作者：
Jang, Mi-Ae;Koh, Won-Jung;Lee, Nam Yong
非结核分枝杆菌(NTM)的种类鉴定具有挑战性，因为已鉴定的NTM种类越来越多，而且缺乏标准化的检测策略。本研究的目的是调查从呼吸道标本中提取的基于多基因序列的NTM菌种的分布情况，并评估鉴定的菌种的临床意义。对232株非结核分枝杆菌临床分离株进行了多基因测序，包括hsp65、rpoB和16S-23SRRNA内转录间隔区(ITS)序列。此外，对样本中含有NTM分离株的所有患者的临床数据进行了分析，以检查临床毒力和治疗历史。通过多基因序列分型，成功地在物种水平上鉴定了169例患者227株菌株中的18株。分离的NTM以禽分枝杆菌复合体和脓肿分支杆菌复合体为主(88%；199/227)，其次为偶发分枝杆菌复合体(4%；10/227)。NTM的致病潜力因物种而异，与其他NTM物种相比，禽类分支杆菌复合体和脓肿分支杆菌复合体显示出特别高的毒力水平。本研究结果支持鸡分支杆菌复合体和脓肿分支杆菌复合体是从临床呼吸道标本中分离到的最常见的具有高致病性的非结核分枝杆菌，可作为韩国非结核分枝杆菌分子流行病学研究的良好资源。
Species identification of nontuberculous mycobacteria (NTM) is challenging due to the increasing number of identified NTM species and the lack of standardized testing strategies. The objectives of this study were to investigate the distribution of NTM species recovered from respiratory specimens by multigene sequence-based typing and to evaluate the clinical significance of identified species. Two hundred thirty-two consecutive clinical NTM isolates were subjected to sequencing of multiple genes, including hsp65, rpoB, and 16S-23S rRNA internal transcribed spacer (ITS) sequence. In addition, clinical data from all patients whose specimens had NTM isolates were analyzed to examine clinical virulence and treatment history. Eighteen strains from 227 isolates from 169 patients were successfully identified at the species level by multigene sequence-based typing. Mycobacterium avium complex and M. abscessus complex made up the majority of isolated NTM (88%; 199/227), followed by M. fortuitum complex (4%; 10/227). The pathogenic potential of NTM differs enormously by species, and M. avium complex and M. abscessus complex revealed especially high levels of virulence compared with findings for other NTM species. The results from our work support M. avium complex and M. abscessus complex being the most common NTM species with highly pathogenic potential isolated from clinical respiratory specimens and could be a good resource for molecular epidemiology of NTM species in South Korea.