复治肺结核患者结核分枝杆菌L型培养结果分析

目的:了解复治肺结核患者的结核分枝杆菌L型培养情况,探讨结核分枝杆菌L型阳性与耐多药的关系。方法:选择180例肺结核患者的痰标本进行结核分枝杆菌培养和结核分枝杆菌L型培养,同时对110例复治组中培养阳性的标本行耐药监测。结果:复治组的L型阳性率为43.6%,初治组的L型阳性率为15.7%,复治组显著高于初治组(P<0.01);菌阳复治组的L型阳性率50%,菌阴复治组的L型阳性率39.4%,菌阳组明显高于菌阴组(P<0.05);L型菌阳性患者的耐药率显著高于L型菌阴性组(P<0.05)。结论:结核分枝杆菌L型阳性是引起结核病复发、耐药的重要原因;MDR-TB与结核分枝杆菌L型感染有关。     

结核分枝杆菌L型致病性的实验研究

以结核分枝杆菌稳定Ｌ型感染豚鼠,证明结核分枝杆菌变为Ｌ型后致病性减弱,发病时间延长,ＯＴ试验阴性,引起的病理变化主要表现为组织的间质性炎症,有干酪样坏死,而无典型结核结节形成。原因在于细菌变为Ｌ型后细胞壁缺损,磷脂减少,不足以刺激巨噬细胞转变为上皮样组胞与郎罕氏巨细胞,而形成结核结节。在诊断上容易造成误诊或漏诊。     

结核分枝杆菌滤过型的初步研究

目的研究结核分枝杆菌滤过型的生物学特性与检测方法。方法菌阴肺结核患者的结核分枝杆菌及其L型的液体培养物经0.45μm滤膜过滤后,涂片观察细菌形态,滤液分别进行分枝杆菌及其L型培养,并采用荧光基因定量法进行结核菌DNA检测。培养物用免疫组化染色鉴定,并采用透射电镜观察。结果30例痰、血滤前、滤后FQ-PCR检测同时阳性为53%,同时阴性为13%,滤前、滤后FQ-PCR结果符合率为67%。滤过后液体培养9例涂片见少许抗酸颗粒或椭圆性球菌。透射电镜见细胞壁缺失的"致密体"样细菌和细胞壁缺如菌。结论菌阴肺结核痰及血培养物中存在结核菌滤过型,滤过型携带遗传信息并可自我复制,采用生物学方法可以对其进行检测。     

分枝杆菌L型诱导

作者在TSA-L培养基上,应用D-环丝氨酸50μg/ml和异烟肼1μg/ml成功地诱导出耻垢杆菌和结核杆菌L型。其L型与原菌相比,表现有形态学的改变和抗酸染色性的变化,并且发现可能是由于两种药物的作用机制不同,其诱导结果也不尽相同。同时实验证明,在分枝杆菌L型的培养和诱导过程中,平皿胶布封口培养可以代替目前常用的烛缸培养,能减少污染又便于观察。     

结核分枝杆菌及其L型耐药机制与茜草素作用的研究进展

结核分枝杆菌的细菌型与L型(细胞壁缺陷型)的耐药,尤其是多重耐药和泛耐药现象对现有的临床抗结核治疗提出了严峻挑战.本文对结核分枝杆菌细菌型和L型耐药机制,以及中草药茜草素的抗菌作用进行了分析,以期建立有效的抗结核治疗方法,提高临床抗结核治疗水平.     

