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Tooulia M, Mellos A, Vougadiotis I, Vrakas S. Mycobacterium marinum infection in a patient with Crohn's disease on anti-tumor necrosis factor treatment. Indian J Gastroenterol 2024:10.1007/s12664-024-01572-8. [PMID: 38652376 DOI: 10.1007/s12664-024-01572-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Affiliation(s)
- Marilena Tooulia
- Gastroenterology Department, Tzaneio General Hospital, Piraeus, Greece
| | | | | | - Spyridon Vrakas
- Gastroenterology Department, Tzaneio General Hospital, Piraeus, Greece.
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2
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Xing F, Lo SKF, Ma Y, Ip JD, Chan WM, Zhou M, Gong M, Lau SKP, Woo PCY. Rapid Diagnosis of Mycobacterium marinum Infection by Next-Generation Sequencing: A Case Report. Front Med (Lausanne) 2022; 9:824122. [PMID: 35187006 PMCID: PMC8854760 DOI: 10.3389/fmed.2022.824122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
We present the first report of histology- and culture-proven Mycobacterium marinum infection diagnosed by next-generation sequencing (NGS). It took <2 days to make a microbiological diagnosis using the Oxford Nanopore Technologies' MinION device, compared to 20 days for the mycobacterium to be isolated from the tissue biopsy. NGS is particularly useful for culture-negative and slow-growing microorganism infections, such as mycobacterial, fungal and partially treated pyogenic bacterial infections. Due to its low equipment cost, short turn-around-time and portable size, the Oxford Nanopore Technologies' MinION device is a useful platform for NGS in routine clinical microbiology laboratories.
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Affiliation(s)
- Fanfan Xing
- Department of Clinical Microbiology and Infection Control, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Simon K. F. Lo
- Department of Clinical Microbiology and Infection Control, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Yuanchao Ma
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Jonathan Daniel Ip
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Wan-Mui Chan
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Meixun Zhou
- Department of Pathology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Miaozi Gong
- Department of Pathology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - Susanna K. P. Lau
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Patrick C. Y. Woo
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- *Correspondence: Patrick C. Y. Woo
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Mijovic H, Henkelman E, Goldfarb DM. 'Finding Gory'-bringing home an unwanted aquatic traveler. Paediatr Child Health 2018; 23:391-393. [PMID: 30455577 DOI: 10.1093/pch/pxx213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hana Mijovic
- Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia
| | - Erika Henkelman
- Department of Plastic Surgery, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia
| | - David M Goldfarb
- Department of Pediatrics and Medical Microbiology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia
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Zimmermann P, Curtis N, Tebruegge M. Nontuberculous mycobacterial disease in childhood - update on diagnostic approaches and treatment. J Infect 2018. [PMID: 28646953 DOI: 10.1016/s0163-4453(17)30204-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Recent studies suggest that the incidence of nontuberculous mycobacterial infections in children may be increasing. Nontuberculous mycobacterial lymphadenitis, skin and soft tissue infection, and pulmonary disease each present unique challenges in relation to diagnosis and treatment. In this update, we critically review the recent literature on the epidemiology, clinical features, diagnostic approaches and treatment of nontuberculous mycobacterial disease in children. In addition, we outline key areas warranting further research.
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Affiliation(s)
- Petra Zimmermann
- Infectious Diseases Unit, Royal Children's Hospital Melbourne, Parkville, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Australia; Murdoch Children's Research Institute, Parkville, Australia
| | - Nigel Curtis
- Infectious Diseases Unit, Royal Children's Hospital Melbourne, Parkville, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Australia; Murdoch Children's Research Institute, Parkville, Australia
| | - Marc Tebruegge
- Department of Paediatrics, The University of Melbourne, Parkville, Australia; Academic Unit of Clinical & Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK; Global Health Research Institute, University of Southampton, Southampton, UK; Department of Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
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De Maio F, Trecarichi EM, Visconti E, Sanguinetti M, Delogu G, Sali M. Understanding cutaneous tuberculosis: two clinical cases. JMM Case Rep 2016; 3:e005070. [PMID: 28348793 PMCID: PMC5343121 DOI: 10.1099/jmmcr.0.005070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 10/18/2016] [Indexed: 11/24/2022] Open
Abstract
Tuberculosis (TB) is an ancient human disease and remains today one of the most important public health problems and the second most frequent cause of death from an infectious disease worldwide. While pulmonary TB is the most common form, extra-pulmonary TB is on the rise due to the increase in immunosuppressed subjects. Cutaneous TB manifestations are rare forms of extra-pulmonary TB due to systemic dissemination of bacilli or direct inoculation, involving skin or skin-associated tissue, more common in immunocompromised subjects. Some risk factors and the features of the lesion may prompt the suspicion of cutaneous TB, but only microbiological assays can confirm the diagnosis. Our work summarizes cutaneous TB manifestations and differences from other skin mycobacterial infections, also describes two characteristic clinical cases.
