-
Frontiers in Microbiology 2024infection is one of the most common causes of non-tuberculosis mycobacterial (NTM) disease worldwide. However, accurate information on the global prevalence of this...
BACKGROUND
infection is one of the most common causes of non-tuberculosis mycobacterial (NTM) disease worldwide. However, accurate information on the global prevalence of this bacterium is lacking. Therefore, this study was conducted to investigate the prevalence of in clinical and environmental isolates.
METHODS
Databases, including PubMed, Scopus, and the Web of Science, were utilized to gather articles on the prevalence of in clinical and environmental isolates. The collected data were analyzed using Comprehensive Meta-Analysis software.
RESULTS
A total of 118 and 16 studies met the inclusion criteria and were used to analyze the prevalence of in clinical and environmental isolates, respectively. The prevalence of in NTM and environmental isolates were 9.4 and 5.8%, respectively. Subsequent analysis showed an increasing prevalence of over the years. Additionally, the results indicated a significant difference in the prevalence of this bacteria among different regions.
CONCLUSION
The relatively high prevalence of among NTM isolates suggests the need for further implementation of infection control strategies. It is also important to establish appropriate diagnostic criteria and management guidelines for screening this microorganism in environmental samples in order to prevent its spread, given its high prevalence in environmental isolates.
PubMed: 38440139
DOI: 10.3389/fmicb.2024.1321273 -
Journal of Korean Medical Science May 2016Nontuberculous mycobacteria (NTM) are ubiquitous organisms; their isolation from clinical specimens does not always indicate clinical disease. The incidence of NTM lung... (Review)
Review
Nontuberculous mycobacteria (NTM) are ubiquitous organisms; their isolation from clinical specimens does not always indicate clinical disease. The incidence of NTM lung diseases has been increasing worldwide. Although the geographic diversity of NTM species is well known, Mycobacterium avium complex (MAC), M. abscessus complex (MABC), and M. kansasii are the most commonly encountered and important etiologic organisms. Two distinct types of NTM lung diseases have been reported, namely fibrocavitary and nodular bronchiectatic forms. For laboratory diagnosis of NTM lung diseases, both liquid and solid media cultures and species-level identification are strongly recommended to enhance growth detection and determine the clinical relevance of isolates. Treatment for NTM lung diseases consists of a multidrug regimen and a long course of therapy, lasting more than 12 months after negative sputum conversion. For MAC lung disease, several new macrolide-based regimens are now recommended. For nodular bronchiectatic forms of MAC lung diseases, an intermittent three-time-weekly regimen produces outcomes similar to those of daily therapy. Treatment of MABC lung disease is very difficult, requiring long-term use of parenteral agents in combination with new macrolides. Treatment outcomes are much better for M. massiliense lung disease than for M. abscessus lung disease. Thus, precise identification of species in MABC infection is needed for the prediction of antibiotic response. Likewise, increased efforts to improve treatment outcomes and develop new agents for NTM lung disease are needed.
Topics: Anti-Bacterial Agents; Drug Therapy, Combination; Humans; Lung Diseases; Mycobacterium Infections, Nontuberculous; Mycobacterium avium Complex; Sputum
PubMed: 27134484
DOI: 10.3346/jkms.2016.31.5.649 -
Respiratory Medicine Oct 2012Mycobacterium kansasii infection is one of the most common causes of nontuberculous mycobacterial lung disease in the world. However, it is not possible to differentiate...
BACKGROUND
Mycobacterium kansasii infection is one of the most common causes of nontuberculous mycobacterial lung disease in the world. However, it is not possible to differentiate completely between M. kansasii and other nontuberculous mycobacteria (NTM) because of a lack of direct comparative studies. This retrospective study sought to identify their clinical and radiological features systematically.
METHODS
The sample included 98 consecutive patients with a culture-positive diagnosis of NTM infection, derived from the databases of the Laboratory of Microbiology of a tertiary medical center and two outpatient tuberculosis centers. Sixty-four patients had M. kansasii infection. All patients fulfilled disease criteria for treatment. Data on patient background and clinical features were collected, and chest radiographs were evaluated.
