ブルガリアで初めて確認されたマイコバクテリウム・マリヌム感染症の病因学的確認例

First Etiologically Confirmed Cases of Mycobacterium Marinum Infection in Bulgaria.

• Elizabeta Bachiyska
• Yuliana Atanasova
• Ana Baykova
• Stanislava Yordanova
• Yana Todorova

抄録

本研究の目的は、ブルガリアで初めて微生物学的に確認された皮膚および軟部組織のMycobacterium marinum感染症の2例を報告することである。非結核性マイコバクテリウム（Nontuberculous Mycobacteria (NTM)）株の分離とその種の同定は、NRL TB、NCIPDで特定の培地と培養条件を用いて行い、陽性培養物からPCRベースのラインプローブアッセイ（LPA）を用いて行った。2名の患者は魚類と貯水池に密接な関係を持っており，両者ともに「プール」または「水槽」肉芽腫として知られるM. mari-num感染症の類似した臨床症状を有していた．リファンピシンとエタンブトールの少なくとも2剤併用による長期にわたる特異的治療と合併症は、患者だけでなく臨床家にとっても大きな課題であった。

This study aimed to describe the first two microbiologically confirmed cases of cutaneous and soft tissue Mycobacterium marinum infection in Bulgaria. The isolation of the Nontuberculous Mycobacteria (NTM) strains and their species identification was performed at NRL TB, NCIPD using specific media and cultivation conditions, and PCR based Line Probe Assay (LPA) from the positive cultures. The two patients had closely related jobs to fishes and water reservoirs and both of them had a similar clinical manifestation of M. mari-num infection known as "swimming pool" or "fish tank" granuloma. The prolonged specific treatment with at least two-drug combina-tion of rifampicin plus ethambutol and some complications were a big challenge for clinicians as well as the patients.

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