不同表型的结核分枝杆菌诱导U937细胞凋亡率差异分析

目的利用流式细胞技术检测耐多药结核分枝杆菌(Multidrug resistant mycobacterium tuberculosis,MDRTB)临床分离株和结核分枝杆菌一、二线药物敏感株分别感染U937细胞后的凋亡率及其时相性变化。方法用两组细菌分别感染U937细胞,在感染后2、4、8及12 h用流式细胞技术检测各组感染U937细胞的凋亡率,并分析其时相性变化。结果结核分枝杆菌MDR株和敏感株均能诱导U937细胞凋亡,两组细胞凋亡率比较差异有统计学意义(P0.01),MDR株诱导U937细胞凋亡率显著低于敏感株诱导的凋亡率,且在诱导后2、4、8及12 h各时间点的凋亡率都显著低于敏感株组,诱导早期凋亡率升高显著,特别是诱导后2 h凋亡率升高最显著,4 h以后凋亡率升高逐渐变慢。结论结核分枝杆菌临床分离株感染U937细胞后能快速诱导其凋亡,凋亡率与诱导菌株的耐药表型相关,敏感株诱导的凋亡率显著高于MDR株,诱导早期凋亡率升高最显著,4 h以后凋亡率升高减慢。     

泌尿系感染细菌L型培养结果分析

尿路感染是临床最常见的感染之一 ,而细菌 L型又是尿路感染较常见的细菌之一。L型细菌培养国内外已开展多年 ,我科近三年在作普通细菌培养的基础上 ,同时增设了 L型细菌培养 ,现将我们所作的 118例尿液标本培养鉴定结果分析报告如下。1　材料与方法1.1　材料　高渗增菌液 ,由武汉市临床检验中心提供。L 型培养基 ,购自浙江省军区后勤部卫生防疫检验所。细胞壁染色液 :10 %鞣酸、5 %龙胆紫。标本来源 :118例标本全部采自本院各科住院患者中段尿。1.2　方法1.2 .1　用无菌方法吸取 0 .1ml尿液于高渗增菌液内进行增菌培养 ,另取 0 .1ml尿液于…     

997例结核分枝杆菌的耐药性分析

目的分析结核病患者的耐药性和临床特点为临床治疗提供依据。方法回顾分析厦门大学附属厦门第一医院2011-2013年送检的结核病患者样本及其分离培养出的结核分枝杆菌的耐药性,为临床合理选用抗结核药物提供依据。结果结核病的耐药率相对较低,三年中全部敏感的分别为41.7%、40.1%和42.6%;结核病耐药性较高的药物主要是异烟肼(INH)、利福平(RFP)和链霉素(SM);复治结核病患者的耐药性明显高于初治患者,2011年RFP和EMB(乙胺丁醇)的P值0.05,INH、SM(链霉素)、PAS(对氨基水杨酸)、K(卡那霉素)、LFX(左氧氟沙星)的P值0.01;2012年EMB、PAS、K的P值0.05,INH、RFP、SM、LFX的P值0.01;2013年INH、SM、K的P值0.05,RFP、EMB、PAS、LFX的P值0.01;差异具有统计学意义。结论结核病的耐药性高,尤其是复治患者,临床上应根据药敏结果合理用药,针对不同患者建立不同治疗方案,加强护理及健康教育以提高治愈率。     

抗利福平结核分枝杆菌的多药耐药性调查

The correlation between rifampin resistance and multiple drug resistance in 236 clinical isolates of Mycobacterium tuberculosis was investigated in this thesis. It has found that 99.4% of the strains with rifampin resistance were multidrug-resistant strains and 89% of the multidrug-resistant strains were resistant to rifampin. This result showed that the rifampin resistance of Tuberculosis baccilli could be used as the marker of multidrug resistance of Mycobacterium tuberculosis.     

肺结核合并肺癌患者的临床分析

目的：探讨肺结核合并肺癌的临床特点,提高临床医师诊断肺结核合并肺癌的警惕性。方法：对2000年1月至2009年12月在我院诊断为肺结核、肺结核合并肺癌、肺癌患者各40例进行回顾性分析。结果：三组之间的临床表现与实验室检查进行相互比较,发现其临床表现并无统计学差异,影像学与支气管镜检查有明显统计学差异外,其他实验室检查无差异。结论：结核合并肺癌与肺结核、肺癌等临床表现、实验室检查近似,易造成漏诊、误诊,临床医师应提高警惕,及时行影像学及支气管镜等检查。     

