关键词:

肺结核, 呼吸道微生态, 细菌, 真菌

Abstract:

Objective To investigate the changes of respiratory tract bacterial and fungal microecology in patients with primary pulmonary tuberculosis and healthy people. Methods Seventy patients with primary tubercu⁃ losis were enrolled in the study group（hereinafter referred to as the TB group）and thirty⁃eight healthy individuals were enrolled in the control group（hereinafter referred to as the HG group），and the bacteria and fungi in respira⁃ tory secretions were detected by culture，and the strains were identified by MALDI ⁃ TOF. The differences in the classification and colony forming unit of bacteria（except Mycobacterium tuberculosis）and fungi were compared and analyzed between the two groups. Results At the Phylum level，Bacteroidetes，Firmicutes，Proteobacteria， Actinobacteria，Clostridium and Fusobacteria were detected in the TB group. The detection rates were 64.29%（45/ 70），100%（70/70），100%（70/70），70.00%（49/70），55.71%（39/70）and 54.29%（38/70），respectively，and the colony forming unit（CFU/mL）were（5.48 ± 5.62），（6.81 ± 6.56），（6.41 ± 5.74），（5.50 ± 5.65），（4.79 ± 4.68），and（6.01 ± 5.85），respectively；The detection rates of each phylum in the HG group were 76.32%（29/38）， 100%（38/38），100%（38/38），92.11%（35/38），and 60.53%（23/38）and 15.79%（6/38），and the colony forming unit（CFU/mL）were（5.78 ± 5.12），（6.29 ± 6.45），（6.56 ± 6.63），（5.09 ± 5.16），（5.33 ± 5.50）and（3.40 ± 3.53），respectively. Chi⁃Squared Test and t⁃test statistical analysis showed the detection rates of Actino⁃ bacteria and Ascomycota and the colony forming unit of Firmicutes，Actinobacteria，Ascomycota and Fusobacteria were significant between the two groups.（P < 0.05）. At the level of Species，67 species were detected in the two groups，of which 26 species were detected in the TB group alone，9 species in the HG group alone，and 32 species in both groups；for the species with a detection rate higher than 50% in any one group，The comparison of the detection rates between the TB and HG groups was 95.71% vs. 100% for Streptococcus oralis/Streptococus mitis， 91.43% vs. 100% for Neisseria，61.43% vs. 71.05% for Veillonellaparvula/Veillonella atypical，and 60.00% vs. 86.84% for Rothiamucilaginosa，58.57% vs. 94.74% for Haemophilusparainfluenzae，45.71% vs. 68.42% for Pre⁃ votellamelaninogenica，38.57% vs. 60.53% for Capnocytophagasputigena and 44.29% vs.57.89% for Leptotrichia⁃ buccalis，respectively. Conclusion Compared with healthy people，the microecology of bacteria and fungi in respiratory tract of patients with primary pulmonary tuberculosis showed little change in dominant bacteria. However， the species and colony density were disordered，which was mainly manifested in the increase of strain types，espe⁃ cially the increase of opportunistic pathogens. This may increase the chance of co⁃infection and is worthy of clinical attention. 

Key words: pulmonary tuberculosis,  , respiratory tract microecological,  , bacteria,  , fungus