未经证实:最近冠状病毒SARS-CoV-2(COVID-19)的大流行导致该国对抗分枝杆菌感染的策略受到限制。这项研究的目的是比较在COVID-19大流行(2018年1月至2021年12月)之前和期间被转诊到国家参考结核病实验室(NRLTB)的疑似结核病(TB)患者,德黑兰,伊朗。鉴定分枝杆菌分离的菌株并与以前的数据进行比较。
UNASSIGNED:从2018年至2021年,共从7041名疑似肺结核患者收集了16,899份临床样本。分枝杆菌分离株的初级分离在Löwenstein-Jensen培养基上进行。然后,从抗酸杆菌培养阳性样品中提取DNA,并使用聚合酶链反应(PCR)通过IS6110,Hsp65和16S-23SrRNA基因进行鉴定,PCR-限制性片段长度多态性,和嵌套PCR方法。
UNASSIGNED:在2018-2019年收集了4866名疑似结核病患者的11679份标本(69.1%),在2020-2021年收集了5220份标本(30.8%;来自2175名患者)。在11679个标本中,852例患者的2046个样本感染了结核分枝杆菌,其余为从102例患者中分离的非结核分枝杆菌(NTM)物种(n=244)。12894个标本的培养物是阴性(76.3%)或被污染(845/16899;5%)。转诊诊断和治疗的患者总数的比较(954/666例,P>0.05)显示在COVID-19大流行期间减少了30.1%。虽然,由于患者人数很少,在疑似肺结核患者中观察到NTM物种的显着增加(P<0.05)。此外,NTM的新物种,例如,恶性分枝杆菌和单发分枝杆菌,被检测到。在过去的20年里,伊朗的肺部患者没有报告这两个物种。
未经证实:在COVID-19大流行期间,结核病诊断网络变得不规则,因此,许多患者无法到达治疗中心,这可能会增加分枝杆菌疾病(TB和NTM)的循环。研究表明,也出现了新的机会性NTM物种。
Recent pandemic of coronavirus SARS-CoV-2 (COVID-19) caused limitations in the country\'s strategies to fight against mycobacterial infections. The aim of this study was to compare the suspected tuberculosis (TB) pulmonary patients before and during the COVID-19 pandemic (January 2018-December 2021) who were referred to the National Reference TB Laboratory (NRL TB), Tehran, Iran. The mycobacterial isolated strains were identified and compared with previous data.
A total of 16,899 clinical samples collected from 7041 suspected pulmonary TB patients were received from 2018 to 2021. Primary isolation of Mycobacterium isolates was done on Löwenstein-Jensen medium. Then, the DNA was extracted from acid-fast bacillus culture-positive samples and identification was performed by IS6110, Hsp65, and 16S-23S rRNA genes using polymerase chain reaction (PCR), PCR-restriction fragment length polymorphism, and nested PCR methods.
A total of 11679 specimens (69.1%) from 4866 suspected TB patients were collected in 2018-2019 and 5220 specimens (30.8%; from 2175 patients) in 2020-2021. Out of 11679 specimens, 2046 samples that belong to 852 patients were infected with Mycobacterium tuberculosis, and the remaining were non-TB Mycobacterium (NTM) species (n = 244) isolated from 102 patients. The cultures for 12894 specimens were either negative (76.3%) or contaminated (845/16899; 5%). A comparison of the total number of patients who were referred for diagnosis and treatment (954/666 patients, P > 0.05) showed a 30.1% reduction during the COVID-19 pandemic. Although, with these low number of patients, the significant increases of NTM species (P < 0.05) among suspected TB pulmonary patients were observed. Besides, new species of NTM, for example, Mycobacterium peregrinum and Mycobacterium montefiorense, were detected. For the past 20 years, these two species were not reported from pulmonary patients in Iran.
During the pandemic of COVID-19, the TB diagnosis network became irregular, as a consequence, many patients could not reach the treatment center, and this could increase the circulation of mycobacterial diseases (TB and NTM). The study shows the emergence of new opportunistic NTM species also.