两种结核分枝杆菌快速检测方法的比较

目的比较荧光定量PCR检测和直接扩增检测两种方法对结核分枝杆菌检测的敏感性、特异性,及在国境口岸卫生检疫工作中的应用前景。方法应用结核分枝杆菌荧光定量PCR和直接扩增检测47份疑似或确诊活动性肺结核空腹痰标本,并与液体培养结果进行比较。结果荧光定量PCR法与直接扩增法对结核分枝杆菌检测敏感性分别为46.7%和100%,特异性分别为81.2%和84.4%。结论结核分枝杆菌直接扩增检测是一种较为敏感而特异的快速检测方法,在国境口岸卫生检疫部门具有重要的应用价值。     

结核分枝杆菌的检验与分型

目的 结核患者的结核分枝杆菌检验和分型.方法 采用PCR及琼脂糖凝胶电泳技术,针对124株结核分枝杆菌的6个可变重复位点做了检验,并应用Gel-Proanalyer3.0软件及BioNumerics(Version3.0)软件对检验结果做了相关的基因型分析,又分析了基因检测与分型之间的关系.结果 136株结核分枝杆菌共分为37个不同的VNTR类型,成簇基因型占74.26％(101/136),单一基因型占25.74％(35/136).结论 耐药菌株的检测在分布上存在统计学的差别.     

非结核分枝杆菌感染与自噬的关系

非结核分枝杆菌(non-Tuberculous Mycobacteria,NTM)是指除结核分枝杆菌（Mycobacterium tuberculosis, M.tuberculosis,MTB）和麻风分枝杆菌以外的其他分枝杆菌。NTM感染后可长期在人体内存在并在合适的条件下发病。自噬在人体巨噬细胞清除病原体的过程中起着重要的作用。NTM的持续感染和巨噬细胞的自噬调控过程密切相关,但其机制尚未完全阐明。本文以不同NTM与巨噬细胞自噬的发生发展为切入点,总结了NTM感染介导的自噬过程的分子机制及其临床意义。     

结核分枝杆菌感染性腹膜炎超声诊断的分析

目的分析超声检查在结核分枝杆菌感染性腹膜炎患者诊断中的临床价值,为结核分枝杆菌感染性腹膜炎的诊断提供参考。方法调查2009年1月-2012年12月于医院经超声检查初步诊断为结核分枝杆菌感染性腹膜炎患者病历资料,对其超声检查结果进行分析。结果在92例患者中经诊断性治疗、临床表现、体检、超声等辅助检查明确诊断为结核分枝杆菌感染性腹膜炎患者83例,超声诊断符合率为90.22%;超声检查主要表现为腹水、网膜肠管粘连、腹膜壁增厚、淋巴结肿大、肠管聚集;发生腹水89例占96.74%,腹膜壁增厚63例占68.48%,网膜肠管粘连33例占35.87%,肠管聚集23例占25.00%,淋巴结肿大19例占20.65%。结论在进行结核分枝杆菌性腹膜炎诊断与鉴别时,超声检查具有无创、高效、便捷的优点,值得临床推广使用。     

结核分枝杆菌腹膜炎患者超声诊断的分析

目的探讨结核分枝杆菌感染性腹膜炎患者应用超声诊断的价值。方法选择2013年1月-2015年1月50例结核分枝杆菌感染性腹膜炎患者进行研究,对所有患者采用超声诊断,记录其诊断结果。结果 50例结核分枝杆菌感染性腹膜炎患者应用超声诊断为单纯腹水型27例占54.0%,团块型15例占30.0%,腹膜、增壁增厚型8例占16.0%;结核分枝杆菌感染性腹膜炎患者中腹痛和腹部压痛均为42例,分布率均为84.0%,有2.0%~19.0%的患者伴有发热、盗汗、消瘦、便秘、恶心、腹泻、腹部柔韧感和腹部包块;50例患者经过超声诊断,共检出结核分枝杆菌腹膜炎合并腹膜外结核患者19例,检出率38.0%;结核分枝杆菌感染性腹膜炎患者检出有不同程度的腹腔积液,其中50例患者均呈现外观淡黄色浑浊或无色透明液体,48例检出白细胞>500×105/L,检出率为96.0%。结论超声诊断对结核分枝杆菌感染性腹膜炎患者的诊断具有重要意义,可以成为结核分枝杆菌感染性腹膜炎患者检测的首选方式之一。     

