Real-time PCR detection of environmental mycobacteria in house dust.

Analysing the number and species of microbes in indoor dust is needed for assessment of human exposure to microbes in dwellings. Environmental mycobacteria are common heterotrophic bacteria in both natural and man-made environments and potential inducers of human immune system. Culture of mycobacteria from samples rich with other microbes is difficult due to the slow growth rate of mycobacteria and this has hampered the studies on their role in indoor human exposure. A quantitative, real-time 5'-nuclease (TaqMan) PCR assay was developed to detect environmental mycobacteria in indoor dust samples. The specificity of the primers and the probe targeting the 16S rDNA of mycobacteria, tested with 26 mycobacterial and 10 non-mycobacterial but related species, proved to be high. When tested on 20 indoor dust samples collected from five homes, the assay gave counts varying between 4.8 x 10(4) and 7.2 x 10(6)cell/g, being on average 1.1 x 10(3) times higher than culture. Seasonal variation in the dust counts of mycobacteria was observed by both culture and qPCR. Total of 140 isolates considered as mycobacteria by Ziehl-Neelsen staining and GLC-analyses were subjected to PCR analysis with the mycobacterial primers, and 39 isolates to partial 16S rDNA sequencing. All proved to be mycobacteria and revealed high diversity of mycobacterial species in the dust samples. Majority of the sequences were related to M. terrae and M. avium complexes.

Mycobacterium arosiense sp. nov., a slowly growing, scotochromogenic species causing osteomyelitis in an immunocompromised child.

A yellow-pigmented, scotochromogenic, slowly growing mycobacterial strain, designated T1921(T), was isolated from the disseminated osteomyelitic lesions of a 7-year-old child with an underlying partial gamma interferon receptor alpha-1 deficiency. Hybridization by the line probe assay indicated the presence of a Mycobacterium species. Sequencing of the 16S rRNA gene, the internally transcribed spacer (ITS) region and the hsp65 and rpoB genes revealed that strain T1921(T) could be differentiated from all recognized species of the genus Mycobacterium. Phylogenetic analysis based on the 16S rRNA gene indicated that strain T1921(T) was related most closely to Mycobacterium intracellulare, whereas analysis based on the ITS and hsp65 and rpoB genes indicated that it was most closely related to Mycobacterium avium. Phenotypic tests were not able to differentiate strain T1921(T) from similar slowly growing mycobacteria. Strain T1921(T) is considered to represent a novel species of the genus Mycobacterium, for which the name Mycobacterium arosiense sp. nov. is proposed. The type strain is T1921(T) (=DSM 45069(T) =ATCC BAA-1401(T)).

Mycobacteria and fungi in moisture-damaged building materials.

In contrast to the growth of fungi, the growth of mycobacteria in moisture-damaged building materials has rarely been studied. Environmental mycobacteria were isolated from 23% of samples of moisture-damaged materials (n = 88). The occurrence of mycobacteria increased with increasing concentrations of fungi. Mycobacteria may contribute to indoor exposure and associated adverse health effects.

Mycobacterium florentinum sp. nov., isolated from humans.

Eight mycobacterial strains isolated during an 11 year period from the sputum of independent patients with various pulmonary disorders and, in one case, from a lymph node of a young girl, were found to present identical features. Phenotypic and genotypic characteristics revealed that the most closely related species to these test isolates were Mycobacterium triplex and Mycobacterium lentiflavum. However, the lipids of the cell wall of the test isolates differed from those of the latter species by TLC and presented unique profiles by both GC and HPLC. Genotypic analysis showed that they had unique 16S rRNA gene and internal transcribed spacer (ITS) sequences, and could be differentiated from all other mycobacterial strains by PCR restriction analysis of hsp65. The strains presented high resistance to antimycobacterial drugs. The name Mycobacterium florentinum sp. nov. is proposed for this taxon, with strain FI-93171(T) (=DSM 44852(T) = CIP 108409(T)) as the type strain.

Potentially pathogenic, slow-growing mycobacteria released into workplace air during the remediation of buildings.

Construction workers' exposure to airborne viable mycobacteria was studied during the remediation of three moldy and two nonmoldy buildings. Furthermore, the concentrations of airborne fungal and actinobacterial spores were determined. The samples for the microbial analyses were collected using a six-stage impactor and an all-glass impinger sampler, and by filter sampling. Specific mycobacteria media and nonselective media were used for the cultures. The samples were cultured for the total numbers of rapidly growing and slow-growing mycobacteria, and the isolates obtained were identified to the genus or species level. Mycobacteria were recovered from the air during the remediation of two of the moldy buildings and one nondamaged building. Concentrations of mycobacteria up to 160 cfu/m3 were detected. A total of 43 mycobacterial isolates was recovered. Most of the isolates were slow-growers, only two rapid-growing strains being detected. The 38 identified isolates belonged to potentially pathogenic species, including Mycobacterium avium complex, M. scrofulaceum, and M. fortuitum, and to saprophytic species, including M. nonchromogenicum and M. terrae. Mycobacteria were the most often detected in samples taken with a six-stage impactor. They were found in buildings with both high and low concentrations of fungi. In conclusion, mycobacteria, both potentially pathogenic and saprophytic species, may be released into the indoor air during the remediation of buildings.

