ABSTRACT
BACKGROUND: Pulmonary infection with nontuberculous mycobacteria (NTM) is increasing in South Korea. Since treatment strategy differs by NTM species, accurate identification is necessary. In this study, using Mycobacterium pulmonary isolates recently recovered from a general hospital in Seoul, the prevalence of NTM isolates was investigated. METHODS: A total of 483 Mycobacterium pulmonary strains isolated between May and November 2018 from an 814-bed general hospital in South Korea were analyzed. Bacterial species were identified based on nucleotide sequences of the 16S–23S rDNA internal transcribed spacer and the rpoB gene. RESULTS: From a total of 1,209 pulmonary specimens from patients suspected to be infected with mycobacteria, 324 deduplicate strains were isolated, comprising 90 Mycobacterium tuberculosis and 229 NTM strains. Among the NTM isolates, 61.5% (n=144) were Mycobacterium avium complex (MAC), including 92 M. avium and 52 Mycobacterium intracellulare, while 8.1% (n=19) represented Mycobacterium abscessus, including 10 M. abscessus subsp. abscessus and 9 M. abscessus subsp. massiliense. In addition, 12 (5.1%) Mycobacterium lentiflavum, 12 (5.1%) Mycobacterium gordonae, 6 (2.6%) Mycobacterium kansasii, and 5 (2.1%) Mycobacterium fortuitum were identified. In addition, Mycobacterium mucogenicum (n=2), Mycobacterium septicum (n=1), Mycobacterium colombiens (n=1), Mycobacterium asiaticum (n=1), and Mycobacterium celatum (n=1) were identified. CONCLUSION: Among the recently recovered Mycobacterium pulmonary strains, more than half were identified as NTM, and MAC was the most prevalent NTM, followed by M. abcessuss.
Subject(s)
Humans , Base Sequence , DNA, Ribosomal , Hospitals, General , Korea , Mycobacterium , Mycobacterium avium Complex , Mycobacterium fortuitum , Mycobacterium kansasii , Mycobacterium tuberculosis , Nontuberculous Mycobacteria , Prevalence , Seoul , Tertiary Care Centers , Tertiary HealthcareABSTRACT
To understand pathogen spectrum of nontuberculosis Mycobacteria (NTM) and the dominant NTM in Gansu Province and provide the scientific basis for the effective prevention and treatment of NTM diseases,875 Mycobacteria isolates were collected from 2012 to 2014 in Lanzhou Pulmonary Hospital,NTM species were identified by means of PNB/TCH differentiate medium and 16S rRNA gene sequence analysis respectively.Forty-six isolats of NTM were identied from 875 PNB/TCH.Then with 16S rRNA gene sequence analysis,the NTM strains were identified to 3 strains of Nocadia and 43 strains of NTM,including M.intracellulare,M.kansasii,M.avium,M.senegalense,M.gordonae,M.szulgai,M.peregrinumand M.fortuitum.Among them,there were 31 strains of M.intracellulare,which accounted for 72.09％ of the total number of NTM strains.The dominant nontuberculosis Mycobacteria in Gansu Province were mainly M.intracellulare.The application of molecular biology can rapidly and accurately identify the species of nontuberculosis Mycobacteria,and can provide relevant evidence for clinical diagnosis and therapy.
ABSTRACT
Objective To investigate the clinical application value of genechip detection system in the mycobacterial species iden-tification and drug resistance analysis .Methods The specimens of sputum ,punctured pus ,pleural and abdominal ascites ,cerebro-spinal fluid and so on were performed the Mycobacterium DNA detection by using the gene chip technique .Then Mycobacterium tuberculosis positive samples were further performed the drug-resistant analysis .Meanwhile the Ziehl-Neelsen acid-fast staining was adopted to detect the sample .The positive rates were compared between the two groups .And TB-IGRA was used to examine the tubercle bacillus infection in partial patients .Results In 4402 samples ,137 cases (3 .36% ) of M ycobacterium tuberculosis (MTB) and 11 cases(7 .4% ) of non-tuberculosis mycobacterium(NTM) were detected .Puncture solution ,bronchoalveolar lavage fluid and tissue specimen had higher positive rate .In the 137 positive M TB samples by rifampicin-resistant gene rpoB ,isoniazide-re-sistant gene katG and inhA detection ,22 cases of resistance gene mutations were detected ;the positive rate of genechip for detecting sputum ,cerebrospinal fluid ,hydrothorax and ascites was higher than that of acid-fast staining .TB-IGRA detection had higher pos-itive rate of TB infection than genechip .Conclusion The genechip detection system can directly conduct Mycobacterium identifica-tion and drug resistance analysis ,which is especially suitable for sputum ,cerebrospinal fluid ,hydrothorax and ascites samples ,and which is simple and rapid with higher sensitivity and good specificity .