两种菌落形态的金结核分枝杆菌引起导管相关血流感染1例并文献复习

金结核分枝杆菌(Mycobacterium aurum,M. aurum)是一种革兰阳性、抗酸染色阳性的细菌,属快速生长分枝杆菌(rapidly growing mycobacteri-um,RGM),常产生色素.M.aurum广泛存在于环境中,几乎不引起人体感染[1].研究[2-3]发现,M.aurum具有与结核分枝...     

结核分枝杆菌感染性腹膜炎诊断中超声的应用价值研究

目的探讨超声在结核分枝杆菌感染性腹膜炎诊断中的应用价值,为结核分枝杆菌感染性腹膜炎的诊断提供参考。方法收集2010年1月-2013年1月123例临床怀疑结核分枝杆菌感染性腹膜炎患者临床资料,所有患者均行超声检查,以实验室检查、手术、病理证实为结核分枝杆菌感染性腹膜炎为金标准。结果 123例可疑患者中超声检查初步诊断为结核分枝杆菌感染性腹膜炎患者85例占69.1%;其中80例有腹水占94.1%,腹膜增厚56例占65.9%,肠管粘连30例占35.3%,淋巴结肿大16例占18.8%;可疑患者中最终确诊为结核分枝杆菌感染性腹膜炎患者88例,非结核分枝杆菌感染性腹膜炎患者35例,超声对结核分枝杆菌感染性腹膜炎的诊断结果显示,准确率93.5%,敏感度94.3%,特异度94.2%,阳性似然比16.3,阴性似然比0.06,阳性预测值97.6%,阴性预测值86.8%。结论超声对结核分枝杆菌感染性腹膜炎有较好的临床诊断价值,无创、操作简单,值得临床推广应用。     

microRNA与结核分枝杆菌感染的致病机制研究进展

结核病是一类严重危害人类生命健康的呼吸道传染病,由结核分枝杆菌感染引起,在全球内影响重大。结核病在早期诊断后可获得较好的治疗效果,同时,在结核分枝杆菌感染后,微小RNA(microRNA,miRNA)参与结核病发病机制,与其发生发展存在一定关系。因此,本文就miRNA与结核分枝杆菌感染的致病机制的研究进展进行综述,为今后结核病的早期预防、及时治疗等提供新的研究思路。     

MPB64抗原检测对分枝杆菌菌型快速鉴别的价值探讨

结核病的控制关键在于早发现和早治疗,在结核的确诊中,必须进行患者痰结核菌的培养鉴定。传统分枝杆菌菌型鉴别耗时长、操作复杂;特异性的核酸探针的检测鉴定方法,需要昂贵的设备和试剂,难以在日常的检查中推广。本实验利用结核分枝杆菌胶体金法对该菌分泌的MPB64特异性蛋白进行检测,以对结核分枝杆菌和非结核分枝杆菌进行鉴别。     

非结核分枝杆菌疾病的现代诊断与治疗

非结核分枝杆菌（Nontuberculous mycobacterium) 常存在于自然环境中,可引起人类的慢性疾病。其感染发病率逐年上升,临床诊断和治疗较困难,且存在争议,需要长期而难以耐受的治疗过程,不易根治。美国胸科协会于2007年第3次发布了关于非结核分枝杆菌疾病的诊疗指南,阐明其感染的流行病学、诊断、治疗和预后。     

Robust fit of Bayesian mixed effects regression models with application to colony forming unit count in tuberculosis research