Gas-chromatographic lipid profiles in identification of currently known slowly growing environmental mycobacteria.

Cellular fatty acid analysis by GLC is widely used in the species identification of mycobacteria. Combining mycolic acid cleavage products with shorter cellular fatty acids increases the informative value of the analysis. A key has been created to aid in the identification of all currently known slowly growing environmental species. In this scheme, the species are classified into six categories, each characterized by a combination of fatty markers shared by those species. Within each category, individual species may be distinguished by the presence or absence of specific marker substances, such as methyl-branched fatty acids or secondary alcohols. This study also describes earlier unpublished GLC profiles of 14 rare, slowly growing, environmental mycobacteria, Mycobacterium asiaticum, Mycobacterium botniense, Mycobacterium branderi, Mycobacterium conspicuum, Mycobacterium cookii, Mycobacterium doricum, Mycobacterium heckeshornense, Mycobacterium heidelbergense, Mycobacterium hiberniae, Mycobacterium kubicae, Mycobacterium lentiflavum, Mycobacterium scrofulaceum, Mycobacterium triplex and Mycobacterium tusciae. Though no single identification technique alone, even sequencing of an entire single gene such as 16S rRNA, can identify all mycobacterial species accurately, GLC has proven to be both reliable and reproducible in the identification of slowly growing mycobacteria. In cases of earlier unknown species, it generates useful information that allows their further classification and may lead to the description of novel species.

Mycobacterium terrae isolated from indoor air of a moisture-damaged building induces sustained biphasic inflammatory response in mouse lungs.

Occupants in moisture-damaged buildings suffer frequently from respiratory symptoms. This may be partly due to the presence of abnormal microbial growth or the altered microbial flora in the damaged buildings. However, the specific effects of the microbes on respiratory health and the way they provoke clinical manifestations are poorly understood. In the present study, we exposed mice via intratracheal instillation to a single dose of Mycobacterium terrae isolated from the indoor air of a moisture-damaged building (1 X 10(7), 5 X 10(7), or 1 X 10(8) microbes). Inflammation and toxicity in lungs were evaluated 2 hr later. The time course of the effects was assessed with the dose of 1 X 10(8) bacterial cells for up to 28 days. M. terrae caused a sustained biphasic inflammation in mouse lungs. The characteristic features for the first phase, which lasted from 6 hr to 3 days, were elevated proinflammatory cytokine [i.e., tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6)] levels in the bronchoalveolar lavage fluid (BALF). TNF-alpha was produced in the lungs more intensively than was IL-6. Neutrophils were the most abundant cells in the airways during the first phase, although their numbers in BALF remained elevated up to 21 days. The characteristics of the second phase, which lasted from 7 to 28 days, were elevated TNF-alpha levels in BALF, expression of inducible nitric oxide synthase in BAL cells, and recruitment of mononuclear cells such as lymphocytes and macrophages into the airways. Moreover, total protein, albumin, and lactate dehydrogenase concentrations were elevated in both phases in BALF. The bacteria were detected in lungs up to 28 days. In summary, these observations indicate that M. terrae is capable of provoking a sustained, biphasic inflammation in mouse lungs and can cause a moderate degree of cytotoxicity. Thus, M. terrae can be considered a species with potential to adversely affect the health of the occupants of moisture-damaged buildings.

Mycobacterium palustre sp. nov., a potentially pathogenic, slowly growing mycobacterium isolated from clinical and veterinary specimens and from Finnish stream waters.

Taxonomic studies were performed on a phenotypically homogeneous group of 13 mycobacteria isolated from clinical, veterinary and stream-water samples. The methods applied included chromatographic analyses of bacterial lipids, biochemical tests and sequencing of the 16S rDNA and the internal transcribed spacer 1 (ITS1) region. Positive results in urease, Tween 80 hydrolysis and pyrazinamidase tests and a negative result in a semi-quantitative catalase test, combined with the ability to grow at 42 degrees C, distinguished this group among the yellow-pigmented, slowly growing mycobacteria. Unique fatty acid and mycolic acid profiles in chromatographic analyses and the results of gene sequencing indicated that the novel isolates represent a previously undescribed species, for which the name Mycobacterium palustre sp. nov. is proposed. The fatty acid profile obtained by GLC was characterized by the presence of several methyl-branched fatty acid markers. The most prominent markers were 2-methyleicosanoic, tetracosanoic and hexacosanoic acids. According to 16S rDNA sequencing, M. palustre is phylogenetically closest to Mycobacterium kubicae, a recently described species. M. palustre gives a false-positive result in a hybridization test with the AccuProbe Mycobacterium avium complex. One of the strains was isolated from a lymph-node biopsy from a child with cervical lymphadenitis. Thus, M. palustre should be listed among potential inducers of paediatric lymphadenitis. The veterinary isolates originated from the lymph nodes of slaughter pigs. The majority of the strains were recovered from natural waters, which highlights the role of the environment as a source of potentially pathogenic mycobacteria. The type strain of M. palustre is strain E846T (= DSM 44572T = ATCC BAA-377T).