脓肿分枝杆菌复合群致急性化脓性腮腺炎病例报告一例及文献复习-现代医学

脓肿分枝杆菌复合群致急性化脓性腮腺炎病例报告一例及文献复习

单位：南京市中西医结合医院检验科, 江苏南京 210014

分类号：R446.5

出版年·卷·期（页码）：2025·44·第三期（480-484）

摘要：

脓肿分枝杆菌复合群(MABC)是非结核分枝杆菌(NTM)中最常见的快速生长型NTM之一，以免疫低下人群为主要易感群体，可感染肺部、关节及皮肤等部位。由于MABC在固体培养基上生长3~7 d才可见菌落且抗酸染色涂片多为阴性，导致MABC检出困难。此外，MABC具有独特的细胞壁结构与代谢机制，能够抵御巨噬细胞和中性粒细胞等免疫细胞攻击。另外，MABC具有天然、多耐药等特性，对大多数抗结核药物效果有限。值得注意的是，NTM的药敏试验尚未在国内大多数实验室开展，专门针对快速生长型NTM开展的药敏试验更是鲜见，导致其治疗周期长、疗效不理想。本文报道了1例由MABC致急性化脓性腮腺炎病例的诊治、病原学检出以及药敏试验过程，旨在提高临床医师的诊疗水平和检验人员病原学的检出能力。

The Mycobacterium abscessus complex(MABC) is one of the most common rapidly-growing non-tuberculous mycobacteria(NTM) among NTM. The immunocompromised population is the main susceptible group, and it can infect the lungs, joints, skin and other parts. Due to the fact that MABC takes 3 to 7 days for colonies to appear when it is cultured on solid medium, and its acid-fast staining smears are mostly negative, resulting in difficulties in detecting MABC. Besides, MABC has a unique cell wall structure and metabolic mechanism, which can resist the attacks of immune cells such as macrophages and neutrophils, and it also has natural and multi-drug resistance characteristics, resulting in limited efficacy against most anti-tuberculosis drugs. Moreover, the drug sensitivity test for NTM has not been carried out in most laboratories in China, and the drug sensitivity test specifically targeting rapid-growing NTM is even rarer, Which leads to long treatment cycles and unsatisfactory therapeutic effects. This article reports the diagnosis, pathogen detection and drug sensitivity test process of a case of acute suppurative parotitis caused by MABC, aiming to improve the diagnostic skills of clinicians and the detection ability of pathogen by laboratory technicians.

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