碩士 / 嘉南藥理大學 / 醫務管理系 / 106 / Nontuberculous mycobacteria (NTM), organisms ubiquitous in our environment, are opportunistic pathogens that are not transmitted by humans. Such NTM infections can cause many different diseases and syndromes. However, there are many differences among the strains of NTM, leading to different treatment schemes, so the identification of NTM is very important. This study identified possible infectious strains based on the NTM infection definition suggested by the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA). Multiple polymerase chain reactions (Multiplex PCR) and restriction fragment length polymorphism (RFLP) were used to identify bacterial strains. Finally, the identification results were tabulated to determine the incidence and prevalence of infections.
During the study period, of the 27,076 mycobacteria culture specimens that were examined, 2788 were culture positive with a culture positive rate of 10.3%. Of those positive cultures, 796 of them were MTBCs (28.55%) and 1992 of them were NTM (71.45%). Following the 2007 American Thoracic Society (ATS) guidelines, the total number of confirmed cases that met infection criteria was 799. Statistical analysis was performed, identifying 424 cases. The results showed that the MAC strains were the most common with 237 strains (55.9%). M. abscessus was second most common, with 58 strains(13.7%). Other cases, in order of decreasing incidence, included an unidentifiable NTM with 50 strains (11.8%), M. fortuitum, with 24 strains (5.7%), M. simiae with 15 strains (3.5%), M. gordonae with 13 strains (3.1%), M. kansasii with 10 strains (2.4%). There were 3 cases of corneal infections during the study, with M. abscessus as the infectious agent. There may be cluster infections. The patient characteristics survey found that there were more men than women, and the age was mainly between 51 and 90 years old.
In this study, the ATS infection definition was incorporated to the count the results of the culture positive cases. Compared with the general clinical microbiology laboratory, the number of positive cultures using NTM was used to count the number of cases. The comparison results were more representative of the trend of clinical infection. The results of this study can provide clinicians and health units with clinical reference to guide diagnostic reasoning.
| Identifer | oai:union.ndltd.org:TW/106CNUP0528018 |
| Date | January 2018 |
| Creators | Chiang, Chin-Cheng, 江金城 |
| Contributors | Chen, Jin-Liang, 陳珹箖 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 46 |
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