No abstract

The nontuberculous mycobacteria are typically environmental organisms residing in soil and water. These microorganisms can cause a wide range of clinical diseases; pulmonary disease is most frequent, followed by lymphadenitis in children, skin and soft tissue disease, and rare extra pulmonary or disseminated infections. Mycobacterium avium complex is the second most common cause of pulmonary mycobacterioses after M. tuberculosis. This review covers the clinical and laboratory diagnosis of infection caused by the members of this complex and particularities for the treatment of different disease types and patient populations.

ABSTRACT:The presence of mycobacteria was studied in Bull Rock Cave ("Byci skala") and the water catchment area of Jedovnice Brook ("Jedovnicky potok") using direct microscopy after Ziehl-Neelsen (ZN) staining, culture examination and molecular techniques. Mycobacteria were detected in 47.1% of a total of 68 samples. The mycobacterial genes hsp65 and dnaA were detected and sequenced in 37 (74.0%) out of the 50 cave environmental samples and in 10 (55.6%) out of the 18 samples of water catchment sediments. Nine species of slowly growing mycobacteria (M. terrae, M. arupense, M. gordonae, M. lentiflavum, M. parascrofulaceum, M. parmense, M. saskatchewanense, M. simiae and M. xenopi) and two subsp. (M. avium subsp. avium and M. avium subsp. hominissuis) were detected. Fourteen species of rapidly growing mycobacteria (M. chelonae, M. chubuense, M. poriferae, M. flavescens, M. fortuitum, M. porcinum, M. rhodesiae, M. gilvum, M. goodii, M. peregrinum, M. mageritense, M. vanbaalenii, M. gadium and M. insubricum) were detected. The highest mycobacterial presence was documented by ZN staining and/or culture examinations in earthworm castings and bat guano (73.3% positivity out of the 15 samples) in the cave environment and in the water sediments collected under the outflow from the wastewater treatment plants (77.8% positivity out of nine samples). The highest total organic carbon (TOC) was detected in wooden material and earthworm castings with pH values between 5.0 and 7.7 in the cave environment and in water sediments collected under the outflow from the wastewater treatment plants with pH between 5.8 and 7.0. It could be concluded that the karst cave environment with its running surface water contaminated with different microorganisms or chemical substances creates favourable conditions not only for animals (especially earthworms) but also for mycobacteria. This fact is also demonstrated by the presence of these mycobacteria in the cave environment mainly in earthworm castings and bat guano.

For epidemiology studies, a decontamination method using a solution containing 4.0% NaOH and 0.5% tetradecyltrimethylammonium bromide (TDAB) represents a relatively simple and universal procedure for processing heavily microbially contaminated matrices together with increase of mycobacteria yield and elimination of gross contamination. A contamination rate only averaging 7.3% (2.4% in Cluster S; 6.9%% in Cluster R and 12.6%% in Cluster E) was found in 787 examined environmental samples. Mycobacteria were cultured from 28.5% of 274 soil and water sediments samples (Cluster S), 60.2% of 251 samples of raw and processed peat and other horticultural substrates (Cluster R), and 29.4% of 262 faecal samples along with other samples of animal origin (Cluster E). A total of 38 species of slow and rapidly growing mycobacteria were isolated. M. avium ssp. hominissuis, M. fortuitum, and M. malmoense were the species most often isolated. The parameters for the quantitative detection of mycobacteria by PCR can be significantly refined by treating the sample suspension before DNA isolation with PMA (propidium monoazide) solution. This effectively eliminates DNA residue from both dead mycobacterial cells and potentially interfering DNA segments present from other microbial flora. In terms of human exposure risk assessment, the potential exposure to live non-tuberculous mycobacteria can be more accurately determined.

Environmental mycobacteria (EM) constitute a health risk, particularly for immunocompromised people. Workers in heavy industry and in collieries represent an at-risk group of people as their immunity is often weakened by long-term employment in dusty environments, frequent smoking and an increased occurrence of pulmonary diseases. This study was concerned with the presence of EM in non-drinking water used for the hygiene of employees in six large industrial companies and collieries. Over a period of ten years, 1096 samples of surface water treated for hygiene purposes (treated surface water) and treated surface water diluted with mining water were examined. EM were detected in 63.4 and 41.5% samples of treated surface water and treated surface water diluted with mining water, respectively. Mycobacterium gordonae, M. avium-intracellulare and M. kansasii were the most frequently detected species. Adoption of suitable precautions should be enforced to reduce the incidence of mycobacteria in shower water and to decrease the infectious pressure on employees belonging to an at-risk group of people.