中国鸟分枝杆菌与胞内分枝杆菌的基因型及药敏情况比较

Comparing the Genotype and Drug Susceptibilities between Mycobacterium avium and Mycobacterium intracellulare in China.

作者信息

Zheng Hui Wen, Pang Yu, He Guang Xue, Song Yuan Yuan, Zhao Yan Lin

机构信息

National institute for communicable disease control and prevention, Chinese center for disease control and prevention, Beijing 102206, China; National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

出版信息

Biomed Environ Sci. 2017 Jul;30(7):517-525. doi: 10.3967/bes2017.068.

DOI:10.3967/bes2017.068

PMID:28756811

Abstract

OBJECTIVE

Mycobacterium avium (M. avium) and Mycobacterium intracellulare (M. intracellulare) are the major causative agents of nontuberculous mycobacteria (NTM)-related pulmonary infections. However, little is known about the differences in drug susceptibility profiles between these two species.

METHODS

A total of 393 NTM isolates were collected from Shanghai Pulmonary Disease Hospital. Sequencing of partial genes was performed to identify the strains at species level. The minimum inhibitory concentration (MIC) was used to evaluate the drug susceptibility against 20 antimicrobial agents. Variable number of tandem repeat (VNTR) typing was conducted to genotype these two species.

RESULTS

A total of 173 (44.0%) M. avium complex (MAC) isolates were identified, including 41 (10.4%) M. avium isolates and 132 (33.6%) M. intracellulare isolates. Clarithromycin and amikacin were the two most effective agents against MAC isolates. The Hunter-Gaston Discriminatory Index (HGDI) values for VNTR typing of M. avium and M. intracellulare isolates were 0.993 and 0.995, respectively. Levofloxacin resistance was more common among the unclustered strains than among the clustered strains of M. intracellulare.

CONCLUSION

M. intracellulare was the most common NTM species in China. Clarithromycin and amikacin had high antimicrobial activities against MAC. VNTR typing of MAC isolates revealed a high discriminatory power. Levofloxacin resistance was associated with unclustered strains of M. intracellulare.

摘要

目的

鸟分枝杆菌（M. avium）和胞内分枝杆菌（M. intracellulare）是非结核分枝杆菌（NTM）相关肺部感染的主要病原体。然而，关于这两个菌种药敏谱的差异知之甚少。

方法

从上海肺科医院收集了总共393株NTM分离株。进行部分基因测序以在种水平鉴定菌株。采用最低抑菌浓度（MIC）来评估对20种抗菌药物的药敏情况。进行可变数目串联重复序列（VNTR）分型以对这两个菌种进行基因分型。

结果

共鉴定出173株（44.0%）鸟分枝杆菌复合群（MAC）分离株，包括41株（10.4%）鸟分枝杆菌分离株和132株（33.6%）胞内分枝杆菌分离株。克拉霉素和阿米卡星是针对MAC分离株最有效的两种药物。鸟分枝杆菌和胞内分枝杆菌分离株VNTR分型的亨特 - 加斯顿鉴别指数（HGDI）值分别为0.993和0.995。左氧氟沙星耐药在胞内分枝杆菌的非聚类菌株中比在聚类菌株中更常见。