Mycobacterium szulgai (M. szulgai) is an unusual pathogen in a human non-tuberculous mycobacterial infection. Pulmonary infection due to M. szulgai may be clinically and radiologically confused with active pulmonary tuberculosis. In contrast to other non-tuberculous mycobacteria, M. szulgai infection is well controlled by combination antimycobacterial therapy. Most of the previously reported cases of M. szulgai pulmonary infection showed cavitary upper lobe infiltrates. We herein describe a case of pulmonary M. szulgai infection that shows clinical and radiological presentations similar to active pulmonary tuberculosis.
Aged ; Antitubercular Agents/therapeutic use ; Humans ; Male ; Mycobacterium Infections, Nontuberculous/drug therapy/*radiography ; Nontuberculous Mycobacteria/*isolation & purification ; Republic of Korea ; Tomography, X-Ray Computed

Mycobacterium neoaurum is rapidly growing mycobacteria that can cause human infections. It commonly causes bloodstream infections in immunocompromised hosts, and unlike other mycobacteria species, it rarely causes pulmonary infections. We confirmed the first pulmonary infection case in Korea caused by M. neoaurum using full-length 16S rRNA gene sequencing.
Adult ; Female ; Humans ; Lung Diseases/*diagnosis/microbiology ; Mycobacterium/genetics/*isolation & purification ; Mycobacterium Infections/*diagnosis/microbiology ; Nontuberculous Mycobacteria/genetics/isolation & purification ; RNA, Ribosomal, 16S/genetics ; Republic of Korea ; Sequence Analysis, RNA

OBJECTIVETo explore the causative pathogens in littoral hand infections which exhibited chronic granulomatous inflammation, the relationship between chronic granulomatous inflammation and mycobacteria and to discuss the prospects of PCR in clinical application for diagnosis of granulomatous inflammation.

METHODWith 16S-rDNA as the target sequence, Nest-PCR was used to detect mycobacteria directly from 37 cases of chronic granulomatous inflammations, and identified them by gene sequencing.

RESULTSTwenty-four of 37 cases were positive for mycobacteria by Nest-PCR, in which 17 were M.marinum, 1 M.chelonae, 2 M.avium, 2 M.kansasii, and 2 M.tubercular through gene sequencing.

CONCLUSIONSNest-PCR combining gene sequencing proved to be a liable and sensitive method to detect Non-tubercular mycobacteria (NTM) in fresh tissue. NTM is the major factor of hand specific chronic infections other than tubercular. Pathological changes are difficult to differentiate TB from NTM and bacterial evidence was necessary.

Chronic Disease ; DNA, Bacterial ; chemistry ; genetics ; Granuloma ; diagnosis ; microbiology ; Hand ; Humans ; Inflammation ; diagnosis ; microbiology ; Molecular Diagnostic Techniques ; Mycobacterium Infections, Nontuberculous ; diagnosis ; microbiology ; Mycobacterium marinum ; genetics ; isolation & purification ; Mycobacterium tuberculosis ; genetics ; isolation & purification ; Nontuberculous Mycobacteria ; genetics ; isolation & purification ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S ; genetics ; Sequence Analysis, DNA

OBJECTIVESTo study the etiology, clinical and pathologic characteristics of periductal mastitis with fistula and estimate the effect of anti-mycobacterial agents for periductal mastitis with fistula.

METHODSTotally 27 patients of periductal mastitis with fistula received anti-mycobacteria drugs therapy from December 2008 to September 2011 were analyzed retrospectively. All of the patients were female. The mean age at onset was 28 years (range 15 to 40 years old). The main clinical manifestation of the 27 patients was breast fistula, including 21 patients with single fistula and 6 patients with multiple fistula. Three patients manifested with pure fistula, 14 patients with both fistula and lump, 10 patients with fistula, lump and abscess. The samples including pus or tissues of all patients were underwent bacteria culture and all patients core needle biopsy. All patients were given primary anti-mycobacteria drugs therapy, parts of patients received surgery based on the evaluation of medical treatment.

