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Journal of Veterinary Diagnostic... Mar 2024An adult male captive diamondback water snake () was found dead after a 1-d history of lethargy and cutaneous ulcers. The snake had eaten 2 sunfish ( spp.) 5 d before...
An adult male captive diamondback water snake () was found dead after a 1-d history of lethargy and cutaneous ulcers. The snake had eaten 2 sunfish ( spp.) 5 d before death. Gross examination revealed white-to-tan nodules in the lung and liver and segmental intestinal impactions with digested fish. Histopathology confirmed disseminated granulomas with numerous intrahistiocytic acid-fast bacteria in the skin, skeletal muscle, lung, liver, and intestines. and were identified by culture of the hepatic granuloma, followed by PCR and gene sequencing. To our knowledge, this is the first description of and coinfection in this species. Although has been isolated from reptiles, lesions associated with its presence in tissues have not been described previously. Interestingly, the mineralization within granulomas that we observed in our case is not reported in mycobacterial infection in reptiles, whereas this finding is common in mammals.
Topics: Male; Animals; Mycobacterium marinum; Mycobacterium Infections, Nontuberculous; Colubridae; Coinfection; Granuloma; Mammals
PubMed: 38205524
DOI: 10.1177/10406387231224465 -
Pathogens (Basel, Switzerland) Aug 2022Rapidly growing mycobacteria (RGM) has gained increasing clinical importance, and treatment is challenging due to diverse drug resistance. The minimum inhibitory...
Rapidly growing mycobacteria (RGM) has gained increasing clinical importance, and treatment is challenging due to diverse drug resistance. The minimum inhibitory concentrations (MIC) of 13 antimicrobial agents using modified broth microdilution and E-test were determined for 32 clinical isolates of RGM, including (22 isolates) and (10 isolates). Our results showed high rates of resistance to available antimicrobial agents. Amikacin remained highly susceptible (87.5%). Clarithromycin was active against the isolates of (95.5%), and (50%), but 36.4% and 20% had inducible macrolide resistance, respectively. Rates of susceptibility to tigecycline were 68.2-70%, and linezolid 45.5-50%, respectively. The quinolones (ciprofloxacin and moxifloxacin) showed better in vitro activity against isolates (50% susceptibility) than the isolates (31.8% susceptibility). The susceptibilities to other conventional anti-mycobacterial agents were poor. The MICs of E-test were higher than broth microdilution and may result in reports of false resistance. In conclusion, the implementation of the modified broth microdilution plates into the routine clinical laboratory workflow to provide antimicrobial susceptibility early, allows for the timely selection of appropriate treatment of RGM infections to improve outcome.
PubMed: 36145400
DOI: 10.3390/pathogens11090969 -
The American Journal of Tropical... Aug 2021Nontuberculosis mycobacteria (NTM) are opportunistic pathogens that cause a wide range of illnesses. Here, the species distribution and prevalence of NTM infections in...
Nontuberculosis mycobacteria (NTM) are opportunistic pathogens that cause a wide range of illnesses. Here, the species distribution and prevalence of NTM infections in tuberculosis suspects was analyzed. A total of 7,073 specimens from pulmonary and extrapulmonary sites were analyzed, and 709 (10%) were found to be culture positive for mycobacteria. Of these, 85.2% were identified as Mycobacterium tuberculosis complex and 14.8% as NTM (65.7% rapid growers and 34.3% slow growers). Speciation of the NTM isolates (n = 69) identified 19 NTM species. M. abscessus (33.3%) and M. fortuitum (24.6%) were the most dominant NTM species isolated from the patients, followed by M. porcinum (5.8%) and M. parascrofulaceum (4.3%). We also report peritonitis caused by rapidly growing NTM among the patients undergoing continuous ambulatory peritoneal dialysis and a case of M. senegalense peritonitis. A low prevalence but high species diversity of NTM was detected in our study. The high species diversity of NTM necessitates the need to unequivocally identify mycobacterial isolates for appropriate treatment.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Humans; India; Infant; Infant, Newborn; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Prevalence; Species Specificity; Tuberculosis; Young Adult
PubMed: 34424857
DOI: 10.4269/ajtmh.21-0095 -
The Journal of the Royal College of... Sep 2019The incidence and prevalence of nontuberculous mycobacteria (NTM) infection is on the rise with many cases still going unreported. Given the vague and nonspecific...
