Identification of non-tuberculous mycobacteria isolated from clinical specimens at a tertiary care hospital: a cross-sectional study
Identification of non-tuberculous mycobacteria isolated from clinical specimens at a tertiary care hospital: a cross-sectional study
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DOI：
10.1186/1471-2334-13-493
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发表时间：
2013-10-22
影响因子：
3.7
通讯作者：
Hasan, Rumina
中科院分区：
文献类型：
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作者：
Ahmed, Imran;Jabeen, Kauser;Hasan, Rumina
背景：非结核分枝杆菌（NTM）是免疫功能低下患者的机会致病菌。它们也越来越被认为是免疫能力强的个体的病原体。在全球范围内，据报告，NTM 隔离有所增加，世界各地不同物种的地理流行率有所不同。缺乏有关巴基斯坦这些生物体的物种分布的数据。治疗方案根据分离的物种及其易感性特征而有所不同。了解当地物种变异将有助于针对性治疗。本研究旨在确定从三级医院实验室提交的各种临床标本中分离出不同 NTM 物种的频率。方法：纳入了两年（2010 年至 2011 年）期间从 25955 份临床标本中分离出的 NTM。所有 NTM 均通过常规测试进行鉴定。药物敏感性测试（DST）通过微量肉汤稀释进行，并根据临床和实验室标准研究所的文件M24-A2进行解释。结果：总共104个NTM被纳入研究。其中，76%（54/71）快速生长的分枝杆菌（RGM）和57.6%（19/33）缓慢生长的分枝杆菌（SGM）可以被进一步鉴定。偶发分枝杆菌 (21/54) 是 RGM 中最常见的 NTM，其次是粘液分枝杆菌 (12/54) 和耻垢分枝杆菌 (11/54)。在 SGM 中，鸟分枝杆菌复合体 (MAC) 是最常见的 (14/19)。可以在有限数量（52/104）的 NTM 分离株中评估临床意义，并且 MAC 似乎是最常见的显着 NTM。发现三例肺外病例是医疗相关感染。 RGM 的药敏试验结果显示对阿米卡星 (100%)、克拉霉素 (100%，偶然分枝杆菌除外，未报告)、利奈唑胺 (90%) 和莫西沙星 (75%) 敏感。而 SGM 对克拉霉素 (100%)、利奈唑胺 (58.8%) 和莫西沙星 (64.7%) 敏感。结论：这是第一项报告从巴基斯坦临床标本中分离出的 NTM 物种及其临床意义的研究。从临床标本中分离 NTM 应有助于评估其临床意义。
Background: Non-tuberculous mycobacteria (NTM) are opportunistic pathogens in immuno-compromised patients. They are also increasingly recognized as pathogens in immuno-competent individuals. Globally, an increase in NTM isolation is being reported with a varied geographic prevalence of different species around the world. There is lack of data on species distribution of these organisms from Pakistan. Treatment options differ according to the species isolated and its susceptibility profile. Knowledge of local species variation would help targeted therapy. This study was performed to determine frequencies of different NTM species isolated from various clinical specimens submitted at a tertiary care hospital laboratory.Methods: NTM isolated from 25955 clinical specimens over a period of two years (2010 to 2011) were included. All NTM were identified using conventional tests. Drug susceptibility testing (DST) was performed by broth microdilution and interpreted according to Clinical and Laboratory Standards Institute's document M24-A2.Results: A total of 104 NTM were included in the study. Of these, 76% (54/71) rapidly growing mycobacteria (RGM) and 57.6% (19/33) slow growing mycobacteria (SGM) could be further identified. Mycobacterium fortuitum (21/54) was the commonest NTM identified among RGM followed by M. mucogenicum (12/54) and M. smegmatis (11/54). Among SGM, M. avium complex (MAC) was the most frequent (14/19). Clinical significance could be assessed in a limited number (52/104) of NTM isolates and MAC appeared to be the commonest significant NTM. Three extra-pulmonary cases were found to be healthcare associated infections. DST results for RGM showed susceptibility to amikacin (100%), clarithromycin (100%, except M. fortuitum where it is not reportable), linezolid (90%) and moxifloxacin (75%). Whereas SGM were susceptible to clarithromycin (100%), linezolid (58.8%) and moxifloxacin (64.7%).Conclusion: This is the first study reporting NTM species and their clinical significance isolated from clinical specimens from Pakistan. Isolation of NTM from clinical specimens should prompt to evaluate their clinical significance.