RESULTS
In the M. kansasii group, n = 27 (42%) were native-born Israelis compared to 9.4% (n = 3) of all other NTM groups (p = 0.0001). Similar rates of co-morbid diseases, including diabetes mellitus, heart disease, lung diseases, and malignancy were noted in both groups. Old TB was less common in the M. kansasii group compared to the other NTM (3.1% vs. 23.5%, p = 0.003). Clinical symptoms were significantly more common in patients with M. kansasii infection. On radiological study, M. kansasii infection was associated with more cavitations and unilaterality. Patients with M. kansasii infection had a higher likelihood of right upper lobe disease (p = 0.001). Pleural effusions and lymphadenopathy were found only in a few patients in each group.
CONCLUSION
Major differences in the epidemiologic and clinical features of M. kansasii infection and other NTM have important diagnostic and clinical implications.
Topics: Adult; Aged; Aged, 80 and over; Antibiotics, Antitubercular; Female; Humans; Lung Diseases; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Mycobacterium kansasii; Nontuberculous Mycobacteria; Radiography; Retrospective Studies; Sputum; Treatment Outcome; Young Adult
PubMed: 22850110
DOI: 10.1016/j.rmed.2012.06.023 -
Current Tropical Medicine Reports Dec 2018is a slow-growing member of the nontuberculous mycobacterial species that manifests clinically with pulmonary, cutaneous, or disseminated forms. Most cases of...
PURPOSE OF REVIEW
is a slow-growing member of the nontuberculous mycobacterial species that manifests clinically with pulmonary, cutaneous, or disseminated forms. Most cases of infection occur in immunocompromised hosts including HIV/AIDS, solid-organ transplantation, anti-interferon-γ antibody disorder, or among those with pulmonary disorders such as chronic obstructive pulmonary disease or cystic fibrosis. In this review, we aim to discuss relevant literature regarding the clinical manifestations of this infection with a particular emphasis on the clinical spectrum and treatment of the cutaneous manifestations of this mycobacterial infection.
RECENT FINDINGS
Infection caused by is associated with exposure to contaminated municipal water systems since this organism thrives in human-engineered environments. Chronic or subacute skin lesions may represent the primary source of entry of the organism due to open sores or traumatic injuries. Alternatively, cutaneous lesions may occur secondary to dissemination of the organism to the skin from pulmonary infection. The diagnosis of of the skin and soft tissues should be entertained among immunocompetent or immunocompromised individuals presenting with subacute or chronic lesions. The differential diagnosis of infection includes infections of skin and soft tissues caused by rapidly growing mycobacteria, subcutaneous mycosis, pyogenic bacterial infections, nocardiosis, free-living amoebas, and protothecosis.
SUMMARY
Cutaneous lesions caused by most commonly manifest in the setting of concomitant pulmonary disease or in the setting of disseminated infection among immunocompromised hosts. When clinicians suspect a cutaneous mycobacterial infection either due to slow-growing mycobacteria such as or due to rapidly growing mycobacteria, obtaining a skin biopsy of chronic nonhealing lesions for histopathologic evaluation and for microbiological assessment is crucial. Mycobacteriology assessment of clinical specimen includes acid-fast bacilli staining, culture in solid/liquid media, and molecular assays for confirmation. Treatment of infection of the skin and subcutaneous tissues follows the same management recommendations as those for the treatment of isolated pulmonary forms or disseminated disease.
PubMed: 35663919
DOI: 10.1007/s40475-018-0160-8 -
Pathogens (Basel, Switzerland) Nov 2020Mycobacterial infections are a major concern in veterinary medicine because of the difficulty achieving an etiological diagnosis, the challenges and concerns of...
Mycobacterial infections are a major concern in veterinary medicine because of the difficulty achieving an etiological diagnosis, the challenges and concerns of treatment, and the potential zoonotic risk. , a slow-growing non-tuberculous mycobacteria, causes disease in both humans and animals. While infections have been well described in humans, where it may be misdiagnosed as tuberculosis, there are fewer reports in animals. Only four cases have been reported in the domestic cat. This case report describes systemic infection in two sibling indoor-only cats that presented two and half years apart with cutaneous disease that was found to be associated with osteolytic and pulmonary pathology. Infection with was confirmed in both cats by polymerase chain reaction on fine-needle aspirate of a lumbosacral soft tissue mass in one cat and on a tissue punch biopsy of a skin lesion in the other; interferon-gamma release assay inferred -complex and -complex infection in the two cats, respectively. Both patients made a full recovery following antimicrobial therapy with rifampicin, azithromycin, and pradofloxacin (plus N-acetyl cysteine in cat 2). This report highlights successful treatment of systemic mycobacteriosis in the cat and the challenge of accurately diagnosing this infection.
