Heterogeneity of Iranian clinical isolates of Mycobacterium fortuitum

The increase of infections caused by nontuberculous mycobacteria [NTM] is receiving increasing attention worldwide. Mycobacterium fortuitum is encountered with increasing frequency in clinical laboratories of Iran. Sequence variation of 48 M. fortuitum clinical isolates, were investigated by sequence analysis of the 16S-23S Internal Transcribed Spacer. Twelve different sequence types [sequevar] were identified by sequence analysis of ITS region. Seven previously described sequevar including MfoA, MfoB, MfoC, MfoD, MfoE, MfoF and MfoG identified. Five novel sequevar namely MfoH, MfoI, MfoJ, MfoK and MfoL that were distinctly different from the previously described sequevar were detected among different clinical strains of M. fortuitum, from Iran. This study showed that the ITS region possesses high discriminatory power between the clinical isolates up to the clonal level. The results also suggest the possibility of the existence of predominant clone of M. fortuitum in affected patients in Iran. The data also point to the conclusion that a large variety of M. fortuitum clone can produce disease although certain clones seem to be predominant

[Isolation and identification of Nocardia asteroids complex isolated from thigh abscess in a patient with Behcet's syndrome: the first report from Iran]

Nocardia species are Gram-positive, partially acid fast, non-motile, cata-lase positive, aerobic and saprophytic actinomycetes found all around the world. They invade the human body from the environment via trauma and respiratory tract and cause cutaneous, pulmonary and systemic diseases. They are able to grow in various media.The organisms opportunistically infect both immunocompromised and immuno-competent individuals. Behcet's disease is an autoimmune disease and immunocompromised patient which may suitable host for Nocardia bacterium. The present study is the first case report of isolation of Nocardia from the thigh abscess in a patient with behcet's disease from Iran. A 39-year-old man with Behcet's disease in August 2011 was admitted to Shariati hospital Tehran, with swelling and pain in the left flank and left thigh. Microscopic identification from direct microbiological slide of thigh abscess discharge demonstrated number of lymphocytes, neutrophils and macrophages foamy and white blood cells together with filamentous bacteria. Further microbiological characterization using phenotypic and antibiogram tests with disk diffusion method, demonstrated that the isolated bacterium is Nocardia asteroides complex. The bacteria were sensitive to ampicillin, vancomycin, ceftriaxone, amikacin and cotrimoxazole but it was resistant to clindamycin, erythromycin, penicillin G, cephalothin and gentamicin. The patient was treated with cotrimoxazole. Because of the high incidence and high mortality of Nocardia infection in immunocompromised cases, rapid detection and timely treatment for these patients is necessary

Chronic Pulmonary Disease Due to Mycobacterium monacense Infection: The First Case from Iran

We herein report a case in which the recently characterized species Mycobacterium monacense was isolated from the sputum of an Iranian patient. This case represents the first isolation of M. monacense from Iran. The isolate was identified by conventional and molecular techniques. Our findings show that M. monacense infection is not restricted to developed countries.

Molecular identification and conventional susceptibility testing of iranian clinical mycobacterium fortuitum isolates

Rapidly growing mycobacteria [RGM] are capable of producing diseases in humans. Since mycobacteria vary in their susceptibility, precise identification is critical for adoption of correct drug therapy. The main aim of this study was molecular identification and evaluation of antimicrobial susceptibility pattern of Iranian clinically isolated Myocbacterium fortuitum. A total of 72 presumptively identified isolates of clinical atypical mycobacteria collected by Isfahan Research Center for Infectious Diseases and Tropical Medicine during 2006-2008 were included in the current study. A combination of conventional and molecular tests was applied to identify the isolates. Molecular methods including genus and group specific PCR and PCR-Restriction Algorithm [PRA] based on hsp65 gene were applied to achieve exact identification of mycobacterial strains. Antimicrobial susceptibility testing on M. fortidtum isolates was performed by in-house prepared broth microdilution test. Out of 72 collected atypical mycobacteria isolates, we identified 25 strains of M. fortuitum. All strains had the specific molecular markers of mycobacterial identity and similar species specific PRA pattern of the international type strain of M fortuitum. Drug susceptibility testing showed that the M. fortidtum isolates are sensitive to amikacin, sulfamethoxazole and ciprofloxacin [100%], imipenem [92%], clarithromycin [76%], cefoxitin [56%] and doxycycline [16%]. Molecular identification of atypical mycobacteria based on PRA is a reliable and rapid approach which can identify mycobacterial strains to the species level. Our study showed that M. fortuitum plays a significant role in pulmonary and extrapulmonary infection in patients and should be given proper considerations when clinical samples are processed