Early bactericidal activity of tuberculosis drugs is conventionally assessed using statistical regression modeling of colony forming unit (CFU) counts over time. Typically, most CFU counts deviate little from the regression curve, but gross outliers due to erroneous sputum sampling are occasionally present and can markedly influence estimates of the rate of change in CFU count, which is the parameter of interest. A recently introduced Bayesian nonlinear mixed effects regression model was adapted to offer a robust approach that accommodates both outliers and potential skewness in the data. At its most general, the proposed regression model fits the skew Student t distribution to residuals and random coefficients. Deviance information criterion statistics and compound Laplace‐Metropolis marginal likelihoods were used to discriminate between alternative Bayesian nonlinear mixed effects regression models. We present a relatively easy method to calculate the marginal likelihoods required to determine compound Laplace‐Metropolis marginal likelihoods, by adapting methods available in currently available statistical software. The robust methodology proposed in this paper was applied to data from 6 clinical trials. The results provide strong evidence that the distribution of CFU count is often heavy tailed and negatively skewed (suggesting the presence of outliers). Therefore, we recommend that robust regression models, such as those proposed here, should be fitted to CFU count.     

利福霉素耐药结核分枝杆菌rpoB突变与利福布丁耐药水平的关系

目的研究利福霉素耐药结核分枝杆菌 rpoB基因突变与利福布丁耐药水平的相关性。方法倍比稀释法测定64株利福霉素耐药及6株敏感菌株对利福布丁的最低抑菌浓度(MIC),并分析其对异烟肼的耐药情况。同时对rpoB全基因扩增后测序,分析rpoB突变位点和突变性质与利福布丁MICs高低及多重耐药的关系。结果6株敏感株rpoB未突变,MICs为 0.25～0.50 mg/L。64株耐药株rpoB突变率为100％。37株利福布丁高度耐药(MICs≥4 mg/L)株中,S531L突变27株,H526R突变和Y389C突变各2株,S531W、H526Y、Q513K、V176F、D516Y联合Q253R突变与D516G联合L511P突变各1株。17株中度耐药 (MICs 2～4 mg/L) 株中,S531L突变16株,D516G联合L511P和S509R突变1株。10株低度耐药（MICs 0.25～1 mg/L）株中,L533P、H526L、H526S、D516V、D516Y单点突变各2株。93.75％(60/64)的利福霉素耐药株对异烟肼耐药。结论检测rpoB突变即可初步筛选多重耐药结核分枝杆菌;中、高水平利福布丁耐药株以S531L突变占绝对优势,rpoB突变位点及突变类型与利福布丁耐药水平有一定相关性。     

A novel nanoemulsion vaccine induces mucosal Interleukin-17 responses and confers protection upon Mycobacterium tuberculosis challenge in mice

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb) is contracted via aerosol infection, typically affecting the lungs. Mycobacterium bovis bacillus Calmette-Guerin (BCG) is the only licensed vaccine and has variable efficacy in protecting against pulmonary TB. Additionally, chemotherapy is associated with low compliance contributing to development of multidrug-resistant (MDR) and extensively drug-resistant (XDR) Mtb. Thus, there is an urgent need for the design of more effective vaccines against TB. Experimental vaccines delivered through the mucosal route induce robust T helper type 17 (Th17)/ Interleukin (IL) -17 responses and provide superior protection against Mtb infection. Thus, the development of safe mucosal adjuvants for human use is critical. In this study, we demonstrate that nanoemulsion (NE)-based adjuvants when delivered intranasally along with Mtb specific immunodominant antigens (NE-TB vaccine) induce potent mucosal IL-17 T-cell responses. Additionally, the NE-TB vaccine confers significant protection against Mtb infection, and when delivered along with BCG, is associated with decreased disease severity. These findings strongly support the development of a NE-TB vaccine as a novel, safe and effective, first-of-kind IL-17 inducing mucosal vaccine for potential use in humans.