中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (11): 775-779.doi: 10.12144/zgmfskin202511775

• 论著 • 上一篇    下一篇

34例皮肤非结核分枝杆菌感染检测结果与临床分析

曾成龙1,付萌1,王胜春1,冯婷1,梁媛媛1,王洪生2,张文月2,陶晓莉3   

  1. 1空军军医大学西京皮肤医院，陕西西安，710032； 2中国医学科学院皮肤病研究所分枝杆菌实验室，江苏南京，210042； 3锦州医科大学基础医学院病原生物学教研室，辽宁锦州，121000
  • 出版日期:2025-11-15 发布日期:2025-11-07

Testing results and clinical analysis of 34 cases with cutaneous nontuberculous mycobacterial infection

ZENG Chenglong1, FU Meng1, WANG Shengchun1, FENG Ting1, LIANG Yuanyuan1, WANG Hongsheng2, ZHANG Wenyue2, TAO Xiaoli3   

  1. 1 Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China; 2 Mycobacterium Laboratory, Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing 210042, China; 3 Department of Pathogenic Biology, School of Basic Medicine, Jinzhou Medical University, Jinzhou 121000, China
  • Online:2025-11-15 Published:2025-11-07

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摘要： 目的：探讨皮肤非结核分枝杆菌感染（nontuberculous mycobacteria，NTM）临床特点和诊疗方法，提高对皮肤NTM感染的认识和诊断水平。方法：收集2022年4月至2024年8月西京医院皮肤科门诊皮肤NTM感染疑诊患者57例，统计分析其培养法、抗酸染色和核酸测序检测结果，随访治疗和预后情况。结果：综合病史、临床和实验室检测结果最终诊断皮肤NTM感染34例，男18例(52.94%)，女16例(47.06%)，发病年龄14～81岁，平均(51.79±15.96)岁，以40岁以上年龄段为主，病期≥6个月患者占比最高72.22%。半数患者发病诱因与外伤有关，其中主要以鱼刺伤为主，多发皮损(22例,64.71%）高于单发皮损(12例,35.29%）。临床表现以斑块为主(15例,44.12%)，主要位于手部(20例，58.82%)。核酸测序鉴定阳性率最高为85.29%，其次是抗酸染色70.59%，组织培养阳性率最低29.41%。菌种鉴定结果显示海分枝杆菌感染率最高21例（61.76%）。手术切除2例、中医治疗1例和抗生素治疗31例，28例临床治愈（82.35%），6例好转（17.65%），总有效率100%，复发4例（11.76%）。结论：皮肤NTM感染主要以海分枝杆菌感染为主，好发于中老年，皮损表现复杂多样，临床诊疗应综合考虑。

关键词: 非结核分枝杆菌, 抗酸染色, 核酸测序

Abstract: Objective: To explore the clinical characteristics, diagnosis and treatment methods of cutaneous NTM (nontuberculous mycobacteria) infection, and to improve the understanding and diagnostic level of cutaneous NTM infection. Methods: From April 2022 to August 2024, 57 patients with suspected cutaneous NTM infection were collected from the Dermatology Outpatient Department of Xijing Hospital. The results of culture method, acid-fast staining, and nucleic acid sequencing, as well as the treatment and prognosis, were statistically analyzed. Results: Thirty four cases were finally diagnosed with cutaneous NTM infection, including 18 males (52.94%) and 16 females (47.06%). The onset age ranged from 14 to 81 years old, with an average age of (51.79±15.96) years old, mainly in the age group over 40 years old. Patients with disease duration ≥6 months accounted for the highest proportion（72.22%）. Half of the patients had trauma-related onset causes, mainly fishbone stabbing. There were 22 cases (64.71%) of multiple skin lesions, which was higher than 12 cases (35.29%) of single skin lesions. The main clinical manifestation was plaques, accounting for 44.12%; the main affected site was the hand, accounting for 58.82%. The positivity rate of nucleic acid sequencing identification was the highest, which was 85.29%, followed by acid-fast staining of 70.59%, and that of tissue culture was the lowest, which was 29.41%. In terms of species identification results, the infection rate of Mycobacterium marinum was the highest, with 21 cases (61.76%). There was 2 case treated by surgical resection, 1 case with traditional Chinese medicine treatment and 31 cases treated with antibiotics. 28 cases (82.35%) were clinically cured, 6 cases (17.65%) improved, the total effective rate was 100%, and 4 cases (11.76%) relapsed. Conclusion: Cutaneous NTM infection is mainly caused by Mycobacterium marinum infection, which is more common in middle-aged and elderly people. The manifestations of skin lesions are complex and diverse, and comprehensive consideration should be given in clinical diagnosis and treatment.

Key words: nontuberculous mycobacteria, acid-fast staining, nucleic acid sequencing