Nontuberculous Mycobacterium

Rajendran, Priya; Padmapriyadarsini, Chandrasekaran; Mondal, Rajesh

doi:10.4103/ijmy.ijmy_141_21

Cited by 22 publications

(3 citation statements)

References 90 publications

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“…However, the phenotypic characteristics could remind us when the morphology did not match the identification result in the clinical laboratory or a simple distinction was made for different genera by rapid staining. In terms of phenotypic characteristics, for example, Tsukamurella and Gordonia isolates grew well on Columbia blood agar plates at 37°C for 48 h. This rapid growth characteristic was completely different from that of M. tuberculosis and nontuberculous mycobacteria ( 60 ). Overall, compared with the colony appearance of Gordonia species, Tsukamurella species were generally bigger, drier, wrinkled, and resembled a rough membrane with irregular spreading fringes.…”

Section: Discussionmentioning

confidence: 96%

Systematic investigation of the emerging pathogen of Tsukamurella species in a Chinese tertiary teaching hospital

Yu,

Ding,

Hua

et al. 2023

Microbiol Spectr

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Tsukamurella species have been clinically regarded as rare but emerging opportunistic pathogens causing various infections in humans. Tsukamurella pneumonia has often been misdiagnosed as pulmonary tuberculosis due to its clinical presentation resembling tuberculosis-like syndromes. Tsukamurella species have also been confused in the laboratory with other phylogenetic bacteria, such as Gordonia . This study aimed to investigate the clinical, microbiological, and molecular characteristics; species distribution; and antimicrobial susceptibility of Tsukamurella species. Immunodeficiency and chronic pulmonary disease appeared to be risk factors for Tsukamurella pneumonia, and the presence of bronchiectasis and pulmonary nodules on imaging was highly correlated with this infection. The study confirmed that groEL (heat shock protein 60) and secA (the secretion ATPase) genes are reliable for identifying Tsukamurella species. Additionally, the ssrA (stable small RNA) gene showed promise as a tool for discriminating between different Tsukamurella species with the shortest sequence length. In terms of antimicrobial susceptibility, quinolones, trimethoprim/sulfamethoxazole, amikacin, minocycline, linezolid, and tigecycline demonstrated potent in vitro activity against Tsukamurella isolates in our study. The study also proposed a resistance mechanism involving a substitution (S91R) within the quinolone-resistance-determining region of the gyrA gene, which confers resistance to levofloxacin and ciprofloxacin. Furthermore, we found that disk diffusion testing is not suitable for testing the susceptibilities of Tsukamurella isolates to ciprofloxacin, imipenem, and minocycline. In conclusion, our systematic investigation may contribute to a better understanding of this rare pathogen. IMPORTANCE Tsukamurella species are rare but emerging human pathogens that share remarkable similarities with other mycolic acid–containing genera of the order Actinomycetales, especially Mycobacterium tuberculosis . Consequently, misdiagnosis and therapeutic failures can occur in clinical settings. Despite the significance of accurate identification, antimicrobial susceptibility, and understanding the resistance mechanism of this important genus, our knowledge in these areas remains fragmentary and incomplete. In this study, we aimed to address these gaps by investigating promising identification methods, the antimicrobial susceptibility patterns, and a novel quinolone resistance mechanism in Tsukamurella species, utilizing a collection of clinical isolates. The findings of our study will contribute to improve diagnosis and successful management of infections caused by Tsukamurella species, as well as establishing well-defined performance and interpretive criteria for antimicrobial susceptibility testing.

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Section: Discussionmentioning

confidence: 96%

Systematic investigation of the emerging pathogen of Tsukamurella species in a Chinese tertiary teaching hospital

Yu,

Ding,

Hua

et al. 2023

Microbiol Spectr

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“…The DNA microarray chip technology had been widely used for the diagnosis of pulmonary mycobacterial infections employing sputum specimens ( Shi et al., 2012 ). Skin represents the most common extrapulmonary organ involved in mycobacterial infections ( Rajendran et al., 2021 ) and therefore warrants an urgent need for efficient and accurate diagnostic methods. In the present study, a novel DNA microarray chip was used for the detection of mycobacterial isolates in clinical skin tissue specimens and was found to be more sensitive and accurate compared to that of the conventional culture method (70.00% vs 91.67%; 77.92% vs 93.51%).…”

Section: Discussionmentioning

confidence: 99%

DNA microarray chip assay in new use: early diagnostic value in cutaneous mycobacterial infection

Wang

Gao

et al. 2023

Front. Cell. Infect. Microbiol.

