The Role of Mycobacteria Other Than Tuberculosis (MOTT) in Patients with Cystic Fibrosis

Hjelt, Karsten; Højlyng, Niels; Howitz, P.; Illum, Niels Ove; Munk, Erik; Valerius, Niels Henrik; Fursted, Kurt; Hansen, Katrine Bagge; Heltberg, Ivar; Koch, Christian

doi:10.3109/00365549409011815

Cited by 58 publications

(50 citation statements)

References 17 publications

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“…It increases considerably thereafter, reaching about 15%. Similar data have been published previously, based on studies on either children or adults (1,4,8,12,13,16,18). However, their relevance can be questioned given the major methodological differences between studies.…”

supporting

confidence: 66%

“…The overall prevalence of NTM was significantly lower in patients under 15 years old than for patients equal to or more than 15 years old (4.8 versus 14.9%, respectively; P ‫؍‬ 0.001). M. abscessus was isolated at all ages, while MAC was not recovered before 15 years (prevalence of 0.0 and 5.2% in patients aged 1 to 14 and 15 to 24, respectively; P ‫؍‬ 0.001).Since 1990, an increasing number of studies have reported the recovery of nontuberculous mycobacteria (NTM) from the respiratory tract of patients with cystic fibrosis (CF) (1,12,13,16). In a recent multicenter study carried out in the United States using standardized bacteriological methods, the overall prevalence of NTM in sputum (percent of patients with at least one positive NTM culture) was 13%, ranging from 7 to 24% depending on the center (16).…”

mentioning

confidence: 99%

“…Since 1990, an increasing number of studies have reported the recovery of nontuberculous mycobacteria (NTM) from the respiratory tract of patients with cystic fibrosis (CF) (1,12,13,16). In a recent multicenter study carried out in the United States using standardized bacteriological methods, the overall prevalence of NTM in sputum (percent of patients with at least one positive NTM culture) was 13%, ranging from 7 to 24% depending on the center (16).…”

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confidence: 99%

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Age-Related Prevalence and Distribution of Nontuberculous Mycobacterial Species among Patients with Cystic Fibrosis

Pierre-Audigier¹,

Ferroni²,

et al. 2005

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We studied the prevalence and species distribution of nontuberculous mycobacteria (NTM) in relation to age in 385 patients with cystic fibrosis (CF) (mean age ؎ standard deviation [range], 12.0 ؎ 6.1 [1 to 24] years; sex ratio, 0.53) attending three Parisian centers. The overall prevalence of NTM in sputum was 8.1% (31 out of 385). The following NTM were isolated (n ‫؍‬ 33): Mycobacterium abscessus (n ‫؍‬ 13, 39.4%), Mycobacterium avium complex (MAC) (n ‫؍‬ 7, 21.2%), Mycobacterium gordonae (n ‫؍‬ 6, 18.2%), and other (n ‫؍‬ 7, 21.2%). Sixteen patients met the American Thoracic Society microbiological criteria for NTM infection, including 11 patients positive for M. abscessus, 4 for MAC, and 1 for MAC and Mycobacterium kansasii. The overall prevalence of NTM was significantly lower in patients under 15 years old than for patients equal to or more than 15 years old (4.8 versus 14.9%, respectively; P ‫؍‬ 0.001). M. abscessus was isolated at all ages, while MAC was not recovered before 15 years (prevalence of 0.0 and 5.2% in patients aged 1 to 14 and 15 to 24, respectively; P ‫؍‬ 0.001).Since 1990, an increasing number of studies have reported the recovery of nontuberculous mycobacteria (NTM) from the respiratory tract of patients with cystic fibrosis (CF) (1,12,13,16). In a recent multicenter study carried out in the United States using standardized bacteriological methods, the overall prevalence of NTM in sputum (percent of patients with at least one positive NTM culture) was 13%, ranging from 7 to 24% depending on the center (16). Mycobacterium avium complex (MAC) (72%) and Mycobacterium abscessus (16%) were the most common species. Other NTM (Mycobacterium gordonae, Mycobacterium kansasii, Mycobacterium lentiflavum, Mycobacterium peregrinum) were much rarer. About 20% of the culture-positive subjects met the American Thoracic Society (ATS) microbiological criteria for NTM pulmonary disease (2); most of these patients were positive for MAC or M. abscessus.Paradoxically, although we know that CF children are vulnerable to bacterial infections from birth, most previous studies on NTM in CF have been conducted in populations mostly or exclusively composed of adults (1, 13, 16). For example, only patients who were 10 years or older were recruited in the multicenter United States study cited above, and the mean age Ϯ standard deviation (SD) was 21 Ϯ 9 years (16). Very few case series involving children with CF have been carried out, and those that have been done mainly used inadequate culture and species identification techniques. However, although imperfect, these studies suggest some differences in the epidemiology of NTM between pediatric and adult CF populations. One of the most intriguing differences is the apparent propensity of CF children to be infected with rapidly growing mycobacteria (RGM). In 1980, Boxerbaum reported that 8 out of 430 CF children were infected with RGM: 6 with organisms referred to as Mycobacterium chelonei (now the M. chelonaeabscessus group) and two with M. fortuitum (4). M. chelonei in...

