Practical Guidance for Clinical Microbiology Laboratories: Mycobacteria

Abstract

Mycobacteria are the causative organisms for diseases such as tuberculosis (TB), leprosy, Buruli ulcer, and pulmonary nontuberculous mycobacterial disease, to name the most important ones. In 2015, globally, almost 10 million people developed TB, and almost half a million patients suffered from its multidrug-resistant form. In 2016, a total of 9,287 new TB cases were reported in the United States. In 2015, there were 174,608 new case of leprosy worldwide. India, Brazil, and Indonesia reported the most leprosy cases. In 2015, the World Health Organization reported 2,037 new cases of Buruli ulcer, with most cases being reported in Africa. Pulmonary nontuberculous mycobacterial disease is an emerging public health challenge. The U.S. National Institutes of Health reported an increase from 20 to 47 cases/100,000 persons (or 8.2% per year) of pulmonary nontuberculous mycobacterial disease among adults aged 65 years or older throughout the United States, with 181,037 national annual cases estimated in 2014. This review describes contemporary methods for the laboratory diagnosis of mycobacterial diseases. Furthermore, the review considers the ever-changing health care delivery system and stresses the laboratory's need to adjust and embrace molecular technologies to provide shorter turnaround times and a higher quality of care for the patients who we serve.

Crystal Structures of Membrane Transporter MmpL3, an Anti-TB Drug Target

“…Mycobacteria cause a number of serious diseases in humans, including tuberculosis (TB), leprosy, Buruli ulcer, and pulmonary nontuberculous mycobacterial disease (Forbes et al, 2018). In 2017 alone, there were an estimated 10 million new cases of TB and 1.3 million deaths, making it the leading cause of human fatality due to infectious disease (World Health Organization, 2018).…”

The role of mini-bronchoalveolar lavage fluid in the diagnosis of pulmonary tuberculosis in critically ill patients

“…According to Practice Guideline for clinical microbiology laboratories that addresses requirements pertaining to laboratory testing for mycobacteria and aspects of acceptable specimens and rejection criteria, an optimal volume for samples of the respiratory tract between 5 and 10 ml is recommended [28]. Therefore, 7 (27%) ETA samples were considered inadequate because they presented insufficient volume (< 5 ml) and five (19%) ETA samples were excluded to insufficient volume for the diagnostic tests (Table 1).…”

Mycobacterium abscessus subsp. bolletii keratitis: rare case reported in Brazil

“…There are some challenges related to the treatment due to poor penetration of the drugs, resistance to most conventional antimicrobials and the emergence of resistant strains, especially using monotherapy 13 , and because of the lack of consensus on the ideal therapeutic scheme in cases of NTM keratitis 1,13 . In this case, vancomycin and gentamicin were used in the fortified eye drops due to the fact that these drugs have been used for the last years in the treatment of keratitis caused by Mycobacterium abscessus subsp.…”

“…Nontuberculous mycobacteria (NTM) are ubiquitous environmental microorganisms that can be recovered from environmental sources (soil, water) and are often found in man-made reservoirs 1 . These are pathogens that have the ability to form biofilms on organic and inorganic materials due to their resistance to disinfectants, antibiotics and heavy metals 1 .…”

“…The NTM can colonize, infect, cause disease, and are therefore, considered opportunistic pathogens that can cause disease when associated with risk factors, such as accidental or surgical trauma, ocular surface diseases, use of contact lenses, or immunosuppression [1][2][3][4] . They are divided into two major groups: 1) slow-growing NTM and 2) rapidly-growing NTM 1,5…”