结核病实验室诊断中常见干扰型非结核分枝杆菌的监测分析

    温颖，张建明，王向阳，何洪涛，吴健，吴培丰，韩彦玲，谭家辉

　　广东国际旅行卫生保健中心，广东 广州 510635

　　摘要：目的 掌握常见干扰结核病（TB）实验室诊断的非结核分枝杆菌（NTM）菌种组成及生长特性，以提高TB实验室诊断水平。方法 采用分子线性探针（LPA）法对139株经实验室初步鉴定为NTM进行快速分型检测，回顾性对照分析其传统细菌学生长特性。结果 脓肿、戈登、偶发、胞内、堪萨斯、鸟、瘰疠和外来分枝杆菌分别占41.01%、20.14%、13.67%、12.95%、5.76%、4.32%、1.44%和0.72%。2例NTM与结核分枝杆菌（MTB）混合培养阳性菌分别为戈登与脓肿分枝杆菌。脓肿分枝杆菌为TB复诊样本中常见干扰型NTM。结论 综合分析常见干扰TB诊断的NTM的分子分型与细菌学生长特性，可提高TB实验室鉴别诊断准确率。

　　关键词：结核病；结核分枝杆菌；非结核分枝杆菌；分子线性探针

　　中图分类号：R446.5   文献标识码：B

　　Analysis of common interfering non-tuberculous mycobacteria

　　in the detection of mycobacterium tuberculosis

　　WEN Ying， ZHANG Jian-ming， WANG Xiang-yang， HE Hong-tao， WU Jian，WU Pei-feng， HAN Yan-ling， TAN Jia-hui

　　Guangdong International Travel Healthcare Center， Guangzhou，Guangdong 510635， China

　　Abstract：  Objective  To understand the speciescomposition and growth characteristics of the common interferingnon-tuberculous mycobacteria （NTM） in tuberculosis （TB） diagnosis，so as to improve the level of TB laboratory diagnosis. Methods  A total of 139 NTM strains were rapid detectedand genotyped by molecular line probe assay（LPA）， and itsbacteriological growth characteristics were analyzed byretrospective comparative.  Results  Upon LPA analysis， 8kinds of NTM were M. abscessus， M. gordonae， M. fortuitum， M.intracellulare， M. kansasii， M. avium， M. scrofulous and M.peregrinum， the percentage of them were 41.01%， 20.14%， 13.67%，12.95%， 5.76%， 4.32%， 1.44% and 0.72%， respectively. Two caseswhich NTM and Mycobacterium tuberculosis （MTB） co-culture positivewere M. gordonae and M. abscessus. M. abscessus was detectedcommonly in TB referral patients.  Conclusion Synthetically analysis of molecular typing andbacteriological growth characteristics of common interfering NTM inTB diagnosis， could improve the accuracy of the differentialdiagnosis in TB laboratory.

　　Key words： Mycobacterium tuberculosis （MTB）； Nontuberculousmycobacteria （NTM）； Molecular line probe assay（LPA）

　　《中国国境卫生检疫杂志》2014年3期