对艾滋病病人痰液中的抗酸分枝杆菌再认识

艾滋病（AIDS）病人由于后天获得免疫缺陷，分枝杆菌感染临床上甚为常见，但从AIDS病人痰液中检出抗酸分枝杆菌能否确认为结核分枝杆菌、患的就是肺结核呢？应给予再认识。     

自贡市非结核分枝杆菌临床分离株的菌种鉴定结果分析

目的 对自贡市35株疑似非结核分枝杆菌（NTM）临床分离株进行菌种鉴定。方法 从自贡市各区（县）及市结核病防治获得的临床分枝杆菌分离株,通过罗氏培养基（L-J）、对硝基苯甲酸（PNB）和噻吩-2-羧酸肼（TCH）鉴别培养基初步鉴定为NTM,再经多位点PCR方法确定为NTM后,对rpoB、hsp64及its基因进行测序及分析鉴定。结果 35株疑似NTM临床分离株,通过初步鉴别,多位点PCR,rpoB、hsp64及its基因测序及分析鉴别出32株NTM,分别为脓肿分枝杆菌（M. abscessus）11株、胞内分枝杆菌（M. intracellulare）7株、堪萨斯分枝杆菌（M. kansasii）5株、鸟分枝杆菌（M. avium）3株、脓毒分枝杆菌（M. septicum）1株、马赛分枝杆菌（M. masseillense）1株、戈登分枝杆菌（M. gordonae）2株、副瘰疬分枝杆菌（M. parascrofulaceum）1株和Mycobacterium peregrinum 1株。结论 抗酸染色阳性、PNB/TCH鉴定为NTM的临床分离株中包含不同种类的NTM,自贡市NTM肺病的病原种类较多,以快生长脓肿分枝杆菌为主,其次为慢生长不产色菌的胞内分枝杆菌和缓慢生长光产色菌的堪萨斯分枝杆菌。实验室应开展进一步菌种鉴定,以指导临床正确诊断和合理治疗。     

大环内酯类抗生素抗分枝杆菌作用的研究

目的研究大环内酯类抗生素抗分枝杆菌的作用。方法分别测定6种大环内酯类抗生素对20种分枝杆菌(包括结核、牛分枝杆菌和18种非结核分枝杆菌)的试管内最低抑菌浓度。结果不同药物显示不同的试管内抗菌作用谱。结论大环内酯类抗生素是临床非结核分枝杆菌病治疗可选择的药物。     

Use of spatial information to predict multidrug resistance in tuberculosis patients, Peru

To determine whether spatiotemporal information could help predict multidrug resistance at the time of tuberculosis diagnosis, we investigated tuberculosis patients who underwent drug susceptibility testing in Lima, Peru, during 2005-2007. We found that crude representation of spatial location at the level of the health center improved prediction of multidrug resistance.     

Multistate outbreak of MDR TB identified by genotype cluster investigation

In 2008, diagnosis and investigation of 2 multidrug-resistant tuberculosis cases with matching genotypes led to identification of an outbreak among foreign-born persons who performed short-term seafood production work in Alaska during 2006. Tuberculosis control programs should consider the possibility of domestic transmission even among foreign-born patients.     

Mycobacterium mucogenicum and other non-tuberculous mycobacteria in potable water of a trauma hospital: a potential source for human infection

This study examined the frequency of occurrence of non-tuberculous mycobacteria (NTM) in potable water samples from a main trauma hospital in Mexico City. Sixty-nine potable water samples were collected, 23 from each source: cistern, kitchen tap and bathroom showers. Of the 69 samples, 36 harboured NTM species. Twenty-nine of the 36 isolates were Mycobacterium mucogenicum, two Mycobacterium rhodesiae, one Mycobacterium peregrinum, one Mycobacterium fortuitum and three were Mycobacterium spp. Hospital potable water harbouring NTM represents a potential source for nosocomial infections, therefore we suggest that hospital potable water microbiological guidelines should include testing for NTM species.     

Mycobacterium chimaera causes tuberculosis-like infection in a male patient with anorexia nervosa

Here we present a 27-year-old male patient--with a known prolonged history of anorexia nervosa (AN)--suffering from tuberculosis like infection. At the time he was admitted to clinical treatment, he had developed fever up to 40°C and survived on a body mass index of 11.8. In this case, Mycobacterium chimaera, generally recognized for low pathogenicity, was identified as the causative agent. Remission from lung infection was achieved after antibiotic treatment according to laboratory susceptibility testing while earlier antituberculosis therapies had failed. Because of a large cavity in the upper left lung, surgical excision was necessary to prevent recurrence of lung infection. Moreover, stabilization of the patient general health problem needs to be supported by a lasting psychotherapy.