Mycobacterium abscessus and Mycobacterium chelonae are two closely related species that are often not distinguished by clinical laboratories despite the fact they cause diseases requiring different treatment regimens. Multilocus enzyme electrophoresis, PCR-restriction fragment length polymorphism analysis of the 65-kDa heat shock protein gene, biochemical tests, and high-performance liquid chromatography of mycolic acids were used to identify 75 isolates as either M. abscessus or M. chelonae that were originally submitted for drug susceptibility testing. Only 36 of these isolates were submitted with an identification at the species level. Using the above methods, 46 of the isolates were found to be M. abscessus and 29 were identified as M. chelonae. Eight isolates originally submitted as M. chelonae were identified as M. abscessus, and one isolate submitted as M. abscessus was found to be M. chelonae. The four identification methods were in agreement in identifying 74 of the 75 isolates. In drug susceptibility testing, all isolates of M. abscessus exhibited resistance to tobramycin (MIC of 8 to >16 g/ml), while all isolates of M. chelonae were susceptible to this drug (MIC of <4 g/ml). The results suggest that once an identification method is selected, clinical laboratories should be able to easily identify isolates of M. abscessus and M. chelonae.Mycobacterium abscessus and Mycobacterium chelonae are two species of rapidly growing mycobacteria frequently associated with nosocomial outbreaks and pseudo-outbreaks (1,11,24). Widespread outbreaks of postinjection abscesses have occurred due to medications contaminated with M. abscessus (6,22). Contamination of hospital equipment and medications can generally be traced to the ubiquitous presence of these organisms in tap water and their resistance to commonly used disinfectants (24).It is clinically important to correctly identify these organisms since they cause infections requiring different treatment regimens (R. J. Wallace, Jr., B. A. Brown, D. E. Griffith, Letter, Pediatr. Infect. Dis. J. 16:829, 1997). Prior to 1992, M. abscessus was considered a subspecies of M. chelonae. Though Kusunoki and Ezaki (10) firmly established through DNA hybridization that these organisms are separate species, they are nearly indistinguishable phenotypically. Only two biochemical tests, those for sodium chloride tolerance and utilization of citrate, are useful for identifying these organisms at the species level (17), but these tests may take up to 4 weeks to complete (5). Identification of rapidly growing species using high-performance liquid chromatography (HPLC) of mycolic acids has been limited with M. abscessus and M. chelonae because they produce very similar mycolic acid patterns (2). Recently, PCRbased methods targeting polymorphic regions of the 65-kDa heat shock protein (HSP) gene have been used successfully to identify isolates of M. abscessus and M. chelonae (8, 15; A. R. Lakshmy, N. Siddiqi, M. Shamim, M. Deb, G. Mehta, and S. E. Hasnain, Letter, Emerg. Infect. Dis. 6...

We developed a scheme for the rapid identification ofMycobacterium species based upon PCR amplification of polymorphic genetic regions with fluorescent primers followed by restriction and analysis by fluorescence capillary electrophoresis.Mycobacterium species were identified by restriction enzyme analysis of a 439-bp segment of the 65-kDa heat shock protein gene (labeled [both strands] at the 5′ end with 4,7,2′,7′-tetrachloro-6-carboxyfluorescein) using HaeIII and BstEII and of a 475-bp hypervariable region of the 16S rRNA gene (labeled [both strands] at the 5′ end with 6-carboxyfluorescein) using HaeIII and CfoI. Samples were analyzed on an automated fluorescence capillary electrophoresis instrument, and labeled fragments were sized by comparison with an internal standard. DNA templates were prepared with pure cultures of type strains. In all, we analyzed 180 strains, representing 22 Mycobacterium species, and obtained distinctive restriction fragment length polymorphism (RFLP) patterns for 19 species. Three members of the Mycobacterium tuberculosis complex had a common RFLP pattern. A computerized algorithm which eliminates subjectivity from pattern interpretation and which is capable of identifying the species within a sample was developed. The convenience and short preparatory time of this assay make it comparable to conventional methodologies such as high-performance liquid chromatography and hybridization assays for identification of mycobacteria.