PubMed: 33218094
DOI: 10.3390/pathogens9110959 -
Respiratory Medicine May 2019Aggressive therapy for Mycobacterium kansasii-pulmonary disease (MK-PD) is recommended because of the virulence of MK. However, some clinicians may be concerned...
BACKGROUND
Aggressive therapy for Mycobacterium kansasii-pulmonary disease (MK-PD) is recommended because of the virulence of MK. However, some clinicians may be concerned regarding the lengthy course and numerous adverse effects. This study evaluated the natural course of MK-PD and investigated its prognostic factors.
METHODS
Radiographic outcome, prognostic factors, and mortality within 1 year for MK-PD were obtained from patients in 6 hospitals in Taiwan from 2010 to 2014 (derivation cohort) and validated using patients in 2015 and 2016 (validation cohort).
RESULTS
Of the 109 patients with MK-PD in the derivation cohort, radiographic progression occurred in 70 (64%), with a 1-year mortality rate of 43% and median survival of 71 days, whereas none of the 39 cases without radiographic progression died. All patients with acid-fast smear (AFS) grade ≥ 3 experienced radiographic progression. For the others, the independent risk factors of radiographic progression were fibroCavitary pattern, Leucocyte count >9000/μL, Old age (age >65 years), pUre MK in sputum (no other mycobacteria), and no Diabetes mellitus (the CLOUD factors). By applying these criteria to the validation cohort (n = 112), 3 (9%) of the 33 patients with MK-PD who initially had AFS grade < 3 and < 3 CLOUD risk factors experienced radiographic progression, and none of the 3 died of MK-PD.
CONCLUSIONS
Because of the high risk of radiographic progression and subsequent fatal outcome, immediate anti-MK treatment is recommended. For patients with MK-PD who have sputum AFS grade <3 and < 3 CLOUD risk factors, regular follow-up may be an alternative.
Topics: Age Factors; Aged; Body Mass Index; Cohort Studies; Disease Progression; Female; Humans; Leukocytosis; Lung Diseases; Male; Mycobacterium Infections, Nontuberculous; Mycobacterium kansasii; Prognosis; Radiography; Retrospective Studies; Risk Factors; Sputum; Taiwan
PubMed: 31047113
DOI: 10.1016/j.rmed.2019.03.015 -
Clinical Microbiology and Infection :... Mar 2023Mycobacterium kansasii pulmonary disease is frequently misdiagnosed and treated as tuberculosis, especially in countries with high tuberculosis burden. This study aimed...
OBJECTIVES
Mycobacterium kansasii pulmonary disease is frequently misdiagnosed and treated as tuberculosis, especially in countries with high tuberculosis burden. This study aimed to investigate the drug resistance profile of M.kansasii in patients with M.kansasii pulmonary disease in Shanghai and to determine the variations in drug resistance after 2 months of antimycobacterial treatment.
METHODS
All patients with a diagnosis of M.kansasii pulmonary disease from 2017 to 2019 in Shanghai were retrospectively analysed. Whole-genome sequencing was performed, and the minimum inhibitory concentration (MIC) to antimycobacterial drugs was measured using the broth microdilution method.
RESULTS
In total, 191 patients had a diagnosis of M.kansasii pulmonary disease. Of them, 24.1% (46/191) had persistent positive culture after 2 months of antimycobacterial treatment. Whole-genome sequencing revealed that the 46 paired isolates had a difference of <17 single nucleotide polymorphisms, thus excluding the possibility of exogenous reinfection. More than 90% of the baseline isolates were sensitive to rifampin, clarithromycin, moxifloxacin, or amikacin, whereas a high resistance to ethambutol (118/191, 61.8%) and 4 μg/mL of isoniazid (32/191, 16.8%) were observed. Two isolates presented high resistance to rifamycin (i.e. a rifampin MIC of >8 μg/mL and a rifabutin MIC of 8 μg/mL) both containing the rpoB mutation (S454L). The increase of MIC to rifampin, ethambutol, and/or isoniazid was identified in 50.0% (23/46) of the patients.
DISCUSSION
A high prevalence of innate resistance to ethambutol and isoniazid was observed among circulating M.kansasii clinical strains in Shanghai. The increase in drug resistance under empirical antimycobacterial treatment highlighted the urgency of definitive species identification before initiating treatment.