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IntroductionThe clinical practicability of DNA microarray chip in detecting the presence of mycobacterial species/isolates directly in the skin tissues has not been evaluated, nor the efficacy of DNA microarray chip as a novel diagnostic tool for the early diagnosis of cutaneous mycobacterial infections is known.MethodsThe present study analyzed the incidence of cutaneous mycobacterial infections in Shanghai and explored the efficacy of a novel DNA microarray chip assay for the clinical diagnosis of the disease from skin tissue specimens compared to traditional detection methods. A total of 60 participants fulfilling the defined diagnostic criteria and confirmed positive for cutaneous mycobacterial infections from 2019 to 2021 were enrolled in the study. Subsequent to recording the participants’ medical history and clinical characteristics, the skin tissue specimens were collected for analyses. The specimens underwent histopathological analyses, skin tissue culture, and DNA microarray chip assay.ResultsIncreased incidence of cutaneous mycobacterial infection was detected from 2019 to 2021. The most common infecting pathogen was M. marinum followed by M. abscessus. The sensitivity, specificity and accuracy of the skin tissue culture method were 70%, 100% and 76.62%, respectively, while that of the DNA microarray chip assay were 91.67%, 100% and 93.51%, respectively. The sensitivity and accuracy of the DNA microarray chip assay were significantly higher than those of the skin tissue culture method. The positive likelihood and diagnostic odds ratio were >10 and >1, respectively for both the methods. The negative likelihood ratio was significantly higher (30% vs 8.33%) and the Youden’s index was significantly lower (70.00% vs 91.67%) in the skin culture method compared to that of the DNA microarray chip assay. There was a significant association of false negative results with a history of antibiotic use in the skin tissue culture method.DiscussionGiven the increasing incidence of cutaneous mycobacterial infections, early diagnosis remains a prime clinical focus. The DNA microarray chip assay provides a simple, rapid, high-throughput, and reliable method for the diagnosis of cutaneous mycobacterial infections with potential for clinical application.

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“…In recent years, frequently encountered NTM species in postsurgical wound infections are M. chelonae and M. fortuitum. 10 NTM are transmitted through aerosol, soil, dust, or contaminated tap water. 11 In our study, all the postoperative wounds were healed initially within 7-10 days of surgery.…”

Section: Discussionmentioning

confidence: 99%

Postoperative wound infection by nontuberculous mycobacteria; case series in Dhaka Medical College Hospital of Bangladesh

Halder,

Tanni,

Kabir

et al. 2023

Clinical Case Reports

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Key Clinical MessageThe incidence of nontuberculous mycobacterial (NTM) infections after operations is increasing in Bangladesh but data regarding clinical presentation, diagnosis, treatment, and prognosis after treatment are lacking. In this case series, three patients having persistent serous discharge from incision wound after operation were studied. Discharge from wounds were collected, wet film microscopy was performed for pus cells and fungus, Gram stain, Ziehl‐Neelsen (ZN) stain, culture in routine culture media and Lowenstein‐Jensen (LJ) media, Xene‐Xpert for mycobacterium tuberculosis (MTB), polymerase chain reaction (PCR) for NTM were done. NTM‐positive patients were treated initially for 6 weeks with four drugs regimen (clarithromycin 500 mg 12 hourly, ciprofloxacin 500 mg 12 hourly, linezolid 400 mg 12 hourly, and amikacin 500 mg 12 hourly), followed by 5 months with three drugs regimen (clarithromycin 500 mg 12 hourly, ciprofloxacin 500 mg 12 hourly, and linezolid 400 mg 12 hourly) as a maintenance dose. Cessation of discharge occurred within 3–4 weeks after starting treatment, and the wounds were healed.

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Nontuberculous Mycobacterium

Cited by 22 publications

References 90 publications

Systematic investigation of the emerging pathogen of Tsukamurella species in a Chinese tertiary teaching hospital

Systematic investigation of the emerging pathogen of Tsukamurella species in a Chinese tertiary teaching hospital

DNA microarray chip assay in new use: early diagnostic value in cutaneous mycobacterial infection

Postoperative wound infection by nontuberculous mycobacteria; case series in Dhaka Medical College Hospital of Bangladesh

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