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supporting

confidence: 66%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Age-Related Prevalence and Distribution of Nontuberculous Mycobacterial Species among Patients with Cystic Fibrosis

Pierre-Audigier¹,

Ferroni²,

et al. 2005

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“…In the past years an increasing prevalence of nontuberculous mycobacteria infection among the cystic fibrosis (CF) population was observed (7,8,9,10,13,26 abscessus, which now have their own species designations (14). This distinction is relevant because antibiotic susceptibility can vary between these two species (24), and, depending upon the site of infection, these species vary in their clinical significance (17,18,29).…”

mentioning

confidence: 99%

“…In the past years an increasing prevalence of nontuberculous mycobacteria infection among the cystic fibrosis (CF) population was observed (7,8,9,10,13,26). Several case reports associate infection with Mycobacterium abscessus with poor clinical outcome (5,17,18,21,22).…”

mentioning

confidence: 99%

Intra- and Interpatient Variability of the hsp65 and 16S-23S Intergenic Gene Region in Mycobacterium abscessus Strains from Patients with Cystic Fibrosis

König¹,

Tammer²,

Sollich

et al. 2005

J Clin Microbiol

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To establish the exact pathogenic role of Mycobacterium abscessus in cystic fibrosis (CF), molecular tests are required for accurate identification. Forty-eight M. abscessus isolates from seven patients with CF were analyzed by sequence analysis for sequence variants within the hsp65 gene and the 16S-23S intergenic sequence (ITS). We detected two different hsp65 genes and correspondingly two ITS sequevars belonging to M. abscessus type I and type II.Nontuberculous mycobacteria (NTM), ubiquitous in the environment, have continued to emerge as important human pathogens. In the past years an increasing prevalence of nontuberculous mycobacteria infection among the cystic fibrosis (CF) population was observed (7,8,9,10,13,26 abscessus, which now have their own species designations (14). This distinction is relevant because antibiotic susceptibility can vary between these two species (24), and, depending upon the site of infection, these species vary in their clinical significance (17,18,29). Accurate identification of mycobacteria to the species level using morphological and biochemical characteristics is often not possible due to the increasing number of Mycobacterium species with overlapping phenotypic characteristics (15,16,23). The most widely used method for molecular identification of NTM is PCR-restriction fragment length pattern analysis (PRA) of the hsp65 gene (3,6,16,25). Tools proposed for the molecular identification of NTM clinical isolates include analysis of the 16S rRNA gene (4,11,12), the genes sod, dnaJ, rpoB, the 32-kDa protein-encoding gene recA, and the DNA gyrase genes as well as the internal transcribed spacer 16S-23S rRNA region (ITS) (20) and sequencing of the hsp65 gene (19). A target region must be sufficiently conserved among the strains of the species for use in genotype identification. Furthermore, the data should be reliable and unambiguous and comparable among laboratories.We analyzed the intra-and interpatient variability of M.abscessus isolates from patients with CF over time. For this purpose we analyzed a total of 48 M. abscessus isolates from different time points of isolation by sequence analysis for sequence variants and genetic variability within the hsp65 gene and the ITS region. All CF patients (n ϭ 61) were routinely examined in the Department of Pediatrics every 3 months. Sputum samples were investigated every 3 months or more frequently in cases of acute exacerbation. The microbiological investigation included the screening for mycobacteria (2). In this regard, respiratory specimens were decontaminated with NALC-NaOH (0.25% N-acetyl-L-cysteine-1% sodium hydroxide). Acid-fast bacillus smears were stained with the BBL TB Kinyoun stain kit (Becton Dickinson, Heidelberg, Germany) and scored according to Deutsches Institut für Normung guidelines. For a positive result at least four bacteria in 100 fields of view are necessary. One Löwenstein-Jensen and one Stonebrink slant was inoculated for each specimen. The slants were examined twice weekly for 2 weeks and then weekly for an...

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Cystic Fibrosis

Greening¹

2000

Crofton and Douglas's Respiratory Diseases

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The Role of Mycobacteria Other Than Tuberculosis (MOTT) in Patients with Cystic Fibrosis

Cited by 58 publications

References 17 publications

Age-Related Prevalence and Distribution of Nontuberculous Mycobacterial Species among Patients with Cystic Fibrosis

Age-Related Prevalence and Distribution of Nontuberculous Mycobacterial Species among Patients with Cystic Fibrosis

Intra- and Interpatient Variability of the hsp65 and 16S-23S Intergenic Gene Region in Mycobacterium abscessus Strains from Patients with Cystic Fibrosis

Cystic Fibrosis

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