Characteristcs of mycobacterial species distribution in acquired immunodeficiency syndrome patients with mycobacterial infection in Shanghai

doi:10.16150/j.1671-2870.2022.04.006

Abstract

Abstract:

Objective: To analyze the distribution of mycobacterium(MB) species in patients with AIDS and with MB. Methods: From January 1, 2012 to December 31, 2021, a total of 9 619 outpatients and inpatients with AIDS and with mycobacterial culture in the Shanghai Public Health Clinical Center were enrolled. The clinical data of those with positive culture of MB were analyzed, and the isolated strains were obtained. The strains were identified using the immunocolloidal gold method of MPB64, a specific secreted protein of tubercle bacilli, or mycobacterial sequencing (16S rDNA) method, and the distribution characteristics of strains in AIDS patients with MB infection were analyzed. Results: A total of 1 478 patients got a positive result of MB culture and among them, 1 367 patients obtained an identified strain species result, including 494 (36.1%) cases of mycobacterium tuberculosis complex (MTBC), 838 (61.3%) cases of non-tuberculous mycobacteria (NTM), and 35 (2.6%) cases of MTBC combined with NTM. The year-by-year composition of NTM (patients with mixed MTBC and NTM infection are not included) from 2012 to 2021 were 55.2%(53/96), 65.5% (78/119), 66.2% (90/136), 55.1% (70/127), 61.6% (93/151), 66.1% (111/168), 58.9% (99/168), 61.8% (94/152), 63.6%(77/121), and 56.6% (73/129). Sputum was the main tissue specimen, accounted for 68.0% (336/494), 78.0% (654/838) and 88.6% (31/35) in patients with MTBC, NTM, mixed MTBC-NTM infection, respectively. One thousand two hundred and seventy-one patients with positive MB culture were admitted to the Department of Infection and Immunology, of which the NTM accounted for 58.5%(743/1 271). Conclusions: From 2012 to 2021, the positive rate of MB culture among AIDS patients in Shanghai is 15.4%(1 478/9 619), of which the composition ratio of NTM are higher than that of MTBC over the years. This suggests that clinicians should pay high attention to the diagnosis and treatment of NTM.

Key words: Human immunodeficiency virus/Acquired immune deficiency syndrome, Mycobacterium tuberculosis, Non-tuberculous mycobacteria

CLC Number:

R541.7

HU Jingjing, LÜ Haiwei, XUN Jingna, SHEN Yinzhong, LIU Li, LU Hongzhou. Characteristcs of mycobacterial species distribution in acquired immunodeficiency syndrome patients with mycobacterial infection in Shanghai[J]. Journal of Diagnostics Concepts & Practice, 2022, 21(04): 450-455.

Figures/Tables 2

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标本类型	MTBC （n=494）	NTM （n=838）	MTBC兼NTM （n=35）
痰液	336（68.0）	654（78.0）	31（88.6）
血液	83（16.8）	160（19.1）	8（22.9）
粪便	24（4.9）	59（7.0）	5（14.3）
脑脊液	33（6.7）	13（1.6）	2（5.7）
穿刺液	16（3.2）	17（2.0）	0（0）
灌洗液	11（2.2）	17（2.0）	1（2.9）
胸水	23（4.7）	5（0.6）	1（2.9）
分泌物	14（2.8）	11（1.3）	0（0）
尿液	7（1.4）	11（1.3）	2（5.7）
支刷物	1（0.2）	6（0.7）	0（0）
腹水	3（0.6）	3（0.4）	0（0）
引流物	5（1.0）	0（0）	0（0）