RESULTSThe common bacteria culture of all patients failed to demonstrate any causative microorganism. Four cases were selected randomly to undergo PCR of mycobacteria, only one case was identified as Massiliense in bacteria culture of mycobacteria. Twenty-seven patients with periductal mastitis with fistula were treated with anti-mycobacterial agents (isoniazid, rifampicin and ethambutol or pyrazinamide of triple oral drugs) for 1 to 3 months, the fistula of all 27 patients were closed well. Sixteen patients were treated with the agents only and cured. Eleven patients received surgical treatment after treated with the medical agents. None of the patients were given mastectomy. All patients had no reccurence until now.

CONCLUSIONSThe periductal mastitis with fistula has a closely relationship with the infection of nontuberculosis mycobacteria. Those patients could be treated with triple anti-mycobacterial agents and could also avoided mastectomy.

Adolescent ; Adult ; Anti-Bacterial Agents ; therapeutic use ; Drug Therapy, Combination ; Ethambutol ; therapeutic use ; Female ; Fistula ; drug therapy ; microbiology ; Humans ; Isoniazid ; therapeutic use ; Mastitis ; drug therapy ; pathology ; Nontuberculous Mycobacteria ; isolation & purification ; Pyrazinamide ; therapeutic use ; Retrospective Studies ; Rifampin ; therapeutic use ; Young Adult

A retrospective analysis was performed in two major HIV/AIDS referral hospitals in Beijing to evaluate the prevalence of Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacterial (NTM) infections in HIV-infected patients. A total of 627 patients' data were reviewed, and 102 (16.3%) patients were diagnosed with culture-confirmed mycobacterial infection, including 84 with MTB, 16 with NTM, and 2 with both MTB and NTM. The most frequent clinical complication by mycobacterial infection was pulmonary infection (48/102, 47.1%). The overall rates of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were 11.9% and 3.4%, respectively. This study underlines the urgent need to intensify screening for mycobacteria coinfection with HIV and to prevent the spread of drug-resistant TB among HIV-infected patients.
AIDS-Related Opportunistic Infections ; epidemiology ; microbiology ; Adult ; Beijing ; Coinfection ; Extensively Drug-Resistant Tuberculosis ; epidemiology ; microbiology ; Female ; HIV Infections ; epidemiology ; microbiology ; Hospitals, Urban ; Humans ; Male ; Mycobacterium Infections, Nontuberculous ; epidemiology ; microbiology ; Mycobacterium tuberculosis ; isolation & purification ; Nontuberculous Mycobacteria ; isolation & purification ; Prevalence ; Retrospective Studies ; Sputum ; microbiology ; Tuberculosis, Multidrug-Resistant ; epidemiology ; microbiology ; Tuberculosis, Pulmonary ; epidemiology ; microbiology

Mycobacterium longobardum is a slow-growing, nontuberculous mycobacterium that was first characterized from the M. terrae complex in 2012. We report a case of M. longobardum induced chronic osteomyelitis. A 71-yr-old man presented with inflammation in the left elbow and he underwent a surgery under the suspicion of tuberculous osteomyelitis. The pathologic tissue culture grew M. longobardum which was identified by analysis of the 65-kDa heat shock protein and full-length 16S rRNA genes. The patient was cured with the medication of clarithromycin and ethambutol without further complications. To the best of our knowledge, this is the first report of a M. longobardum infection worldwide.
Aged ; Anti-Bacterial Agents/therapeutic use ; Bacterial Proteins/genetics ; Chaperonin 60/genetics ; Clarithromycin/therapeutic use ; Elbow/pathology ; Ethambutol/therapeutic use ; Humans ; Male ; Mycobacterium Infections, Nontuberculous/*microbiology ; Nontuberculous Mycobacteria/classification/genetics/*isolation & purification ; Osteomyelitis/diagnosis/drug therapy/*microbiology/pathology ; RNA, Ribosomal, 16S/genetics ; Treatment Outcome

