腎移植患者胞內分枝桿菌感染的分子診斷_《華西醫學》

作者：

王曉輝 ^1,2 , 姜勇 ³ , 周陶友 ^1,2 ,  宗志勇 ^1,2

四川大學華西醫院（成都，610041）1感染性疾病中心，2生物治療國家重點實驗室感染性疾病研究室，3病理科;

關鍵詞：

胞內分枝桿菌分子診斷腎移植皮膚軟組織感染 hsp65基因

DOI：

10.7507/1002-0179.20130306

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目的　探討腎移植患者非結核分枝桿菌（NTM）病臨床特點及分子診斷。方法　回顧性分析2011年4月1例皮膚軟組織NTM感染的腎移植患者的臨床特點，并以其病變組織DNA為模板，聚合酶鏈反應（PCR）擴增hsp65基因和rpoB基因序列，測序比對鑒定其NTM菌種。結合文獻復習NTM病及分析分子生物學技術在移植患者NTM感染診斷中的作用。結果　該腎移植患者系皮膚軟組織胞內分枝桿菌感染，臨床特點與結核病極其相似，難以進行鑒別診斷。PCR擴增、測序的結果顯示hsp65產物和rpoB產物序列與胞內分枝桿菌GeneBank中FJ643456.1及CP003324.1序列100%一致。結論　NTM病的臨床表現與結核病相似，分子生物學方法鑒定菌種對移植患者胞內分枝桿菌病的診斷有幫助。

引用本文： 王曉輝,姜勇,周陶友,宗志勇. 腎移植患者胞內分枝桿菌感染的分子診斷. 華西醫學, 2013, 28(7): 984-987. doi: 10.7507/1002-0179.20130306 復制

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4.	Dai J, Chen Y, Lauzardo M. Web-accessible database of hsp65 sequences from Mycobacterium reference strains [J]. J Clin Microbiol, 2011, 49(6): 2296-2303.
5.	Lai CC, Tan CK, Chou CH, et al. Increasing incidence of nontuberculous mycobacteria, Taiwan, 2000-2008 [J]. Emerg Infect Dis, 2010, 16(2): 294-296.
6.	Thomson RM. Changing epidemiology of pulmonary nontuberculous mycobacteria infections [J]. Emerg Infect Dis, 2010, 16(10): 1576-1583.
7.	Nicholson O, Feja K, LaRussa P, et al. Nontuberculous mycobacterial infections in pediatric hematopoietic stem cell transplant recipients: case report and review of the literature [J]. Pediatr Infect Dis J, 2006, 25(3): 263-267.
8.	Haas S, Scully B, Cohen D, et al. Mycobacterium avium complex infection in kidney transplant patients [J]. Transpl Infect Dis, 2005, 7(2): 75-79.
9.	Gupta A, Clauss H. Prosthetic joint infection with Mycobacterium avium complex in a solid organ transplant recipient [J]. Transpl Infect Dis, 2009, 11(6): 537-540.
10.	Caroti L, Zanazzi M, Rogasi P, et al. Subcutaneous nodules and infectious complications in renal allograft recipients [J]. Transplant Proc, 2010, 42(4): 1146-1147.
11.	Singh S, Yosypiv IV, Iorember FM. Disseminated mycobacterium avium complex infection in a pediatric renal transplant recipient [J]. Clin Pediatr (Phila), 2011, 51(9): 892-895.
12.	David NG, Robert CM, George M. Sanford guide to antimicrobial therapy [M]. 40 ed. Sperryville: Antimicrobial Therapy, 2011: 122-123.
13.	Kim BJ, Lee SH, Lyu MA, et al. Identification of mycobacterial species by comparative sequence analysis of the RNA polymerase gene (rpoB) [J]. J Clin Microbiol, 1999, 37(6): 1714-1720.
14.	McNabb A, Adie K, Rodrigues M, et al. Direct identification of mycobacteria in primary liquid detection media by partial sequencing of the 65-kilodalton heat shock protein gene [J]. J Clin Microbiol, 2006, 44(1): 60-66.
15.	Ong CS, Ngeow YF, Yap SF, et al. Evaluation of PCR-RFLP analysis targeting hsp65 and rpoB genes for the typing of mycobacterial isolates in Malaysia [J]. J Med Microbiol, 2010, 59(Pt 11): 1311-1316.