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Objective To explore CT findings of pulmonary non‐tuberculosis mycobacteria (NTM ) disease .Methods Forty‐two patients with pulmonary NTM disease confirmed by the biphasic medium flora identification (NTM group) ,and 60 patients with lung tuberculosis (TB group) confirmed by the tubercle bacillus cultivation and flora identification in our hospital were included in the ret‐rospective analysis .9 CT signs and distribution features of the lesions were analyzed and compared between the two groups .The difference was statistically significant if P<0 .05 .Results Pulmonary NTM disease was more common in female patients (χ2=5 .500 ,P=0 .019) ,and the mean age was significantly older than that of the tuberculosis (t=3 .456 ,P=0 .001) .The detection rate in the right middle lobe and left tongue section was high in NTM group than in TB group (χ2 =8 .361 ,P=0 .004) .Logistic regression showed that bronchiectasis and bronchial stenosis or occlusion were independent risk factors for the NTM disease .They were important signs for the differential diagnosis from tuberculosis .Conclusion MSCT findings of pulmonary NTM disease have certain characteristic , which are helpful for the diagnosis .
ABSTRACT
Las infecciones causadas por micobacterias no tuberculosas (MNT) o atípicas constituyen en la actualidad un grave problema de salud, especialmente en pacientes inmunocomprometidos. Estas micobacterias presentan patrones de susceptibilidad a antibióticos particulares y distintos a M. tuberculosis, por lo que la administración del tratamiento adecuado requiere de un método rápido, sencillo y sensible de identificación. La técnica de PRA (Análisis de Restricción de Productos de PCR), basada en la digestión enzimática del producto de amplificación del gen hsp65, ha mostrado ser un método adecuado de identificación de micobacterias. En el presente trabajo se comparó la técnica de PRA con el estándar de identificación de micobacterias representado por las pruebas bioquímicas en 30 aislados provenientes del Laboratorio de Tuberculosis del Instituto de Biomedicina. La técnica de PRA permitió identificar 96% de las cepas analizadas, en comparación con 92.% de cepas identificadas por las técnicas bioquímicas. Los resultados obtenidos fueron idénticos en 18 de 22 cepas, correspondiendo al 82% de los resultados. Se concluye que el PRA es un método rápido, sencillo y económico que produce resultados concordantes con las técnicas tradicionales, con un menor grado de error. Basados en estos resultados se recomienda el uso del PRA en los laboratorios clínicos como método de identificación de rutina para micobacterias.
Infections caused by atypical mycobacteria at present constitute a serious health problem, especially in immunocompromised patients. These mycobacteria present particular susceptibility patterns, different from M. tuberculosis, due to which the administration of an adequate treatment requires a fast, simple and sensitive identification method. The PRA technique (PCR Restriction), based on the enzymatic digestion of the amplification product of the hsp65 gene has shown to be an adequate method for the identification of mycobacteria. In this study we compared the PRA technique with the standard mycobacterial identification method, represented by biochemical tests, in 30 isolates from the Tuberculosis Laboratory of the Instituto de Biomedicina. The PRA technique allowed the identification of 96% of the strains analyzed, as compared with 92% of strains identified through biochemical methods. The results obtained were identical in 18 of 22 strains, corresponding to 82% of the results. It is concluded that the PRA technique is a fast, simple and economical method that produces results in concord with traditional techniques, with a lesser degree of error. Based in these results, the use of PRA as routine identification technique for mycobacteria is recommended for clinical laboratories.