BACKGROUND: A peptide nucleic acid (PNA) probe-based real-time PCR (PNAqPCR(TM) TB/NTM detection kit; PANAGENE, Korea) assay has been recently developed for the simultaneous detection of Mycobacterium tuberculosis complex (MTBC) and nontuberculous mycobacteria (NTM) in clinical specimens. The study was aimed at evaluation of the performance of PNA probe-based real-time PCR in respiratory specimens. METHODS: To evaluate potential cross-reactivity, the extracted DNA specimens from Mycobacterium species and non-mycobacterial species were tested using PNA probe-based real-time PCR assay. A total of 531 respiratory specimens (482 sputum specimens and 49 bronchoalveolar washing fluid specimens) were collected from 230 patients in July and August, 2011. All specimens were analyzed for the detection of mycobacteria by direct smear examination, mycobacterial culture, and PNA probe-based real-time PCR assay. RESULTS: In cross-reactivity tests, no false-positive or false-negative results were evident. When the culture method was used as the gold standard test for comparison, PNA probe-based real-time PCR assay for detection of MTBC had a sensitivity and specificity of 96.7% (58/60) and 99.6% (469/471), respectively. Assuming the combination of culture and clinical diagnosis as the standard, the sensitivity and specificity of the new real-time PCR assay for detection of MTBC were 90.6% (58/64) and 99.6% (465/467), respectively. The new real-time PCR for the detection of NTM had a sensitivity and specificity of 69.0% (29/42) and 100% (489/489), respectively. CONCLUSIONS: The new real-time PCR assay may be useful for the detection of MTBC in respiratory specimens and for discrimination of NTM from MTBC.
Bronchoalveolar Lavage Fluid/microbiology ; DNA Probes/chemistry/metabolism ; DNA, Bacterial/*analysis ; Humans ; Molecular Typing/*methods ; Mycobacterium tuberculosis/*genetics/isolation & purification ; Nontuberculous Mycobacteria/*genetics/isolation & purification ; Nucleic Acid Hybridization ; Peptide Nucleic Acids/chemistry/*metabolism ; *Real-Time Polymerase Chain Reaction ; Respiratory System/*microbiology ; Sputum/microbiology

No abstract available.
Anti-Bacterial Agents/pharmacology ; DNA, Bacterial/analysis ; Female ; Humans ; Hypertrophy/diagnosis ; Magnetic Resonance Imaging ; Microbial Sensitivity Tests ; Middle Aged ; Mycobacterium/classification/drug effects/*isolation & purification ; Nontuberculous Mycobacteria/classification/drug effects/isolation & purification ; Phylogeny ; RNA, Ribosomal, 16S/chemistry/metabolism ; Real-Time Polymerase Chain Reaction ; Republic of Korea ; Sequence Analysis, RNA ; Sequence Homology, Nucleic Acid ; Tenosynovitis/*diagnosis/microbiology/pathology

Objective: To understand the etiological characteristics and drug susceptibility of Mycobacterium thermoresistibile and Mycobacterium elephantis isolated from a cow with mastitis and provide evidence for the prevention and control of infectious mastitis in cows. Methods: The milk sample was collected from a cow with mastitis, which was pretreated with 4% NaOH and inoculated with L-J medium for Mycobacterium isolation. The positive cultures were initially identified by acid-fast staining and multi-loci PCR, then Mycobacterium species was identified by the multiple loci sequence analysis (MLSA) with 16S rRNA, hsp65, ITS and SodA genes. The drug sensitivity of the isolates to 27 antibiotics was tested by alamar blue assay. Results: Two anti-acid stain positive strains were isolated from the milk of a cow with mastitis, which were identified as non-tuberculosis mycobacterium by multi-loci PCR, and multi-loci nucleic acid sequence analysis indicated that one strain was Mycobacterium thermoresistibile and another one was Mycobacterium elephantis. The results of the drug susceptibility test showed that the two strains were resistant to most antibiotics, including rifampicin and isoniazid, but they were sensitive to amikacin, moxifloxacin, levofloxacin, ethambutol, streptomycin, tobramycin, ciprofloxacin and linezolid. Conclusions:Mycobacterium thermoresistibile and Mycobacterium elephantis were isolated in a cow with mastitis and the drug susceptibility spectrum of the pathogens were unique. The results of the study can be used as reference for the prevention and control the infection in cows.
Animals ; Anti-Bacterial Agents/pharmacology* ; Antitubercular Agents/pharmacology* ; Cattle ; Drug Resistance, Bacterial ; Female ; Humans ; Mastitis, Bovine/microbiology* ; Microbial Sensitivity Tests ; Milk/microbiology* ; Mycobacterium/isolation & purification* ; Mycobacterium Infections/veterinary* ; Mycobacterium tuberculosis/drug effects* ; Nontuberculous Mycobacteria/isolation & purification* ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S/genetics*