1. 　全國第五次結核病流行病學抽樣調查技術指導組. 2010年全國第五次結核病流行病學抽樣調查報告[J]. 中國防癆雜志, 2012, 34(8): 485-508.
2. 　Telenti A, Marchesi F, Balz M, et al. Rapid identification of mycobacteria to the species level by polymerase chain reaction and restriction enzyme analysis [J]. J Clin Microbiol, 1993, 31(2): 175-178.
3. 　Kim BJ, Lee KH, Park BN, et al. Differentiation of mycobacterial species by PCR-restriction analysis of DNA (342 base pairs) of the RNA polymerase gene (rpoB) [J]. J Clin Microbiol, 2001, 39(6): 2102-2109.
4. 　Dai J, Chen Y, Lauzardo M. Web-accessible database of hsp65 sequences from Mycobacterium reference strains [J]. J Clin Microbiol, 2011, 49(6): 2296-2303.
5. 　Lai CC, Tan CK, Chou CH, et al. Increasing incidence of nontuberculous mycobacteria, Taiwan, 2000-2008 [J]. Emerg Infect Dis, 2010, 16(2): 294-296.
6. 　Thomson RM. Changing epidemiology of pulmonary nontuberculous mycobacteria infections [J]. Emerg Infect Dis, 2010, 16(10): 1576-1583.
7. 　Nicholson O, Feja K, LaRussa P, et al. Nontuberculous mycobacterial infections in pediatric hematopoietic stem cell transplant recipients: case report and review of the literature [J]. Pediatr Infect Dis J, 2006, 25(3): 263-267.
8. 　Haas S, Scully B, Cohen D, et al. Mycobacterium avium complex infection in kidney transplant patients [J]. Transpl Infect Dis, 2005, 7(2): 75-79.
9. 　Gupta A, Clauss H. Prosthetic joint infection with Mycobacterium avium complex in a solid organ transplant recipient [J]. Transpl Infect Dis, 2009, 11(6): 537-540.
10. 　Caroti L, Zanazzi M, Rogasi P, et al. Subcutaneous nodules and infectious complications in renal allograft recipients [J]. Transplant Proc, 2010, 42(4): 1146-1147.
11. 　Singh S, Yosypiv IV, Iorember FM. Disseminated mycobacterium avium complex infection in a pediatric renal transplant recipient [J]. Clin Pediatr (Phila), 2011, 51(9): 892-895.
12. 　David NG, Robert CM, George M. Sanford guide to antimicrobial therapy [M]. 40 ed. Sperryville: Antimicrobial Therapy, 2011: 122-123.
13. 　Kim BJ, Lee SH, Lyu MA, et al. Identification of mycobacterial species by comparative sequence analysis of the RNA polymerase gene (rpoB) [J]. J Clin Microbiol, 1999, 37(6): 1714-1720.
14. 　McNabb A, Adie K, Rodrigues M, et al. Direct identification of mycobacteria in primary liquid detection media by partial sequencing of the 65-kilodalton heat shock protein gene [J]. J Clin Microbiol, 2006, 44(1): 60-66.
15. 　Ong CS, Ngeow YF, Yap SF, et al. Evaluation of PCR-RFLP analysis targeting hsp65 and rpoB genes for the typing of mycobacterial isolates in Malaysia [J]. J Med Microbiol, 2010, 59(Pt 11): 1311-1316.

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腎移植患者胞內分枝桿菌感染的分子診斷

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《華西醫學》

腎移植患者胞內分枝桿菌感染的分子診斷

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