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Affiliation(s)
- Flavio De Maio
- Insitute of Microbiology, Università Cattolica del Sacro Cuore , Rome , Italy
| | | | - Elena Visconti
- Institute of Infectious Diseases, Università Cattolica del Sacro Cuore , Rome , Italy
| | | | - Giovanni Delogu
- Insitute of Microbiology, Università Cattolica del Sacro Cuore , Rome , Italy
| | - Michela Sali
- Insitute of Microbiology, Università Cattolica del Sacro Cuore , Rome , Italy
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Abstract
ABSTRACT
The immunocompromised host is at increased risk of
Mycobacterium tuberculosis
complex and nontuberculous mycobacteria infection. Although
Mycobacterium tuberculosis
complex is a significant mycobacterial pathogen, nontuberculous mycobacteria causes substantial disease in those with suppressed immune responses. Mycobacterial infections can cause significant morbidity and mortality in this patient population, and rapid identification and susceptibility testing of the mycobacterial species is paramount to patient management and outcomes. Mycobacterial diagnostics has undergone some significant advances in the last two decades with immunodiagnostics (interferon gamma release assay), microscopy (light-emitting diode), culture (automated broth-based systems), identification (direct PCR, sequencing and matrix-assisted laser-desorption ionization–time of flight mass spectrometry) and susceptibility testing (molecular detection of drug resistance from direct specimens or positive cultures). Employing the most rapid and sensitive methods in the mycobacterial laboratory will have a tremendous impact on patient care and, in the case of
Mycobacterium tuberculosis
complex, in the control of tuberculosis.
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Tebruegge M, Pantazidou A, MacGregor D, Gonis G, Leslie D, Sedda L, Ritz N, Connell T, Curtis N. Nontuberculous Mycobacterial Disease in Children - Epidemiology, Diagnosis & Management at a Tertiary Center. PLoS One 2016; 11:e0147513. [PMID: 26812154 PMCID: PMC4727903 DOI: 10.1371/journal.pone.0147513] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 12/25/2015] [Indexed: 11/18/2022] Open
Abstract
Background There are limited data on the epidemiology, diagnosis and optimal management of nontuberculous mycobacterial (NTM) disease in children. Methods Retrospective cohort study of NTM cases over a 10-year-period at a tertiary referral hospital in Australia. Results A total of 140 children with NTM disease, including 107 with lymphadenitis and 25 with skin and soft tissue infections (SSTIs), were identified. The estimated incidence of NTM disease was 0.6–1.6 cases / 100,000 children / year; no increasing trend was observed over the study period. Temporal analyses revealed a seasonal incidence cycle around 12 months, with peaks in late winter/spring and troughs in autumn. Mycobacterium-avium-complex accounted for most cases (77.8%), followed by Mycobacterium ulcerans (14.4%) and Mycobacterium marinum (3.3%). Polymerase chain reaction testing had higher sensitivity than culture and microscopy for acid-fast bacilli (92.0%, 67.2% and 35.7%, respectively). The majority of lymphadenitis cases underwent surgical excision (97.2%); multiple recurrences in this group were less common in cases treated with clarithromycin and rifampicin compared with clarithromycin alone or no anti-mycobacterial drugs (0% versus 7.1%; OR:0.73). SSTI recurrences were also less common in cases treated with two anti-mycobacterial drugs compared with one or none (10.5% versus 33.3%; OR:0.23). Conclusions There was seasonal variation in the incidence of NTM disease, analogous to recently published observations in tuberculosis, which have been linked to seasonal variation in vitamin D. Our finding that anti-mycobacterial combination therapy was associated with a reduced risk of recurrences in patients with NTM lymphadenitis or SSTI requires further confirmation in prospective trials.