The incidence and prevalence of nontuberculous mycobacteria (NTM) infection is on the rise with many cases still going unreported. Given the vague and nonspecific clinical features of NTM infections, it is often missed or mistaken for Mycobacterium tuberculosis. The presumption that NTM infections are benign and do not contribute to morbidity no longer holds true. NTM infections need to be considered in patients with disseminated multisystem disease and in those not responding to standard M. tuberculosis treatment. As NTM infection is associated with granuloma formation, it can result in hypercalcaemia. Interestingly, there is evidence that there may be other mechanisms in play contributing to hypercalcaemia besides the increased calcitriol levels.
Topics: Aged; Anti-Bacterial Agents; Antibodies; Cefoxitin; Ciprofloxacin; Clarithromycin; Doxycycline; Drug Therapy, Combination; Female; Granuloma; Humans; Hypercalcemia; Interferons; Liver; Macrophage Colony-Stimulating Factor; Mycobacterium Infections, Nontuberculous; Mycobacterium abscessus; Mycobacterium fortuitum; Singapore
PubMed: 31497789
DOI: 10.4997/JRCPE.2019.309 -
Clinical Infectious Diseases : An... Aug 2019On 29 April 2015, the Florida Department of Health in Miami-Dade County (DOH Miami-Dade) was notified by a local dermatologist of 3 patients with suspected...
BACKGROUND
On 29 April 2015, the Florida Department of Health in Miami-Dade County (DOH Miami-Dade) was notified by a local dermatologist of 3 patients with suspected nontuberculous mycobacterial (NTM) infection after receiving tattoos at a local tattoo studio.
METHODS
DOH Miami-Dade conducted interviews and offered testing, described below, to tattoo studio clients reporting rashes. Culture of clinical isolates and identification were performed at the Florida Bureau of Public Health Laboratories. Characterization of NTM was performed by the Centers for Disease Control and Prevention and the US Food and Drug Administration (FDA), respectively. Whole-genome sequencing (WGS) and single-nucleotide polymorphism (SNP) analyses were used to construct a phylogeny among 21 Mycobacterium isolates at the FDA.
RESULTS
Thirty-eight of 226 interviewed clients were identified as outbreak-associated cases. Multivariate logistic regression revealed that individuals who reported gray tattoo ink in their tattoos were 8.2 times as likely to report a rash (95% confidence interval, 3.1-22.1). Multiple NTM species were identified in clinical and environmental specimens. Phylogenetic results from environmental samples and skin biopsies indicated that 2 Mycobacterium fortuitum isolates (graywash ink and a skin biopsy) and 11 Mycobacterium abscessus isolates (5 from the implicated bottle of graywash tattoo ink, 2 from tap water, and 4 from skin biopsies) were indistinguishable. In addition, Mycobacterium chelonae was isolated from 5 unopened bottles of graywash ink provided by 2 other tattoo studios in Miami-Dade County.
CONCLUSIONS
WGS and SNP analyses identified the tap water and the bottle of graywash tattoo ink as the sources of the NTM infections.
Topics: Adult; Disease Outbreaks; Environment; Female; Florida; Genome, Bacterial; Humans; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Phylogeny; Public Health Surveillance; Skin; Skin Diseases, Bacterial; Tattooing; Whole Genome Sequencing; Young Adult
PubMed: 30452604
DOI: 10.1093/cid/ciy979 -
MMWR. Morbidity and Mortality Weekly... Oct 2021During December 2018-February 2019, a multistate investigation identified 101 patients with vaccination-associated adverse events among an estimated 940 persons in...
During December 2018-February 2019, a multistate investigation identified 101 patients with vaccination-associated adverse events among an estimated 940 persons in Kentucky, Indiana, and Ohio who had received influenza; hepatitis A; pneumococcal; or tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines at the workplace during September 11-November 28, 2018. These vaccines had been administered by staff members of a third-party health care company contracted by 24 businesses. Company A provided multiple vaccine types during workplace vaccination events across 54 locations in these adjoining states. Injection-site wound isolates from patients yielded Mycobacterium porcinum, a nontuberculous mycobacteria (NTM) species in the Mycobacterium fortuitum group; subtyping using pulsed-field gel electrophoresis of all 28 available isolates identified two closely related clusters. Site visits to company A and interviews with staff members identified inadequate hand hygiene, improper vaccine storage and handling, lack of appropriate medical record documentation, and lack of reporting to the Vaccine Adverse Event Reporting System (VAERS). Vaccination-associated adverse events can be prevented by training health care workers responsible for handling or administering vaccines in safe vaccine handling, administration, and storage practices, timely reporting of any suspected vaccination-associated adverse events to VAERS, and notifying public health authorities of any adverse event clusters.
