Related Strains of<i>Mycobacterium avium</i>Cause Disease in Children with AIDS and in Children with Lymphadenitis

Hazra, Rohan; Lee, Sun Hwa; Maslow, Joel N.; Husson, Robert N.

doi:10.1086/315378

Cited by 10 publications

(4 citation statements)

References 24 publications

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“…The majority of cases of MAC lymphadenitis are caused by M. avium isolates belonging to the Mav-B sequevar (11). The isolate we describe here must be added to a long list of organisms similar to M. avium that have been identified as causes of lymphadenitis in children (1, 6, 8-10, 12, 15, 19, 20).…”

Section: Discussionmentioning

confidence: 99%

Novel Mycobacterium Related to Mycobacterium triplex as a Cause of Cervical Lymphadenitis

Hazra

Floyd

Sloutsky³

et al. 2001

J Clin Microbiol

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The Mycobacterium avium complex (MAC) is an important cause of cervical lymphadenitis in children, and its incidence appears to be increasing in the United States and elsewhere. In areas where Mycobacterium tuberculosis is not prevalent, M. avium causes the vast majority of cases of mycobacterial lymphadenitis, although several other nontuberculous mycobacterial species have been reported as etiologic agents. This report describes the case of a child with cervical lymphadenitis caused by a nontuberculous mycobacterium that could not be identified using standard methods, including biochemical reactions and genetic probes. Direct 16S ribosomal DNA sequencing showed greater than 99% homology with Mycobacterium triplex, but sequence analysis of the 283-bp 16S-23S internal transcribed spacer (ITS) sequence showed only 95% identity, suggesting that it is a novel species or subspecies within a complex of organisms that includes M. triplex. Mycolic acid high-performance liquid chromatography analysis also identified this isolate as distinct from M. triplex, and differences in susceptibility to streptomycin and rifampin between this strain and M. triplex were also observed. These data support the value of further testing of clinical isolates that test negative with the MAC nucleic acid probes and suggest that standard methods used for the identification of mycobacteria may underestimate the complexity of the genus Mycobacterium. ITS sequence analysis may be useful in this setting because it is easy to perform and is able to distinguish closely related species and subspecies. This level of discrimination may have significant clinical ramifications, as closely related organisms may have different antibiotic susceptibility patterns.The Mycobacterium avium complex (MAC) is an important cause of cervical lymphadenitis in children, and its incidence appears to be increasing in the United States and elsewhere. Surgical excision achieves a high cure rate, but complete excision is often not feasible. Antibiotic therapy may be of benefit in some cases (12, 13).M. avium causes the vast majority of cases of lymphadenitis in these children, although several other nontuberculous mycobacterial species have been reported as etiologic agents, including M. bohemicum, M. celatum, M. genavense, M. haemophilum, M. heidelbergense, M. interjectum, M. intracellulare, M. lentiflavum, M. malmoense, and M. triplex (1, 6, 8-10, 12, 15, 19, 20). Species identification has generally been performed using biochemical tests and 16S ribosomal DNA (rDNA) gene sequence analysis. However, 16S rDNA sequence variability among selected mycobacterial species is limited. The 16S-23S rDNA internal transcribed spacer (ITS) is transcribed, but it does not code for a functional product and therefore is not as highly conserved as 16S rDNA. This sequence heterogeneity may serve to differentiate mycobacterial species whose 16S rDNA sequences are closely related or identical.Here we report the case of a child with cervical lymphadenitis due to a nontuberculous mycobac...

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Section: Discussionmentioning

confidence: 99%

Novel Mycobacterium Related to Mycobacterium triplex as a Cause of Cervical Lymphadenitis

Hazra

Floyd

Sloutsky³

et al. 2001

J Clin Microbiol

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“…In AIDS patients, MAC is the most common nontuberculous mycobacteria causing disease, especially in developed countries, and usually produces disseminated infections (8,16). However, MAC also causes infection in immunocompetent individuals with underlying pulmonary disease and in children with lymphadenitis or cystic fibrosis (10,14,16).…”

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Genetic Diversity of Mycobacterium avium Isolates Recovered from Clinical Samples and from the Environment: Molecular Characterization for Diagnostic Purposes

et al. 2008

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“…Numbers next to sequevar names represent the total number of subject isolates (case or control) that belonged to this sequevar group. (3,19), is better able to invade and replicate inside macrophages than M. intracellulare (14), and has been associated with more invasive forms of MAC disease (3,10,21,27). Our data differ from the findings of a recent study by Han et al, who found that M. avium (identified by 16S rRNA sequencing) isolated from clinical specimens was actually less likely to be associated with pulmonary disease than was M. intracellulare (9).…”

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Association between 16S-23S Internal Transcribed Spacer Sequence Groups of Mycobacterium avium Complex and Pulmonary Disease

et al. 2008

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Organisms within the Mycobacterium avium complex (MAC) may have differential virulence. We compared 33 subjects with MAC pulmonary disease to 75 subjects with a single positive culture without disease. M. avium isolates were significantly more likely to be associated with MAC pulmonary disease (odds ratio ‫؍‬ 5.14, 95% confidence interval ‫؍‬ 1.25 to 22.73) than M. intracellulare.Exposure to aerosols containing organisms in the Mycobacterium avium complex (MAC) likely occurs often (11, 12), but resultant pulmonary disease is uncommon (13, 16). The MAC group of organisms consists of two relatively common named species, M. avium and M. intracellulare, and a third group of organisms that until recently were not denoted by species names. Whether some species of MAC are more likely to cause pulmonary disease than others is unknown.(This article was previously published as an abstract [abstr.

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Related Strains ofMycobacterium aviumCause Disease in Children with AIDS and in Children with Lymphadenitis

Cited by 10 publications

References 24 publications

Novel Mycobacterium Related to Mycobacterium triplex as a Cause of Cervical Lymphadenitis

Novel Mycobacterium Related to Mycobacterium triplex as a Cause of Cervical Lymphadenitis

Genetic Diversity of Mycobacterium avium Isolates Recovered from Clinical Samples and from the Environment: Molecular Characterization for Diagnostic Purposes

Association between 16S-23S Internal Transcribed Spacer Sequence Groups of Mycobacterium avium Complex and Pulmonary Disease

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