Erythromycin ribosome methyltransferase gene (erm) sequences of Mycobacterium massiliense and Mycobacterium bolletii isolates were newly investigated. Forty nine strains of M. massiliense that were analyzed in the present study had a deleted erm(41). Due to a frame-shift mutation, large deletion, and truncated C-terminal region, the Erm(41) of M. massiliense had only 81 amino acids encoded by 246 nucleotides. Corresponding to these findings, most of the M. massiliense isolates (89.8%) were markedly clarithromycin susceptible, but resistant strains invariably had a point mutation at the adenine (A 2058 or A 2059 ) in the peptidyltransferase region of the 23S rRNA gene, which is quite different from Mycobacterium abscessus and M. bolletii. In addition, erm(41) sequences of M. massiliense were more conserved than those of M. abscessus and M. bolletii. The results of species identification using erm(41) showed concordant results with those of multi-locus sequence analysis (rpoB, hsp65, sodA and 16S-23S ITS) where there were originally inconsistent results between rpoB and hsp65 sequence analysis in previous research. Therefore, erm(41) PCR that was used in the present study can be efficiently used to simply differentiate M. massiliense from M. abscessus and M. bolletii. Key words clarithromycin resistance, erm(41), Mycobacterium abscessus, Mycobacterium massiliense.Mycobacterium massiliense and Mycobacterium bolletii are recently described RGM that are closely related to Mycobacterium abscessus (1, 2). Mycobacterium chelonae, M. abscessus, and Mycobacterium immunogenum are generally defined as members of the M. chelonae-M. abscessus group, which is the causative agent of 95% of soft tissue RGM infections (3). As predicted by the continuous changes in the name of M. abscessus, evaluation of isolates by genotype analysis revealed a heterogeneous population of M. abscessus (4-6). One of them, M. abscessus Group II strains, was reported as M. massiliense and M. bolletii (7). As a genetic identification method to differentiate M. massiliense from M. abscessus and other species recently became available, human infections caused by M. massiliense have been continuously reported (8)(9)(10)(11)(12). Nearly half of the RGM isolates initially identified as M. abscessus, which is

The release of extracellular vesicles, also known as outer membrane vesicles, membrane vesicles, exosomes, and microvesicles, is an evolutionarily conserved phenomenon from bacteria to eukaryotes. It has been reported that Mycobacterium tuberculosis releases extracellular vesicles harboring immunologically active molecules, and these extracellular vesicles have been suggested to be applicable in vaccine development and biomarker discovery. However, the comprehensive proteomic analysis has not been performed for M. tuberculosis extracellular vesicles. In this study, we identified a total of 287 vesicular proteins by four LC-MS/MS analyses with high confidence. In addition, we identified several vesicular proteins associated with the virulence of M. tuberculosis. This comprehensive proteome profile will help elucidate the pathogenic mechanism of M. tuberculosis. The data have been deposited to the ProteomeXchange with identifier PXD001160 (http://proteomecentral.proteomexchange.org/dataset/PXD001160).

Kocuria spp. are members of the Micrococcaceae family that are frequently found in the environment and on human skin. Few human infections have been reported. We describe what appear to be the first two cases of Kocuria marina peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. CASE REPORTS Case 1.A 57-year-old man was admitted to the emergency department because of turbid dialysis effluent for 1 day. He had end-stage renal disease as a result of diabetic nephropathy and had been undergoing continuous ambulatory peritoneal dialysis (CAPD) for 6 years. Upon physical examination, he was afebrile, with a normal-appearing catheter exit site. However, the peritoneal dialysate fluid was straw colored and cloudy, with a total leukocyte count of 0.78 ϫ 10 9 leukocytes/ liter and a neutrophil count of 90%. No microorganisms were seen on a Gram stain. In the peripheral blood, the hemoglobin concentration was 10.1 g/dl, the white blood cell (WBC) count was 7.40 ϫ 10 9 cells/liter, and the platelet count was 171 ϫ 10 9 platelets/liter. The C-reactive protein concentration was 2.76 mg/dl (reference concentration, Ͻ0.5 mg/dl), and the serum urea and creatinine concentrations were 53 mg/dl and 11.2 mg/dl, respectively. Intraperitoneal administration of netilmicin and narrow-spectrum cephalosporin (ceftezole) was started for empirical treatment of CAPD peritonitis, which was changed to intraperitoneal ceftazidime and clindamycin when there was no response. Culture of the dialysate yielded a pure culture of grampositive cocci in pairs or clusters (strain M07-0128). After 48 h of incubation at 35°C in 5% CO 2 on sheep blood agar, the 1-to 2-mm colonies were nonhemolytic and yellow. The isolate was identified as Kocuria varians/Kocuria kristinae with a 50.28%/49.72% probability, respectively, by a Vitek 2 system (bioMérieux, St. Louis, MO) and as K. kristinae (code number 6714014) with a 99.3% probability by an API Staph system (bioMérieux, Marcy l'Etoile, France). We performed 16S rRNA gene sequencing as previously described (5) and compared the obtained sequence with sequences similar to those of the type strains using BLAST and EzTaxon (4). The result showed 99.86% homology with Kocuria marina; the second closest match was Kocuria carniphila, with 98.30% homology. This isolate was finally identified as K. marina by 16S rRNA gene sequence analysis. In spite of the start of administration of intravenous vancomycin on day 10, the response remained unsatisfactory. The Tenckhoff catheter in his abdomen was removed on day 17, and he was switched to hemodialysis with the placement of an arteriovenous shunt. The patient improved with antibiotic therapy for 7 days after catheter removal and was discharged.We performed antimicrobial susceptibility testing on the isolate using the agar dilution method, according to the Clinical and Laboratory Standards Institute (CLSI) guidelines for Staphylococcus (4a). The isolate was susceptible to penicillin, ampicillin, ampicillin-sulbactam, gentamicin, cephalothin (cefaloti...