Experience of selection, indication and identication of non-tuberculous mycobacteria, got during I National research on study of distribution of drugresistant of tuberculosis in Ukraine

Abstract

Objective — a study of presence of non-tuberculosis mycobacteriumin a circulatory mycobacterial population among patients by a white plague in Ukraine, finding out of etiologic role of non-tuberculosis mycobacterium, their selection and identification, study of some morphological and biological properties.Materials and methods. The strokes of sputum were investigational in the presence of acid proof bacteria by a direct microscopy after coloring on the method of Ziehl—Neelsen. For all standards with the positive results of microscopy all spectrum of bacteriologicexaminations was executed on diagnostics of tubercu­losis, according to the algorithm ratified by the order of MH of Ukraine N 620. Bacteriological studies were undertaken on identification of clinical isolates on standard methodologies that is expounded in the order of MH of Ukraine N 45. Specific identification of the got cultures consisted of two stages: primary and final.In process for sowing environments were used: liquid — broth of Middlebrook 7Н9 and dense egg Lowenstein—Jensen medium. Pressed treatment of clinical material was carried out by means of a 0,5 % sterile solution of N-acetyl-L-of cystein from 1.0 % gidroxid of natrium (BBL Mycoprep NALC-NAOH). Test tubes placed in the system ВАСТЕС МGIТ 960 and did incubation. Sowing was carried out in parallel on the dense environment of Lowenstein—Jensen medium. For identification of the distinguished strains ID МТВ MGIT test used and determination of ability of height of clinical isolates of mycobacterium on an environment with a salicylic sour natrium and p-nitrodracylic acid with the purpose of determination of belonging of distinguished mycobacterium to the tuberculosis complex.For realization of final identification of mycobacterium used the system GenoType® MTB DR (Нain, Laifsains), that allowed to define the type of non-tuberculosis mycobacterium.Results and discussion. During Ist of National research on the study of distribution of drug resistant of tuberculosis1598 clinical isolates of mycobacterium were got in Ukraine. The analysis of results of bacteriologicexamination educed, that 48 (2.9 %) clinical isolates had been identified as non-tuberculosis mycobacterium. A chart over of primary authentication of non-tuberculosis mycobacteriumis brought.Nonphotochromogen mycobacterium prevailed in the structure of distinguished non-tuberculosis mycobacterium– 77.1 %. Photochromogen mycobacterium distinguished at level — 16.7 %, fast-growing mycobacterium was made the least — 6.3 %.For determination of specific belonging of non-tuberculosis mycobacterium used the system GenoType® MTB DR (Нain, Laifsains). Next non-tuberculosis mycobacterium were distinguished: M. kansasii, M. xenopi, M. avium, M. fortuitum. From 48 distinguished strains 20 strains were the clean cultures of non-tuberculosis mycobacterium (41.7 %), 28 strains (58.3 %) were in mix (М. tuberculosis + non-­tuberculosis mycobacterium). The results of researches showed that more often from the sputum of patients M. avium was distinguished in mix with М. tuberculosis — 39.6 %, in the clean culture of M. avium was distinguished in 20.8 % cases. Minimum was specific gravity of selection of M. fortuitum — 6.25 %. Here found out reliable difference was between prevalence of the distinguished strains of M. avium and other strains of non-tuberculosis mycobacterium.Conclusions. During Ist of National research on study of distribution of drug resistant of tuberculosis 48 strains of mycobacterium (2.9 %) that were identified as non-tuberculosis mycobacterium were got in Ukraine. Thus in 20 cases (1.2 %) were found out the clean cultures of non-tuberculosis mycobacterium. In 28 (1.7 %) cases were discovered in mix, that contained as M. tuberculosis, so non-tuberculosis mycobac­terium. Authors are bringing a chart over of primary identification of non-tuberculosis mycobacterium. Nonphotochromogen mycobacterium prevailed in the structure of non-tuberculosis mycobacterium — 77.1 %. Photochromogen mycobacterium distinguished at level — 16.7 %, fast-growing mycobacterium was made the least — 6.3 %. For determination of specific belonging of non-tuberculosis mycobacterium used the system GenoType® MTB DR (Нain, Laifsains). Next non-tuberculosis mycobacterium were distinguished: M. kansasii, M. xenopi, M. avium, M. fortuitum. The results of researches showed that more often from the patient’s sputum M. avium was distinguished. In mix with М. tuberculosis – 39.6 %, in the clean culture of M. avium was distinguished in 20.8 % cases. Minimum was specific gravity of selection of M. fortuitum — 6.25 %. Here found out a reliable difference was between prevalence of the distinguished strains of M. avium and other strains of non-tuberculosis mycobacterium.