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Affiliation(s)
- Marc Tebruegge
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases Unit, Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Academic Unit of Clinical & Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- * E-mail:
| | - Anastasia Pantazidou
- Infectious Diseases Unit, Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia
| | - Duncan MacGregor
- Department of Anatomical Pathology, Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia
| | - Gena Gonis
- Department of Microbiology, Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia
| | - David Leslie
- Mycobacterium Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, North Melbourne, Australia
| | - Luigi Sedda
- Department of Geography and Environment, University of Southampton, Southampton, United Kingdom
| | - Nicole Ritz
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases Unit, University Children’s Hospital Basel, Basel, Switzerland
| | - Tom Connell
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases Unit, Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Nigel Curtis
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases Unit, Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
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Necrotizing Soft Tissue Infection Occurring after Exposure to Mycobacterium marinum. Case Rep Infect Dis 2014; 2014:702613. [PMID: 25506004 PMCID: PMC4254079 DOI: 10.1155/2014/702613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 11/08/2014] [Accepted: 11/08/2014] [Indexed: 12/03/2022] Open
Abstract
Cutaneous infections caused by Mycobacterium marinum have been attributed to aquarium or fish exposure after a break in the skin barrier. In most instances, the upper limbs and fingers account for a majority of the infection sites. While previous cases of necrotizing soft tissue infections related to M. marinum have been documented, the importance of our presenting case is to illustrate the aggressive nature of M. marinum resulting in a persistent necrotizing soft tissue infection of a finger that required multiple aggressive wound debridements, followed by an amputation of the affected extremity, in order to hasten recovery.
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Bratschi MW, Ruf MT, Andreoli A, Minyem JC, Kerber S, Wantong FG, Pritchard J, Chakwera V, Beuret C, Wittwer M, Noumen D, Schürch N, Um Book A, Pluschke G. Mycobacterium ulcerans persistence at a village water source of Buruli ulcer patients. PLoS Negl Trop Dis 2014; 8:e2756. [PMID: 24675964 PMCID: PMC3967953 DOI: 10.1371/journal.pntd.0002756] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 02/11/2014] [Indexed: 11/18/2022] Open
Abstract
Buruli ulcer (BU), a neglected tropical disease of the skin and subcutaneous tissue, is caused by Mycobacterium ulcerans and is the third most common mycobacterial disease after tuberculosis and leprosy. While there is a strong association of the occurrence of the disease with stagnant or slow flowing water bodies, the exact mode of transmission of BU is not clear. M. ulcerans has emerged from the environmental fish pathogen M. marinum by acquisition of a virulence plasmid encoding the enzymes required for the production of the cytotoxic macrolide toxin mycolactone, which is a key factor in the pathogenesis of BU. Comparative genomic studies have further shown extensive pseudogene formation and downsizing of the M. ulcerans genome, indicative for an adaptation to a more stable ecological niche. This has raised the question whether this pathogen is still present in water-associated environmental reservoirs. Here we show persistence of M. ulcerans specific DNA sequences over a period of more than two years at a water contact location of BU patients in an endemic village of Cameroon. At defined positions in a shallow water hole used by the villagers for washing and bathing, detritus remained consistently positive for M. ulcerans DNA. The observed mean real-time PCR Ct difference of 1.45 between the insertion sequences IS2606 and IS2404 indicated that lineage 3 M. ulcerans, which cause human disease, persisted in this environment after successful treatment of all local patients. Underwater decaying organic matter may therefore represent a reservoir of M. ulcerans for direct infection of skin lesions or vector-associated transmission. Buruli ulcer (BU) is a neglected tropical disease caused by Mycobacterium ulcerans which affects mainly children in West Africa. Although it is commonly believed that the infection originates from an environmental source, both the reservoir of M. ulcerans and the mode of transmission to human patients remain to be elucidated. Previous investigations indicated that transmission likely takes place away from the homes of patients. We therefore screened the farms as well as village and farm water locations of 46 laboratory confirmed BU patients of the Mapé Basin of Cameroon for the presence of M. ulcerans DNA by real-time PCR. In this analysis three positive village water locations were identified. By studying one of these locations in great detail we found that M. ulcerans DNA persists in underwater detritus in one section of the village water location even after all local cases had been treated. The detritus may represent a reservoir of M. ulcerans from where infection could take place through either direct contamination of skin lesions or through contamination or colonization of insect vectors.
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Affiliation(s)
- Martin W. Bratschi
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| | - Marie-Thérèse Ruf
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Arianna Andreoli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jacques C. Minyem
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- FAIRMED Africa Regional Office, Yaoundé, Cameroon
| | - Sarah Kerber
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - James Pritchard
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Victoria Chakwera
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | | | | | | | | | - Gerd Pluschke
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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