Tuberculosis patients co-infected with Mycobacterium bovis and Mycobacterium tuberculosis in an urban area of Brazil

In this cross-sectional study, mycobacteria specimens from 189 tuberculosis (TB) patients living in an urban area in Brazil were characterised from 2008-2010 using phenotypic and molecular speciation methods (pncA gene and oxyR pseudogene analysis). Of these samples, 174 isolates simultaneously grew on Löwenstein-Jensen (LJ) and Stonebrink (SB)-containing media and presented phenotypic and molecular profiles of Mycobacterium tuberculosis, whereas 12 had molecular profiles of M. tuberculosis based on the DNA analysis of formalin-fixed paraffin wax-embedded tissue samples (paraffin blocks). One patient produced two sputum isolates, the first of which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, and the second of which only grew on SB media and presented phenotypic profiles of Mycobacterium bovis. One patient provided a bronchial lavage isolate, which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, but had molecular profiles of M. bovis from paraffin block DNA analysis, and one sample had molecular profiles of M. tuberculosis and M. bovis identified from two distinct paraffin blocks. Moreover, we found a low prevalence (1.6%) of M. bovis among these isolates, which suggests that local health service procedures likely underestimate its real frequency and that it deserves more attention from public health officials.     

Prevalence and Drug Resistance Pattern of Mycobacterium Tuberculosis Isolated from Tuberculosis Patients in Basra,Iraq

Drug-resistant Mycobacterium tuberculosis (DR-MTB) is a major health threat to human beings. This study aimed to evaluate the prevalence and drug resistance profile of MTB. Data were collected from 2,296 newly diagnosed, and 246 retreated tuberculosis (TB) patients who attended the Advisory Clinic for Chest Diseases and Respiratory in Basra province from January 2016 to December 2020. Both new diagnostic and retreated TB cases showed that DR-MTB cases were significantly higher at age 15–34 years, pulmonary TB, and urban residents but with no significant difference regarding gender. The drugs resistance was significantly higher among the retreated cases compared with the new diagnostic patients (20.3% vs. 2.4%, p < 0.0001), with the percentage of the resistance to first-line drugs in primary and secondary cases including isoniazid (1% and 17.1%), rifampicin (0.78% and 15.8%), ethambutol (0.56% and 8.5%), streptomycin (1.3% and 9.75%). Notice that the most common drug resistance was against streptomycin with 1.3% in new patients and against isoniazid (17.1%) in retreated patients. The rate of total drug-resistant TB, multi-drug resistant TB, mono-drug resistant TB, and rifampicin-resistant TB among new tuberculosis cases increased in this period from 2.2 to 6.7%, 0.17 to 1.6%, 0.85 to 4%, and 0.17 to 4%, with a percentage change of 204.54, 841.17, 370.58, 22.5%, respectively. The rates of poly drug-resistant TB and ethambutol-resistant-TB dropped in this period by 15.96%, and 0.7%, with a decrease from 1.19 to 1% and from 1 to 0.3%, respectively. Similarly, the increase of drug-resistant TB among secondary cases has also occurred. In conclusion, the temporal trend showed an increase in the rate of drug resistance of M. tuberculosis since 2016, with a predominant multi-drug-resistant TB and isoniazid-resistant TB. Open in a separate window     

肺结核合并肺癌患者的临床分析

目的:探讨肺结核合并肺癌的临床特点,提高临床医师诊断肺结核合并肺癌的警惕性.方法:对2000年1月至2009年12月在我院诊断为肺结核、肺结核合并肺癌、肺癌患者各40例进行回顾性分析.结果:三组之间的临床表现与实验室检查进行相互比较,发现其临床表现并无统计学差异,影像学与支气管镜检查有明显统计学差异外,其他实验室检查无差异.结论:结核合并肺癌与肺结核、肺癌等临床表现、实验室检查近似,易造成漏诊、误诊,临床医师应提高警惕,及时行影像学及支气管镜等检查.     