ABSTRACT
Las micobacterias no tuberculosas son patógenos oportunistas capaces de producir infecciones pulmonares y extrapulmonares. El aumento de su incidencia se ha acelerado después de la aparición del Síndrome de Inmunodeficiencia Adquirida (SIDA). En este trabajo se estudiaron 40 cepas aisladas de pacientes infectados por el Virus de Inmunodeficiencia Humana, A los aislamientos con significación patogénica se le aplicó el estudio de los patrones de las fracciones de ácidos micólicos. Los resultados fueron: 9 Mycobacterium avium, 8 Mycobacterium fortuitum, 4 Mycobacterium flavescens, 4 Mycobacterium smegmatis, 3 Mycobacterium marinum, 4 Mycobacterium gastri, 2 Mycobacterium gordonae, 2 Mycobacterium chelonae, 1 Mycobacterium xenopi, 1 Mycobacterium phlei, 1 Mycobacterium triviale, y 1 Mycobacterium malmoense. Sólo 5 de estas cepas estaban asociadas a cuadros clínicos: 2 Mycobacterium avium (micobacteriosis diseminada y renal respectivamente), 1 Mycobacterium gordonae (lesiones en piel), 1 Mycobacterium fortuitum (linfadenitis submaxilar), 1 Mycobacterium malmoense (linfadenitis submaxilar). Las especies más frecuentemente aisladas fueron M. avium y M. fortuitum acorde con lo revisado en la literatura. La aplicación simultánea de las técnicas convencionales y el estudio de las fracciones de ácidos micólicos ha permitido obtener resultados más confiables por lo que recomendamos su aplicación en estos estudios.
Non tuberculosis mycobacteria are opportunist pathogens whose frequency in human infections has increased after the appearance of the Acquired Immunodefficiency Syndrome (AIDS). In this work we studied 40 strains isolated from patients infected by the Human Immunodefficiency Virus and isolates with pathogenic significance were further analyzed for diagnostic confirmation by the method that studies mycolic acid fractions. After identification, the results were: 9 Mycobacterium avium, 8 Mycobacterium fortuitum, 4 Mycobacterium flavescens, 4 Mycobacterium smegmatis, 3 Mycobacterium marinum, 4 Mycobacterium gastri, 2 Mycobacterium gordonae, 2 Mycobacterium chelonae, 1 Mycobacterium xenopi, 1 Mycobacterium phlei, 1 Mycobacterium triviale, and 1 Mycobacterium malmoense. Only five of these strains were associated to clinical symptoms: 2 Mycobacterium avium (disseminated and renal mycobacteriosis respectively), 1 Mycobacterium gordonae (skin lesions), 1 Mycobacterium fortuitum (submaxilar lymphoadenitis), and 1 Mycobacterium malmoense (submaxilar lymphoadenitis). The species most frequently isolated were: M. avium and M. fortuitum, in agreement with a bibliographic revision. The simultaneous application of conventional techniques and the study of mycolic acid allowed us to obtain more trustworthy results.
ABSTRACT
Objective To investigate the feasibility of multiplex PCR for rapid identification of Mycobacterium tuberculosis and non-tuberculosis Mycobacteria. Methods According to MTP40 gene sequence of Mycobacterium tuberculosis, 32kD gene sequence of Mycobacterium and IS6110 insertion sequence gene sequence of Mycobacterium tuberculosis complex, three specific pairs of primers (PT1-PT2, MT1-MT2 and IS5-IS6) for Mycobacterium were designed, and the target DNA for MTP40, 32kD and IS6110 was 396bp, 506bp and 984bp, respectively. The genome of 92 Mycobacterium tuberculosis clinically isolated strains and 5 non-tuberculosis Mycobacteria clinical strains were amplified in the same system, and the results were compared with reference strains. Results Among 92 clinical strains of Mycobacterium tuberculosis, the DNA fragments of 396bp, 506bp and 984bp were found in 90 Mycobacterium tuberculosis clinical strains, as well as in the reference strain H37Rv; the sensitivity of multiplex PCR for Mycobacterium tuberculosis was 97.8%, and the specificity was 100.0%. The DNA fragments of 506bp were all found in 5 non-tuberculosis Mycobacteria clinical strains, the sensitivity and specificity for non-tuberculosis Mycobacterium were both 100.0%. Conclusion The multiplex PCR is a rapid, sensitive and specific method for identification of Mycobacterium tuberculosis and non-tuberculosis Mycobacteria, and it may provide an effective way for clinical diagnosis of Mycobacterium tuberculosis and non-tuberculosis Mycobacteria, therefore useful in clinical application.