Topics: Adult; Aged; Female; Humans; Indiana; Kentucky; Male; Middle Aged; Mycobacteriaceae; Ohio; Skin Diseases, Bacterial; Soft Tissue Infections; Vaccination; Young Adult
PubMed: 34673748
DOI: 10.15585/mmwr.mm7042a3 -
Experimental and Clinical... Oct 2021Data are limited regarding the clinical significance of nontuberculous mycobacteria pulmonary infections among lung transplant recipients. We investigated the incidence...
OBJECTIVES
Data are limited regarding the clinical significance of nontuberculous mycobacteria pulmonary infections among lung transplant recipients. We investigated the incidence and characteristics of pulmonary nontuberculous mycobacteria infection in ourlung transplant patient population.
MATERIALS AND METHODS
We obtaineddata of the patients who underwent lung transplant in our center from January 1997 to March 2019.
RESULTS
Of 690 patients, nontuberculous mycobacteria were identified in 58 patients (8.4%) over a median follow-up of 3 years. Types of species were as follows: Mycobacterium simiae (n = 24), avium complex (n = 12), abscessus (n = 9), fortuitum (n = 6), chelonae (n = 2), szulgai (n = 1), kansasii (n = 1), lentiflavum (n = 1), and undefined mycobacteria (n = 2). When we compared infections in the early versus late period posttransplant (before and after 6 months), infections with Mycobacterium simiae (16 vs 8 incidents) and Mycobacterium fortuitum (5 vs 1 incident) were more often observed within the early period, whereas most Mycobacterium abscessus (7 vs 1 incident) and Mycobacterium avium complex (9 vs 3 incidents) were observed in the later period. The median forced expiratory volume in 1 second overtime did not differ significantly between patients with and without nontuberculous mycobacteria infection (P = .29). Nontuberculous mycobacteria acquisition was significantly associated with decreased survival (relative risk of 2.41, 95% CI, 1.70-3.43; P ⟨ .001).
CONCLUSIONS
The nontuberculous mycobacteria species isolated varied according to the time elapsed since transplant. Among lung transplant recipients, nontuberculous mycobacteria infection was associated with increased mortality but not with lung dysfunction.
Topics: Humans; Lung; Mycobacterium; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Opportunistic Infections; Transplant Recipients; Treatment Outcome
PubMed: 34641777
DOI: 10.6002/ect.2021.0177 -
MYCOBACTERIA IN SKIN LESIONS AND THE HABITAT OF THE ENDANGERED HOUSTON TOAD (ANAXYRUS HOUSTONENSIS).Journal of Wildlife Diseases Jul 2021Head-starting of the federally endangered Houston toad (Anaxyrus houstonensis), that is, the release of egg strands, tadpoles, and metamorphic juveniles produced in...
Head-starting of the federally endangered Houston toad (Anaxyrus houstonensis), that is, the release of egg strands, tadpoles, and metamorphic juveniles produced in captivity into the original breeding ponds, requires assessment of potential threats for the transmission of pathogens from captive to free-ranging toads. We used Illumina-based 16S rRNA V3 amplicon sequencing to investigate the community structure of bacteria from skin lesions of captive Houston toad and habitat (pond) samples. Proteobacteria, alone or together with Actinobacteria and, in some samples, Cyanobacteria represented virtually all reads in tissue lesion samples, whereas pond samples were much more diverse, with Acidobacteria, Actinobacteria, Bacteriodetes, Chloroflexi, Cyanobacteria, Firmicutes, Planctomycetes, Proteobacteria, and Verrucomicrobia present with little variation between samples. If present in lesions, Actinobacteria were largely represented by Mycobacteriaceae, and here mainly by one sequence identical to sequences of members of the Mycobacterium chelonae-abscessus complex. In pond samples, mycobacteria represented only a small portion of the actinobacteria, although at higher diversity with six distinct reads. Sequences for reads obtained from pond samples were identical to those representing the M. chelonae-abscessus complex, a group with Mycobacterium marinum, Mycobacterium kansasii, Mycobacterium avium, a group with Mycobacterium vaccae, Mycobacterium fortuitum, Mycobacterium poriferae, and a group with Mycobacterium elephantis and Mycobacterium celeriflavum, whereas sequences of high similarity were detected for reads related to those of Mycobacterium holsaticum, Mycobacterium pallens, and Mycobacterium obuense, and Mycobacterium goodii. Our results indicated that lesions observed on the Houston toad in captivity are not the result of mycobacteria in every case, and that the presence of mycobacteria in the captive colony does not represent a novel pathogen threat to the wild populations because such bacteria are also seen in the natural pond habitats for the Houston toad.