Topics: Humans; Mycobacterium kansasii; Ethambutol; Rifampin; Isoniazid; Retrospective Studies; China; Anti-Bacterial Agents; Tuberculosis; Lung Diseases; Microbial Sensitivity Tests; Antitubercular Agents
PubMed: 36209990
DOI: 10.1016/j.cmi.2022.10.002 -
Frontiers in Cellular and Infection... 2020is an important opportunistic pathogen of humans and has a close phylogenetic relationship with . Seven subtypes (I-VII) have been identified using molecular biology...
is an important opportunistic pathogen of humans and has a close phylogenetic relationship with . Seven subtypes (I-VII) have been identified using molecular biology approaches, of which subtype I is the most frequent causative agent of human disease. To investigate the genotypes and pathogenic components of , we sequenced and compared the complete base-perfect genomes of different subtypes. Our findings support the proposition that "subtypes" I-VI, whose assemblies are currently available, should be considered as different species. Furthermore, we identified the exclusive presence of the operon in subtype I, and we confirmed its role in the pathogenicity of in a cell infection model. The operon is exclusively present in mycobacterial species that induce phagosomal rupture in host phagocytes and is known to be a major determinant of ESX1-mediated virulence in pathogenic mycobacteria. Comparative transcriptome analysis of the I-V strains identified genes potentially associated with virulence. Using a comparative genomics approach, we designed primers for PCR genotyping of subtypes I-V and tested their efficacy using clinically relevant strains of .
Topics: Gene Expression Profiling; Genomics; Humans; Mycobacterium Infections, Nontuberculous; Mycobacterium kansasii; Phylogeny; Transcriptome; Virulence
PubMed: 32266172
DOI: 10.3389/fcimb.2020.00122 -
Respiration; International Review of... 2016Non-tuberculous mycobacteria (NTM) include more than 160 ubiquitous, environmental, acid-fast-staining bacterial species, some of which may cause disease in humans.... (Review)
Review
Non-tuberculous mycobacteria (NTM) include more than 160 ubiquitous, environmental, acid-fast-staining bacterial species, some of which may cause disease in humans. Chronic pulmonary infection is the most common clinical manifestation. Although patients suffering from chronic lung diseases are particularly susceptible to NTM pulmonary disease, many affected patients have no apparent risk factors. Host and pathogen factors leading to NTM pulmonary disease are not well understood and preventive therapies are lacking. NTM isolation and pulmonary disease are reported to rise in frequency in Europe as well as in other parts of the world. Differentiation between contamination, infection, and disease remains challenging. Treatment of NTM pulmonary disease is arduous, lengthy, and costly. Correlations between results of in vitro antibiotic susceptibility testing and clinical treatment outcomes are only evident for the Mycobacterium avium complex, M. kansasii, and some rapidly growing mycobacteria. We describe the epidemiology of NTM pulmonary disease as well as emerging NTM pathogens and their geographical distribution in non-cystic fibrosis patients in Europe. We also review recent innovations for the diagnosis of NTM pulmonary disease, summarize treatment recommendations, and identify future research priorities to improve the management of patients affected by NTM pulmonary disease.
Topics: Europe; Humans; Lung; Mycobacterium Infections, Nontuberculous; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Mycobacterium kansasii; Mycobacterium xenopi; Nontuberculous Mycobacteria; Tomography, X-Ray Computed; Tuberculosis, Pulmonary
PubMed: 27207809
DOI: 10.1159/000445906 -
Dermatology Reports Nov 2021Patient under anti-TNF-alpha treatment have an increased risk of mycobacterial infections, particularly tuberculosis. Only four case reports of infection under...
Patient under anti-TNF-alpha treatment have an increased risk of mycobacterial infections, particularly tuberculosis. Only four case reports of infection under anti-TNF-α treatment (two with etanercept, two with infliximab) have been reported, but none under adalimumab. A 72-year-old man treated with adalimumab for psoriasis vulgaris and arthropathic psoriasis, complained on nocturnal cough, occasional hemoptysis and the new onset of ill-defined, reddish, asymptomatic persistent plaques-nodules covered by serum crusts on his back, on the dorsum of the right hand and right middle finger. Routine laboratory investigations, HIV and TB screening (QuantiFERON-TB-Gold test) were all within normal limits. A skin biopsy was inconclusive and special staining resulted negative for microorganisms. Only PCR identified The patient stopped adalimumab and started anti-TB treatment with gradual improvement of the skin lesions. At 26 months follow-up visit no signs or symptoms of relapse of disease occurred.
PubMed: 35035803
DOI: 10.4081/dr.2021.8797