多重PCR检测菲律宾奎松市耐多药结核病患者中的非结核分枝杆菌

Q4 Medicine
Acta Medica Philippina Pub Date : 2025-03-31 eCollection Date: 2025-01-01 DOI:10.47895/amp.v59i4.9049
Michelle M Cabanatan, Alice Alma C Bungay, Sharon Yvette Angelina M Villanueva, Marohren C Tobias-Altura, Dario D Defensor, Maria Margarita M Lota
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引用次数: 0

摘要

背景与目的:非结核分枝杆菌(NTM)肺部疾病表现为结核感染,但对主要抗结核药物具有耐药性。因此,痰样本抗酸杆菌(AFB)和细菌培养多次呈阳性的患者,应评估继发于结核病的受损肺中NTM的定植或感染。在这种情况下,虽然耐药结核病可以得到充分治疗,但治疗也可能需要针对NTM。在NTM治疗中,持续时间和治疗剂的选择取决于具体的生物体和疾病程度。本研究采用一步多重PCR (mPCR)方法对Ogawa培养基中固体培养物快速分化为结核分枝杆菌(MTB)和/或结核分枝杆菌(NTM)。方法:对2018年1月至12月从菲律宾肺中心获得的80株库存分离株进行小川培养基生长、酸牢度和MPT64 TB抗原检测结果的NTM筛选。这些数据来自耐多药结核病(MDR-TB)患者的痰标本。从在Ogawa培养基中培养的培养液(n=55)中提取DNA,并进行一步mPCR鉴定NTM至物种水平。结果:在80份样本中,共有55株分离株被鉴定为NTM。其中,12.73%(7/55)为脓肿支原体,34.55%(19/55)为马氏支原体,1.82%(1/55)为堪萨斯支原体,50.91%(28/55)为分枝杆菌属,未检出复合支原体和胞内支原体。结论:MPT64结核抗原试验的初步筛选结果与一步法mPCR鉴定MTB或NTM的结果一致。多重PCR在种水平上的鉴定更为特异。使用mPCR识别MTB和临床显著的NTM适合于分枝杆菌感染的充分治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Identification of Nontuberculous Mycobacteria in Patients with Multidrug-resistant Tuberculosis in Quezon City, Philippines, Using Multiplex PCR.

Background and objective: Nontuberculous mycobacteria (NTM) lung disease appears like tuberculosis infection but is resistant to primary anti-tuberculosis drugs. Hence, patients whose sputum sample tests positive for acid-fast bacilli (AFB) and bacterial culture for several times should be assessed for colonization or infection with NTM in a damaged lung secondary to TB. In such cases, though drug-resistant TB may be adequately treated, treatment may need to be directed towards the NTM as well. In NTM therapy, the duration and choice of treatment agent is based upon the specific organism and disease extent. This study used one-step multiplex PCR (mPCR) assay for rapid differentiation of solid cultures in Ogawa medium as Mycobacterium tuberculosis (MTB) and/or NTM.

Methods: A total of 80 stocked isolates obtained from the Lung Center of the Philippines from January to December 2018 were screened for NTM in terms of growth in Ogawa medium, acid fastness, and MPT64 TB antigen test result. These were from sputum specimens of multidrug-resistant tuberculosis (MDR-TB) patients. DNA was extracted from cultures (n=55) grown in Ogawa medium and one-step mPCR was performed to identify NTM to the species level.

Results: Out of 80 samples screened, a total of 55 isolates were identified as NTM. One-step mPCR identified 12.73% (7/55) as M. abscessus, 34.55% (19/55) as M. massiliense, 1.82% (1/55) as M. kansasii, and 50.91% (28/55) were identified only up to genus Mycobacteria spp. Neither M. avium complex nor M. intracellulare was identified among the samples tested.

Conclusion: One-step mPCR was able to identify isolates as MTB or NTM coinciding with the initial screening using MPT64 TB antigen test. Multiplex PCR has given a more specific identification to the species level. The use of mPCR in identifying MTB and clinically significant NTM's is suitable for the adequate treatment of mycobacterial infection.

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Acta Medica Philippina
Acta Medica Philippina Medicine-Medicine (all)
CiteScore
0.40
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199
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