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高雄市長期照護機構環境中美洲蟑螂及德國蟑螂體內外分布之分枝桿菌研析 = ...

國立高雄大學運動健康與休閒學系碩士班

高雄市長期照護機構環境中美洲蟑螂及德國蟑螂體內外分布之分枝桿菌研析 = A Study of Mycobacterium of Periplaneta americana and Blattella germanica around the Long-Term Care Organizations in Kaohsiung City

紀錄類型:	書目-語言資料,印刷品 : 單行本
並列題名:	A Study of Mycobacterium of Periplaneta americana and Blattella germanica around the Long-Term Care Organizations in Kaohsiung City
作者:	潘炤穎,
其他團體作者:	國立高雄大學
出版地:	[高雄市]
出版者:	撰者;
出版年:	民99[2010]
面頁冊數:	75面圖，表 : 30公分;
標題:	非結核性分枝桿菌
標題:	Non-tuberculous Mycobacteria（NTM）
電子資源:	http://handle.ncl.edu.tw/11296/ndltd/88402455262924156729
摘要註:	本研究目的係藉由調查高雄市立案的長期照護機構環境中之蟑螂，其體內外所分離出的非結核性分枝桿菌，及生活其中的住民臨床檢體，以明瞭其在環境中分佈和蟑螂之病媒潛能。於高雄市69家（75%）安養及養護機構以捕蟑盒誘捕蟑螂，共捕獲558隻美洲蟑螂119隻（21.3%）、德國蟑螂439隻（78.7%）；分別抽樣並萃取其體內外之灌洗液共計516個（46.24%）檢體，且取得住民臨床檢體51個，進行分枝桿菌的培養、分離與鑑定。經BATEC MGIT 960培養系統6週後，共得37個含有經抗酸性染色鏡檢，呈現分枝桿菌生長的陽性檢體，整體陽性率為7.17％（37/516）；分別為蟑螂體外21個陽性檢體（56.76％，21/37）、體內共16個陽性檢體（43.24％，16/37）；而住民臨床檢體陽性率為1.96％（1/51）。選取液態培養基呈現分枝桿菌陽性檢體轉殖於固態培養基並俟其長成菌落後，以核酸增幅限制酶片段分析（PCR-RFLP）分子生物學檢驗方法，針對hsp65基因段應用TB11及TB12兩種引子（primer）增幅35個循環之後，以BstEⅡ、HaeⅢ兩種限制酶（restriction enzyme）切分其核酸增幅產物，再以3％電泳膠分析之，獲得其結果為M. trivale 7株、M. gordonae 3株、M. szulgai 6株、M. nonchronogencum II 3株、M. abscessus 4株、M. flavesscens I 1株。其他未能以上述兩種限制酶鑑別的NTM計13株。綜上所述，非結核性分枝桿菌因其廣泛的分布於生活環境之中，經蟑螂居家病媒傳播，造成長期照護機構年老住民或免疫功能不良者伺機性感染的可能性極高，故而有效防範長期照護機構住民或醫療機構患者遭受非結核性分枝桿菌侵襲的方法，應著重於日常的環境整潔衛生維護，居家蟑螂的管制工作尤其應列為常規重點項目之一。 This study is aimed to the determinate distribution of non-tuberculous Mycobacteria (NTM) of cockroaches as potential vectors around the long-term care organizations in Kaohsiung city. All NTM samples were isolated from either the intra- and extra-lavages of cockroaches or the inhabitants in the legal long-term care facilities of Kaohsiung city. Herein, 558 in numbers of cockroaches were caught, which existed commonly in sixty-nine (75%) long-term care organizations of Kaohsiung city. The NTM samples sources came from two different parts, one was 558 cockroaches, 119 (21.3%) and 439 (78.7%) of them were classified to Blattella germanica and Periplaneta Americana, respectively. The other part was fifty-one clinical inhabitants’ samples. The numbers of 516 (46.24%) of the intra- and extra-lavages of cockroach samples were extracted with normal saline. All NTM samples were cultured for six weeks in BATEC MGIT 960 culture system and Mycobacterium examination were performed by acid-fast stain analysis. The result showed that thirty-seven lavage samples were Mycobacterium positive and the total positive rate was 7.17%. In detail, twenty-one (21/37, 56.76%) and sixteen (16/37, 43.24%) of these Mycobacterium positive samples were extra- and intra-lavage samples, respectively. The Mycobaterium positive rate of the clinical inhibiants’samples was 1.96% (1/51). Furthermore, to identify the classification of non-tuberculous mycobacteria of acid-fast stain positive lavages samples of cockroach, the polymerase chain reaction- restriction fragment length polymorphism（PCR-RFLP） analysis technology was used. Two primers, TB11 and TB12 were used in PCR program, and the DNA fragments were amplified after thirty-five thermo-cycles. All the PCR products were digested with two restriction enzymes, BstEII and HaeIII and analyzed by electrophoresis with 3% agarose gel. The electrophoresis results were certified that seven of M. trivale, three of M. gordonae, six of M. szulgai, three of M. nonchronogencum II, four of M. abscessus, and one of M. flavesscens. However, thirteen samples were not certified by these two enzymes. To sum up, NTM universally surrounds in our environment and can be spread out through the housed media, like cockroaches. Highly risk of opportune infection can be happened among the inhabitants of long-term care facilities or immuno-deficient patients. To prevent the NTM spread out in those long-term care facilities or hospitals, neatly clean and sanitation in daily should be noticed. Moreover, the restraints of the housed media should be listed in one of the important conventional rules.

