CAJ | 학술논문

目的分析马赛分枝杆菌肺病的临床特征,探讨其鉴别诊断方法.方法分析患者的临床表现及实验室检测结果,对其临床分离菌株进行细菌学检查和分子生物学鉴定,采用PCR扩增rpoB和hsp65基因片段和双向DNA测序,并与美国国立生物技术信息中心(NCBI)数据库比对进行菌种鉴定.结果患者女,72岁,体质瘦弱,因反复出现呼吸道症状而入院,既往多次治疗无效.该病例的临床分离菌株经细菌学检查和分子生物学鉴定确定为马赛分枝杆菌,rpoB和hsp65基因片段测序结果与NCBI数据库马赛分枝杆菌相应片段的同源性分别为100%和99%,结合临床表现确诊为马赛分枝杆菌肺病.药敏试验结果显示该菌株对多种药物耐药,根据药敏试验结果和患者的身体条件确定治疗方案,采用静脉滴注头孢西丁和口服阿米卡星治疗有效.结论马赛分枝杆菌肺病多发于免疫功能低下人群,其临床和影像学表现与结核病相似,通过实验室细菌学检测和菌种鉴定,可以对二者进行鉴别.
목적 분석마새분지간균폐병적림상특정,탐토기감별진단방법.방법 분석환자적림상표현급실험실검측결과,대기림상분리균주진행세균학검사화분자생물학감정,채용PCR확증rpoB화hsp65기인편단화쌍향DNA측서,병여미국국립생물기술신식중심(NCBI)수거고비대진행균충감정.결과 환자녀,72세,체질수약,인반복출현호흡도증상이입원,기왕다차치료무효.해병례적림상분리균주경세균학검사화분자생물학감정학정위마새분지간균,rpoB화hsp65기인편단측서결과여NCBI수거고마새분지간균상응편단적동원성분별위100%화99%,결합림상표현학진위마새분지간균폐병.약민시험결과현시해균주대다충약물내약,근거약민시험결과화환자적신체조건학정치료방안,채용정맥적주두포서정화구복아미잡성치료유효.결론 마새분지간균폐병다발우면역공능저하인군,기림상화영상학표현여결핵병상사,통과실험실세균학검측화균충감정,가이대이자진행감별.
Objective To analyze the clinical features and differential diagnosis of pulmonary infection with Mycobacterium massiliease (M.ruassiliense ).Methods The clinical manifestations and laboratory test results of our patient were analyzed and the strain isolated from the patient was tested by bacteriological and molecular methods.The partial gene fragments of rpoB and hsp65 were amplified by PCR, sequenced and compared with GeneBank database in NCBI for identification of Mycobacterium species.Results The patient was a 72 year old female, who had been admitted to hospital several times because of recurrent respiratory symptoms which had failed to improve upon treatment.This time, pulmonary infection with M.massiliense was confirmed by clinical manifestation and laboratory results.M.massilence isolated from the sputum of our patient was confirmed by bacteriological and molecular methods.The results of specific segments of rpoB and hsp65 tested by PCR and sequence analysis, and compared with that of mycobacterium in NCBI, showed that the DNA homology was 100% and 99% respectively.The results of drug sensitivity test showed that this strain was resistant to multiple drugs.According to the results of drug susceptibility tests and the condition of the patient, therapy with cefoxitin sodium and amikacin was used and the drugs were effective.Conclusions The clinical manifestations and the chest imaging of pulmonary infection with M.massiliens were similar to those of Mycobacterium tuberculosis, which can be differentiated by laboratory tests.