Lethal<i>Mycobacterium massiliense</i>Sepsis, Italy

Tortoli, Enrico; Gabini, Rita; Galanti, Irene; Mariottini, Alessandro

doi:10.3201/eid1406.080194

Cited by 23 publications

(17 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…massiliense infection was linked to intramuscular injections of an antimicrobial agent in South Korea (11). This bacterium was also the source of a lethal case of sepsis in Italy (12) and has been found in cystic fibrosis patients in France (13). Several cases of bacteremia and cutaneous pulmonary infections have also been reported in Japan (14)(15)(16)(17).…”

mentioning

confidence: 99%

Discrimination of Mycobacterium abscessus subsp. massiliense from Mycobacterium abscessus subsp. abscessus in Clinical Isolates by Multiplex PCR

et al. 2014

View full text Add to dashboard Cite

The rapidly growing mycobacterium M. abscessus sensu lato is the causative agent of emerging pulmonary and skin diseases and of infections following cosmetic surgery and postsurgical procedures. M. abscessus sensu lato can be divided into at least three subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii. Clinical isolates of rapidly growing mycobacteria were previously identified as M. abscessus by DNA-DNA hybridization. More than 30% of these 117 clinical isolates were differentiated as M. abscessus subsp. massiliense using combinations of multilocus genotyping analyses. A much more cost-effective technique to distinguish M. abscessus subsp. massiliense from M. abscessus subsp. abscessus, a multiplex PCR assay, was developed using the whole-genome sequence of M. abscessus subsp. massiliense JCM15300 as a reference. Several primer sets were designed for single PCR to discriminate between the strains based on amplicons of different sizes. Two of these single-PCR target sites were chosen for development of the multiplex PCR assay. Multiplex PCR was successful in distinguishing clinical isolates of M. abscessus subsp. massiliense from samples previously identified as M. abscessus. This approach, which spans whole-genome sequencing and clinical diagnosis, will facilitate the acquisition of more-precise information about bacterial genomes, aid in the choice of more relevant therapies, and promote the advancement of novel discrimination and differential diagnostic assays. bolletii, and that a new subspecies, M. abscessus subsp. abscessus, should be designated (9). However, a recent whole-genome study strongly supported the hypothesis that the species can be divided into at least three subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii (10). M. abscessus subsp. massiliense was initially isolated from the sputum of a patient with pneumonia in France in 2004 (5). In 2005, an outbreak of M. abscessus subsp. massiliense infection was linked to intramuscular injections of an antimicrobial agent in South Korea (11). This bacterium was also the source of a lethal case of sepsis in Italy (12) and has been found in cystic fibrosis patients in France (13). Several cases of bacteremia and cutaneous pulmonary infections have also been reported in Japan (14-17).A novel approach is required to differentiate M. abscessus subsp. massiliense from M. abscessus subsp. abscessus and M. abscessus subsp. bolletii because conventional methods such as biochemical assays and 16S rRNA genotyping cannot make the discrimination. Moreover, the clinical profile of M. abscessus subsp. massiliense is different from those of M. abscessus subsp. abscessus and M. abscessus subsp. bolletii. In particular, antibiotic treatment with clarithromycin is more effective against M. abscessus subsp. massiliense lung infections, with resistance developing more readily in cases of M. abscessus subsp. abscessus lung disease. Therefore, differentiating ...

show abstract

mentioning

confidence: 99%

Discrimination of Mycobacterium abscessus subsp. massiliense from Mycobacterium abscessus subsp. abscessus in Clinical Isolates by Multiplex PCR

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Information on the pathogenic role of M. massiliense and M. bolletii is still scant. Recent reports have described the isolation of M. massiliense from two patients in the United States (29) and one patient in Italy (35) and, lately, the identification of M. massiliense and M. bolletii among South Korean isolates (18). Both M. massiliense and M. bolletii have also been linked to health care-associated outbreaks (8,19,37).…”

mentioning

confidence: 99%

Cohort Study of Molecular Identification and Typing of Mycobacterium abscessus, Mycobacterium massiliense , and Mycobacterium bolletii

