初治肺结核患者与健康人群呼吸道细菌与真菌微生态比较  

A comparative study of respiratory tract bacterial and fungal microecology in patients with primary pulmonary tuberculosis and healthy population

作　　者：黄业伦[1] 刘志辉[1] 张院良[1] 康晓明 林媛[1] 吴碧彤[1] 蔡杏珊[1] HUANG Yelun;LIU Zhihui;ZHAGN Yuanliang;KANG Xiaoming;LIN Yuan;WU Bitong;CAI Xingshan(State Key Laboratory of Respiratory Diseasesin Guangzhou Chest Hospital,Guangzhou 510095,China)

机构地区：[1]广州市胸科医院呼吸疾病国家重点实验室,广州510095

出　　处：《实用医学杂志》2022年第6期685-690,共6页The Journal of Practical Medicine

基　　金：广东省医学科学技术研究基金项目(编号:A2019342)。

摘　　要：目的 探讨初治肺结核患者与健康人群呼吸道细菌与真菌微生态的异同。方法 以70例初治肺结核患者为观察组、38例健康人群为对照组,检测呼吸道分泌物的细菌和真菌,应用MALDI-TOF方法鉴定菌种,比较分析两组间检出细菌(除外结核分枝杆菌)、真菌分类与密度的差异。结果 (1)在“门”水平上,观察组在拟杆菌门、厚壁菌门、变形菌门、放线菌门、梭杆菌门和真菌子囊菌门的检出率分别为64.29%(45/70)、100%(70/70)、100%(70/70)、70.00%(49/70)、55.71%(39/70)和54.29%(38/70),菌落密度(CFU/mL)分别为(5.48±5.62)、(6.81±6.56)、(6.41±5.74)、(5.50±5.65)、(4.79±4.68)和(6.01±5.85);对照组各门的检出率分别为76.32%(29/38)、100%(38/38)、100%(38/38)、92.11%(35/38)、60.53%(23/38)和15.79%(6/38),菌落密度(CFU/mL)分别为(5.78±5.12)、(6.29±6.45)、(6.56±6.63)、(5.09±5.16)、(5.33±5.50)和(3.40±3.53);统计分析显示放线菌门、子囊菌门检出率以及厚壁菌门、放线菌门、子囊菌门、梭杆菌门的菌落密度在两组间差异均有统计学意义(P <0.05)。(2)在“种”水平上,两组共检测到67个菌种,其中26个菌种为观察组单独检出,9个菌种为对照组单独检出,32个菌种为两组共同检出;对于在任何一组人群中检出率高于50%的菌种,其在观察组与对照组的检出率的对比分别为口腔链球菌/缓症链球菌95.71%vs.100%、奈瑟菌91.43%vs.100%、小韦荣球菌/不典型韦荣球菌61.43%vs.71.05%、粘滑罗斯菌60.00%vs.86.84%、副流杆嗜血杆菌58.57%vs.94.74%、产黑色素普雷沃菌45.71 vs.68.42%、生痰二氧化碳嗜纤维菌38.57%vs.60.53%和口腔纤毛菌44.29%vs.57.89%。结论 初治肺结核患者呼吸道细菌与真菌微生态与健康人群比较,优势菌种变化不大,但菌种及菌落密度发生紊乱,主要表现在菌种类型增多,特别是条件致病菌的增加,此将可能增大合并感染的机会,值得临床密切关注。Objective To investigate the changes of respiratory tract bacterial and fungal microecology in patients with primary pulmonary tuberculosis and healthy people.Methods Seventy patients with primary tuberculosis were enrolled in the study group(hereinafter referred to as the TB group)and thirty-eight healthy individuals were enrolled in the control group(hereinafter referred to as the HG group),and the bacteria and fungi in respiratory secretions were detected by culture,and the strains were identified by MALDI-TOF.The differences in the classification and colony forming unit of bacteria(except Mycobacterium tuberculosis)and fungi were compared and analyzed between the two groups.Results At the Phylum level,Bacteroidetes,Firmicutes,Proteobacteria,Actinobacteria,Clostridium and Fusobacteria were detected in the TB group.The detection rates were 64.29%(45/70),100%(70/70),100%(70/70),70.00%(49/70),55.71%(39/70)and 54.29%(38/70),respectively,and the colony forming unit(CFU/mL)were(5.48±5.62),(6.81±6.56),(6.41±5.74),(5.50±5.65),(4.79±4.68),and(6.01±5.85),respectively;The detection rates of each phylum in the HG group were 76.32%(29/38),100%(38/38),100%(38/38),92.11%(35/38),and 60.53%(23/38)and 15.79%(6/38),and the colony forming unit(CFU/mL)were(5.78±5.12),(6.29±6.45),(6.56±6.63),(5.09±5.16),(5.33±5.50)and(3.40±3.53),respectively.Chi-Squared Test and t-test statistical analysis showed the detection rates of Actinobacteria and Ascomycota and the colony forming unit of Firmicutes,Actinobacteria,Ascomycota and Fusobacteria were significant between the two groups.(P<0.05).At the level of Species,67 species were detected in the two groups,of which 26 species were detected in the TB group alone,9 species in the HG group alone,and 32 species in both groups;for the species with a detection rate higher than 50%in any one group,The comparison of the detection rates between the TB and HG groups was 95.71%vs.100%for Streptococcus oralis/Streptococus mitis,91.43%vs.100%for Neisseria,61.43%vs.71.05%for Veillonellaparvula/

关 键 词：肺结核 呼吸道微生态 细菌 真菌 

分 类 号：R372[医药卫生—病原生物学]