高雄市長期照護機構環境中美洲蟑螂及德國蟑螂體內外分布之分枝桿菌研析 = A Study of Mycobacterium of Periplaneta americana and Blattella germanica around the Long-Term Care Organizations in Kaohsiung City
潘, 炤穎

高雄市長期照護機構環境中美洲蟑螂及德國蟑螂體內外分布之分枝桿菌研析 = A Study of Mycobacterium of Periplaneta americana and Blattella germanica around the Long-Term Care Organizations in Kaohsiung City / 潘炤穎撰 - [高雄市] : 撰者, 民99[2010]. - 75面 ; 圖，表 ; 30公分.
參考書目：面.
非結核性分枝桿菌Non-tuberculous Mycobacteria（NTM）

高雄市長期照護機構環境中美洲蟑螂及德國蟑螂體內外分布之分枝桿菌研析 = A Study of Mycobacterium of Periplaneta americana and Blattella germanica around the Long-Term Care Organizations in Kaohsiung City
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330 $a 本研究目的係藉由調查高雄市立案的長期照護機構環境中之蟑螂，其體內外所分離出的非結核性分枝桿菌，及生活其中的住民臨床檢體，以明瞭其在環境中分佈和蟑螂之病媒潛能。於高雄市69家（75%）安養及養護機構以捕蟑盒誘捕蟑螂，共捕獲558隻美洲蟑螂119隻（21.3%）、德國蟑螂439隻（78.7%）；分別抽樣並萃取其體內外之灌洗液共計516個（46.24%）檢體，且取得住民臨床檢體51個，進行分枝桿菌的培養、分離與鑑定。經BATEC MGIT 960培養系統6週後，共得37個含有經抗酸性染色鏡檢，呈現分枝桿菌生長的陽性檢體，整體陽性率為7.17％（37/516）；分別為蟑螂體外21個陽性檢體（56.76％，21/37）、體內共16個陽性檢體（43.24％，16/37）；而住民臨床檢體陽性率為1.96％（1/51）。選取液態培養基呈現分枝桿菌陽性檢體轉殖於固態培養基並俟其長成菌落後，以核酸增幅限制酶片段分析（PCR-RFLP）分子生物學檢驗方法，針對hsp65基因段應用TB11及TB12兩種引子（primer）增幅35個循環之後，以BstEⅡ、HaeⅢ兩種限制酶（restriction enzyme）切分其核酸增幅產物，再以3％電泳膠分析之，獲得其結果為M. trivale 7株、M. gordonae 3株、M. szulgai 6株、M. nonchronogencum II 3株、M. abscessus 4株、M. flavesscens I 1株。其他未能以上述兩種限制酶鑑別的NTM計13株。綜上所述，非結核性分枝桿菌因其廣泛的分布於生活環境之中，經蟑螂居家病媒傳播，造成長期照護機構年老住民或免疫功能不良者伺機性感染的可能性極高，故而有效防範長期照護機構住民或醫療機構患者遭受非結核性分枝桿菌侵襲的方法，應著重於日常的環境整潔衛生維護，居家蟑螂的管制工作尤其應列為常規重點項目之一。 This study is aimed to the determinate distribution of non-tuberculous Mycobacteria (NTM) of cockroaches as potential vectors around the long-term care organizations in Kaohsiung city. All NTM samples were isolated from either the intra- and extra-lavages of cockroaches or the inhabitants in the legal long-term care facilities of Kaohsiung city. Herein, 558 in numbers of cockroaches were caught, which existed commonly in sixty-nine (75%) long-term care organizations of Kaohsiung city. The NTM samples sources came from two different parts, one was 558 cockroaches, 119 (21.3%) and 439 (78.7%) of them were classified to Blattella germanica and Periplaneta Americana, respectively. The other part was fifty-one clinical inhabitants’ samples. The numbers of 516 (46.24%) of the intra- and extra-lavages of cockroach samples were extracted with normal saline. All NTM samples were cultured for six weeks in BATEC MGIT 960 culture system and Mycobacterium examination were performed by acid-fast stain analysis. The result showed that thirty-seven lavage samples were Mycobacterium positive and the total positive rate was 7.17%. In detail, twenty-one (21/37, 56.76%) and sixteen (16/37, 43.24%) of these Mycobacterium positive samples were extra- and intra-lavage samples, respectively. The Mycobaterium positive rate of the clinical inhibiants’samples was 1.96% (1/51). Furthermore, to identify the classification of non-tuberculous mycobacteria of acid-fast stain positive lavages samples of cockroach, the polymerase chain reaction- restriction fragment length polymorphism（PCR-RFLP） analysis technology was used. Two primers, TB11 and TB12 were used in PCR program, and the DNA fragments were amplified after thirty-five thermo-cycles. All the PCR products were digested with two restriction enzymes, BstEII and HaeIII and analyzed by electrophoresis with 3% agarose gel. The electrophoresis results were certified that seven of M. trivale, three of M. gordonae, six of M. szulgai, three of M. nonchronogencum II, four of M. abscessus, and one of M. flavesscens. However, thirteen samples were not certified by these two enzymes. To sum up, NTM universally surrounds in our environment and can be spread out through the housed media, like cockroaches. Highly risk of opportune infection can be happened among the inhabitants of long-term care facilities or immuno-deficient patients. To prevent the NTM spread out in those long-term care facilities or hospitals, neatly clean and sanitation in daily should be noticed. Moreover, the restraints of the housed media should be listed in one of the important conventional rules.
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