肺结核患者血细胞结果特点分析

目的:为肺结核的诊断及观察预后提出新的思路。方法:对新住院肺结核患者的血常规标本400份及以上患者出院前血常规标本400份,使用MEK-6318K血细胞分析仪检测分析。结果:新住院400例肺结核患者中血小板计数>300×109/L的92例,占23%。92例血小板计数升高的患者中,除9例贫血患者外,83例患者中红细胞计数和血红蛋白量都不低于参考值,但红细胞计数和血红蛋白量呈现不一致性,即针对血红蛋白量而红细胞计数偏高,体现出小红细胞少量增多,这种情况在83例中所占比例为86%。出院前400例肺结核患者血小板计数>300×109/L的5例,占1.2%。结论:由于肺结核患者大多数伴有营养不良,导致造血系统功能障碍,导致小红细胞少量增多,增多的小红细胞被血细胞分析仪计数到血小板计数里,导致血小板计数偏高。这个指标在肺结核诊断中意义很大,为肺结核的诊断探索出新的思路。     

结核分枝杆菌乙胺丁醇耐药机制的研究进展

耐多药结核病的出现和流行对结核病的防控造成了严重威胁。乙胺丁醇(Ethambutol, EMB)是一线抗结核药物,常与异烟肼、利福平等联合应用,还可用于耐药结核病的治疗。但近年来EMB耐药形势严峻,我国复治结核病患者中EMB耐药率已达17.2%,并呈上升趋势;耐多药结核病患者中,EMB耐药率约为51.3%~66.7%,情况不容乐观。明确EMB耐药的产生机制对于有效防控EMB耐药率的上升、充分发挥EMB的作用十分重要,因此本文对结核分枝杆菌EMB的耐药现状、EMB的作用机制及其耐药产生机制方面的研究进展进行了综述。     

A Study of Unusual Pacemaker Infection by Mycobacterium Tuberculosis in Indian Patients

Background

The expanding clinical indications of cardiac rhythm management have led to an increased use of pacemaker implantation which is associated with increased incidence of pacemaker infections. Staphylococcus aureus and epidermidis account for the vast majority of pacemaker infections. Pacemaker infection due to Mycobacterium tuberculosis (M. tuberculosis) is very rare, only few cases having been reported till date.

Methods

We describe here a study of three patients of pacemaker pocket infection with M. tuberculosis.

Conclusion

The possibility of mycobacterial pacemaker infection should always be kept in mind in patients with delayed pacemaker infection.     

新疆喀什维吾尔族结核病患者结核分枝杆菌5个VNTRs基因分型研究

目的:应用多位点数目可变串联重复序列分析(multiple loci VNTR analysis,MLVA)技术,对新疆喀什地区维吾尔族结核病患者结核分枝杆菌临床分离株进行基因分型,探讨5个数目可变串联重复序列(VNTR)基因型种类及其分布。方法:收集结核分枝杆菌,采用PCR和琼脂糖凝胶电泳技术,结合BioNumerics5.0软件,对其5个VNTR位点进行结果分析。结果:分离出58株结核分枝杆菌,分为4个基因群21个基因型,分别为Ⅰ群占19.1%,含7个基因型;Ⅱ群占3.4%,含2个基因型;Ⅲ群占67.2%,含9个基因型;Ⅳ群占10.3%,含5个基因型。结论:新疆喀什地区维吾尔族结核病患者的结核分枝杆菌存在明显的基因多态性,且存在主要流行菌群。     

结核分枝杆菌蛋白抗原的研究进展

结核病当今世界人类致死的主要疾病之一,早期诊断发现病人、选择敏感的抗结核药物进行有效治疗是控制结核病的关键。而临床上对结核病患者检出率低,漏诊率和误诊率高,结果导致结核耐药的情况越来越严重。简便、快速、准确的免疫学检测方法在诊断结核病中起到了重要的作用。本文对用于免疫学检测的蛋白抗原作一综述。