Zelazny

Root

Shea³

et al. 2009

J Clin Microbiol

208

174

View full text Add to dashboard Cite

Rapidly growing mycobacteria (RGM) are ubiquitous organisms increasingly emerging as important human pathogens. Mycobacterium abscessus is commonly associated with wound infections and abscess formation and is the most frequent RGM causing chronic lung disease, often in immunocompromised patients (15,22,24). M. abscessus is also notable for its resistance to treatment and the poor clinical outcome of infection with the organism (22, 24). Within the past decade, two new species of mycobacteria closely related to M. abscessus, M. massiliense and M. bolletii, have been described (1, 3). Information on the pathogenic role of M. massiliense and M. bolletii is still scant. Recent reports have described the isolation of M. massiliense from two patients in the United States (29) and one patient in Italy (35) and, lately, the identification of M. massiliense and M. bolletii among South Korean isolates (18). Both M. massiliense and M. bolletii have also been linked to health care-associated outbreaks (8,19,37).The species-level identification of RGM can provide the first indication of antibiotic susceptibility and can suggest the appropriate type of patient management. For example, M. abscessus is more resistant to many antibiotics both in vivo and in vitro than M. fortuitum and M. mucogenicum, but it is usually susceptible to amikacin and clarithromycin (6,15,24). M. massiliense was originally reported to be distinguishable from M. abscessus and related species by its susceptibility to doxycycline (3); however, resistant isolates have since been described (19, 37), suggesting that antibiotic susceptibility results may not reliably differentiate among these closely related species. Although 16S rRNA gene sequencing has been used for the identification of nontuberculous mycobacteria (NTM), including RGM, it has limited value in distinguishing among some closely related species (9,14). Therefore, the use of several other gene targets for the identification of mycobacteria has been proposed (2,5,11,23,25,31,32,39,41). Discrimination among M. abscessus, M. massiliense, and M. bolletii (which have identical 16S rRNA gene sequences) has proven to be difficult, with sequencing of different gene targets often providing conflicting results. Among these gene targets, partial sequencing of rpoB has increasingly been used (1,19,29,37).Genotypic analysis of NTM has proven useful not only in the investigation of outbreaks and pseudo-outbreaks (38) but also in characterizing the molecular epidemiology of strains, and in * Corresponding author. Mailing address:

show abstract

“…In Korea, an outbreak was linked to intramuscular injections of an antimicrobial agent (9). This bacterium was also the source of a lethal case of sepsis in Italy and has been found in cystic fibrosis patients in France (15,20). Among pulmonary M. abscessus group isolates, almost half of the isolates in Korea and 30% of those in the Netherlands are M. massiliense (8,21).…”

mentioning

confidence: 99%

Multiple Cases of Cutaneous Mycobacterium massiliense Infection in a “Hot Spa” in Japan

et al. 2011

View full text Add to dashboard Cite

Seven body polishers working in the same "hot spa" presented with multiple red nodules and papules on their hands and forearms. A causative agent was successfully isolated from two of the subjects and from a swab sample collected from the underside of a bed cover in the body-polishing facility. The two cutaneous isolates and the environmental isolate were rapidly growing mycobacteria that formed nonphotochromogenic smooth or smooth/rough colonies on Ogawa egg slants. They were identified as Mycobacterium massiliense by multigenotypic analysis using the 16S rRNA, hsp65, and rpoB genes and the 16S-23S rRNA internal transcribed spacer (ITS) region. However, the use of the 16S rRNA gene sequence and/or DNA-DNA hybridization (DDH Mycobacteria Kit) alone would not distinguish M. massiliense from mycobacteria in the M. chelonae-M. abscessus group. The three isolates were significantly more susceptible to clarithromycin, doxycycline, and minocycline than the M. abscessus and M. bolletii reference strains. One cutaneous isolate and the environmental isolate were in a related cluster by randomly amplified polymorphic DNA PCR (RAPD-PCR). Of the several mycobacterial species found in the day spa, only M. massiliense was isolated from biopsy specimens of the skin lesions, suggesting that this bacterium is a human skin pathogen. This is the first known report of cutaneous M. massiliense infections that could not be attributed to a prior invasive procedure. This is also the first report of M. massiliense infection in Japan.Mycobacterium massiliense was initially isolated from the sputum of a patient with pneumonia in France in 2004 (1). Epidemiologically, M. massiliense has been recognized as an emerging pathogen in the United States (16,24) and Brazil, where outbreaks have been associated with postsurgical and cosmetic procedures (2, 4, 22). In Korea, an outbreak was linked to intramuscular injections of an antimicrobial agent (9). This bacterium was also the source of a lethal case of sepsis in Italy and has been found in cystic fibrosis patients in France (15,20). Among pulmonary M. abscessus group isolates, almost half of the isolates in Korea and 30% of those in the Netherlands are M. massiliense (8,21). It has been suggested that M. massiliense should be reclassified taxonomically as a subspecies of M. abscessus (11). The clinical significance of differentiating these two species has also been explored (7). However, M. massiliense has not been fully characterized. Although mycobacteria are a frequent source of dermal infection, M. massiliense has never been reported as an etiological agent. This report describes the first case of an M. massiliense dermal infection in Japan. Case ReportsIn November 2007, a 49-year-old female who worked as a body polisher in a hot spa developed multiple red nodules and papules on her hands and forearms. The number of lesions gradually increased over several months, precipitating a visit to a local hospital in June 2008 (case 1). A skin biopsy specimen of a nodule stained with hematoxylin a...

show abstract

LethalMycobacterium massilienseSepsis, Italy

Cited by 23 publications

References 7 publications

Discrimination of Mycobacterium abscessus subsp. massiliense from Mycobacterium abscessus subsp. abscessus in Clinical Isolates by Multiplex PCR

Discrimination of Mycobacterium abscessus subsp. massiliense from Mycobacterium abscessus subsp. abscessus in Clinical Isolates by Multiplex PCR

Cohort Study of Molecular Identification and Typing of Mycobacterium abscessus, Mycobacterium massiliense , and Mycobacterium bolletii

Multiple Cases of Cutaneous Mycobacterium massiliense Infection in a “Hot Spa” in Japan

Contact Info

Product

Resources

About