Topics: Animals; Ecosystem; Mycobacteriaceae; Mycobacterium; RNA, Ribosomal, 16S
PubMed: 33857294
DOI: 10.7589/JWD-D-20-00145 -
Journal of Clinical Tuberculosis and... Dec 2021Bloodstream infections (BSI) with rapidly growing mycobacteria (RGM) resulted in recent nosocomial outbreaks predominantly in immunocompromised patients. A little is...
BACKGROUND
Bloodstream infections (BSI) with rapidly growing mycobacteria (RGM) resulted in recent nosocomial outbreaks predominantly in immunocompromised patients. A little is known about the clinical implications of RGM BSI with different species.
METHODS
We conducted a multicenter retrospective cohort study of patients with RGM BSI from November 2011 to December 2020. Demographic data, clinical presentation, laboratory and radiographic findings and microbiological characteristics were used to tabulate descriptive statistics. We performed a comparative analysis of patients with BSI due to complex (MABC) vs. other RGM.
RESULTS
We identified 32 patients with positive blood cultures for RGM, 4/32 (12.5%) were considered to have unclear significance. The most common source for RGM BSI was intravascular catheters (14/28, 50%). Compared to other sources, patients with catheter-related bloodstream infection (CRBSI) received a shorter course of antimicrobial therapy (median [IQR]: one month [0.37-2.25] vs. six months [2-12]), ( = 0.01). The most common species isolated were MABC (12/28, 42.9%), followed by group (6/28, 21.4%) and (6/28, 21.4%). Compared to other RGM, MABC BSI was more likely to be secondary to skin and soft tissue infection, associated with longer hospital stay ( = 0.04) and higher death rates despite a higher number of antimicrobial agents used for empirical and directed therapy per patient.
CONCLUSION
MABC BSI is associated with an overall more resistant profile, longer hospital stay, and higher death rate despite a more aggressive therapy approach.
PubMed: 34849410
DOI: 10.1016/j.jctube.2021.100288 -
Journal of Wildlife Diseases Oct 2020Nontuberculous mycobacteria (NTM) are opportunistic pathogens of humans and animals and are transmitted among the environment, wildlife, livestock, and humans. The aim...
Nontuberculous mycobacteria (NTM) are opportunistic pathogens of humans and animals and are transmitted among the environment, wildlife, livestock, and humans. The aim of this study was to investigate the rate of isolation and antimicrobial susceptibility of NTM in wildlife. In total, 178 samples of feces (n=131) and tissues (n=47) were collected from 11 wildlife species in Gifu Prefecture and Mie Prefecture, Japan, between June 2016 and October 2018. We isolated NTM from 15.3% (20/ 131) of fecal samples using Ogawa medium, and isolates were identified by sequencing the rpoB and hsp65 genes. The rpoB sequences were compared with those from other strains of human and environmental origin. The NTM isolates were obtained from sika deer (Cervus nippon), wild boar (Sus scrofa), Japanese monkey (Macaca fuscata), raccoon dog (Nyctereutes procyonoides), masked palm civet (Paguma larvata), and Japanese weasel (Mustela itatsi) and were classified as rapidly growing mycobacteria (RGM) and slowly growing mycobacteria (SGM). The 12 RGM identified were Mycolicibacterium peregrinum (n=5), Mycolicibacterium fortuitum (n=3), Mycolicibacterium septicum (n=3), and Mycolicibacterium thermoresistibile (n=1), and the eight SGM were Mycobacterium paraense (n=4), Mycolicibacter arupensis (n=2), Mycolicibacter virginiensis (n=1), and Mycobacterium nebraskense (n=1). The NTM from wildlife showed ≥99% similarity with strains from different sources including humans. The RGM were susceptible to the antimicrobial agents tested except for M. fortuitum, which was resistant to azithromycin and clarithromycin. The SGM showed multiple drug resistance qualities but were susceptible to amikacin, clarithromycin, and rifabutin. These results indicate that wildlife may be reservoir hosts of NTM in Japan. The presence of antimicrobial-resistant NTM in wildlife suggests that the trends of NTM antimicrobial susceptibility in wildlife should be monitored.
Topics: Animals; Animals, Wild; Disease Reservoirs; Feces; Japan; Nontuberculous Mycobacteria; Phylogeny
PubMed: 32402237
DOI: 10.7589/2019-10-261