CAJ | 학술논문

目的：探讨广州地区艾滋病患者合并感染分枝杆菌菌种的分布特征。方法选择艾滋病合并分枝杆菌感染患者133例，非艾滋病合并分枝杆菌感染患者150例。提取分枝杆菌基因组DNA，用多基因测序分析的方法鉴定菌株。比较艾滋病患者与非艾滋病患者感染分枝杆菌的菌种分布，分析艾滋病患者 CD4＋ T 淋巴细胞水平与分枝杆菌菌种分布特点。计数资料的比较采用χ2检验。结果在艾滋病患者感染的133株分枝杆菌中，结核分枝杆菌复合群82株，非结核分枝杆菌51株；非结核分枝杆菌以鸟分枝杆菌复合群为主有31株。非艾滋病患者感染150株分枝杆菌中，结核分枝杆菌复合群126株，非结核分枝杆菌24株；非结核分枝杆菌以脓肿分枝杆菌为主（9株）。艾滋病患者 CD4＋ T淋巴细胞计数≤100／μL 时，分枝杆菌的检出率为75．94％（101／133），鸟分枝杆菌复合群的检出率为93．55％（29／31），其他非结核分枝杆菌的检出率为85．00％（17／20）；CD4＋ T 淋巴细胞计数＞100／μL时，各菌种的检出率均明显下降。结论广州地区艾滋病患者感染非结核分枝杆菌显著高于非艾滋病患者，且分别以鸟分枝杆菌复合群为主和以脓肿分枝杆菌为主。艾滋病患者 CD4＋ T 淋巴细胞计数越低，分枝杆菌感染率越高。
목적：탐토엄주지구애자병환자합병감염분지간균균충적분포특정。방법선택애자병합병분지간균감염환자133례，비애자병합병분지간균감염환자150례。제취분지간균기인조DNA，용다기인측서분석적방법감정균주。비교애자병환자여비애자병환자감염분지간균적균충분포，분석애자병환자 CD4＋ T 림파세포수평여분지간균균충분포특점。계수자료적비교채용χ2검험。결과재애자병환자감염적133주분지간균중，결핵분지간균복합군82주，비결핵분지간균51주；비결핵분지간균이조분지간균복합군위주유31주。비애자병환자감염150주분지간균중，결핵분지간균복합군126주，비결핵분지간균24주；비결핵분지간균이농종분지간균위주（9주）。애자병환자 CD4＋ T림파세포계수≤100／μL 시，분지간균적검출솔위75．94％（101／133），조분지간균복합군적검출솔위93．55％（29／31），기타비결핵분지간균적검출솔위85．00％（17／20）；CD4＋ T 림파세포계수＞100／μL시，각균충적검출솔균명현하강。결론엄주지구애자병환자감염비결핵분지간균현저고우비애자병환자，차분별이조분지간균복합군위주화이농종분지간균위주。애자병환자 CD4＋ T 림파세포계수월저，분지간균감염솔월고。
Objective To investigate the characteristics of mycobacteria species distribution in human immunodeficiency virus (HIV)-positive patients co-infected with mycobacteria in Guangzhou. Methods A total of 133 mycobacteria strains isolated from HIV-positive patients and 150 strains isolated from HIV-negative patients were included in this study. After DNA extraction of mycobacteria, mycobacteria species identification was performed by sequencing of multiple genes.Differences in the identified species were compared between patients with and without HIV infection and the correlation between CD4 + T cells level and the mycobacterial species distribution was analyzed.Chi-square test was used for statistical analysis.Results Of the 133 mycobacteria strains isolated from HIV-positive patients, 82 were identified as Mycobacterium tuberculosis complex (MTC ). Fifty-one were identified as nontuberculous mycobacteria (NTM),of which the main species was Mycobacterium avium complex (MAC,31/51).Of the 150 mycobacteria strains isolated from HIV-negative patients,126 were identified as MTC and 24 as NTM,of which the main species was Mycobacterium abscessus (9/24).In patients with CD4 + T cell counts ≤100/μL,the positive rate of mycobacteria was 75 .94%(101/133),93.55 %(29/31) of MAC and 85 .00%(17/20)of other NTM.When the CD4 + T cell counts >100/μL,the positive rate for mycobacteria were all obviously decreased.Conclusions The proportion of NTM infection is higher in HIV-positive patients than HIV-negative patients in Guangzhou. Among HIV-positive patients > the most prevalent NTM species is MAC, while Mycobacterium abscessus is the most common species in HIVnegative patients. Mycobacterial infection in acquired immunodeficiency syndrome patients is closely associated with low CD4+ cells level.