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首页> 外文期刊>Journal of Clinical Microbiology >First Report of Disseminated Mycobacterium Skin Infections in Two Liver Transplant Recipients and Rapid Diagnosis by hsp65 Gene Sequencing
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First Report of Disseminated Mycobacterium Skin Infections in Two Liver Transplant Recipients and Rapid Diagnosis by hsp65 Gene Sequencing

机译：通过两个hsp65基因测序在两个肝移植受者中传播分枝杆菌皮肤感染的首次报道和快速诊断

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We present here the first report of disseminated skin Mycobacterium infections in two liver transplant recipients, in which hsp65 gene sequencing was used for rapid species identification. Both patients had hepatitis B virus-related cirrhosis and diabetes mellitus and presented with progressive generalized, nodular skin lesions. In one patient, a 50-year-old woman who had frequent contact with marine fish, an acid-fast bacillus was isolated from skin biopsy tissue after 2 months of culture. While awaiting phenotypic identification results, hsp65 gene sequencing showed that it was most closely related to that of Mycobacterium marinum with 100% nucleotide identity. The patient was treated with oral rifampin, ethambutol, and moxifloxacin. In the other patient, a 59-year-old woman, direct PCR for Mycobacterium using hsp65 gene from skin biopsy tissue was positive, with the sequence most closely related to that of M. haemophilum with 100% nucleotide identity. Based on PCR results, the patient was treated with clarithromycin, ethambutol, moxifloxacin, and amikacin. A strain of M. haemophilum was only isolated after 3 months. Skin lesions of both patients resolved after 1 year of antimycobacterial therapy. Nontuberculous Mycobacterium infections should be considered in liver transplant recipients presenting with chronic, nodular skin lesions. This report highlights the crucial role of hsp65 gene PCR and sequencing on both cultured isolates and direct clinical specimens for rapid diagnosis of slow-growing Mycobacterium infection.
机译：我们在此介绍了在两个肝移植受者中传播的皮肤分枝杆菌感染的第一份报告，其中使用了 hsp65 基因测序来快速鉴定物种。两名患者均患有乙型肝炎病毒相关性肝硬化和糖尿病，并表现为进行性全身性结节性皮肤病变。在一名患者中，一名经常与海鱼接触的50岁女性，在培养2个月后从皮肤活检组织中分离出了一种耐酸杆菌。在等待表型鉴定结果的同时， hsp65 基因测序表明它与具有100％核苷酸同一性的海藻分枝杆菌的亲缘关系最密切。该患者接受了口服利福平，乙胺丁醇和莫西沙星的治疗。在另一例患者中，一名59岁妇女使用皮肤活检组织中的 hsp65 基因对分枝杆菌进行直接PCR呈阳性，其序列与100％核苷酸的嗜血杆菌分枝杆菌最密切相关。身份。根据PCR结果，该患者接受了克拉霉素，乙胺丁醇，莫西沙星和阿米卡星治疗。仅在3个月后分离出嗜血支原体菌株。经过一年的抗分枝杆菌治疗，两名患者的皮肤病变均得到缓解。对于患有慢性结节性皮肤病变的肝移植患者，应考虑非结核性分枝杆菌感染。该报告强调了 hsp65 基因PCR和测序在培养的分离株和直接临床标本中对于快速诊断缓慢增长的分枝杆菌感染的关键作用。

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