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Ma X, Kong Y, Xu H, Bi Q, Liang M, Mai K, Zhang Y. Short-Term Alternate Feeding between Terrestrially Sourced Oil- and Fish Oil-Based Diets Modulates the Intestinal Microecology of Juvenile Turbot. BIOLOGY 2023; 12:biology12050650. [PMID: 37237464 DOI: 10.3390/biology12050650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/15/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023]
Abstract
A nine-week feeding trial was conducted to investigate changes in the intestinal microbiota of turbot in response to alternate feeding between terrestrially sourced oil (TSO)- and fish oil (FO)-based diets. The following three feeding strategies were designed: (1) continuous feeding with the FO-based diet (FO group); (2) weekly alternate feeding between soybean oil (SO)- and FO-based diets (SO/FO group); and (3) weekly alternate feeding between beef tallow (BT)- and FO-based diets (BT/FO group). An intestinal bacterial community analysis showed that alternate feeding reshaped the intestinal microbial composition. Higher species richness and diversity of the intestinal microbiota were observed in the alternate-feeding groups. A PCoA analysis showed that the samples clustered separately according to the feeding strategy, and among the three groups, the SO/FO group clustered relatively closer to the BT/FO group. The alternate feeding significantly decreased the abundance of Mycoplasma and selectively enriched specific microorganisms, including short-chain fatty acid (SCFA)-producing bacteria, digestive bacteria (Corynebacterium and Sphingomonas), and several potential pathogens (Desulfovibrio and Mycobacterium). Alternate feeding may maintain the intestinal microbiota balance by improving the connectivity of the ecological network and increasing the competitive interactions within the ecological network. The alternate feeding significantly upregulated the KEGG pathways of fatty acid and lipid metabolism, glycan biosynthesis, and amino acid metabolism in the intestinal microbiota. Meanwhile, the upregulation of the KEGG pathway of lipopolysaccharide biosynthesis indicates a potential risk for intestinal health. In conclusion, short-term alternate feeding between dietary lipid sources reshapes the intestinal microecology of the juvenile turbot, possibly resulting in both positive and negative effects.
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Affiliation(s)
- Xiuhua Ma
- Key Laboratory of Aquaculture Nutrition and Feed (Ministry of Agriculture and Rural Affairs) & Laboratory of Mariculture (Ministry of Education), Ocean University of China, Qingdao 266003, China
| | - Yaoyao Kong
- Key Laboratory of Aquaculture Nutrition and Feed (Ministry of Agriculture and Rural Affairs) & Laboratory of Mariculture (Ministry of Education), Ocean University of China, Qingdao 266003, China
| | - Houguo Xu
- Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, China
| | - Qingzhu Bi
- Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, China
| | - Mengqing Liang
- Yellow Sea Fisheries Research Institute, Chinese Academy of Fishery Sciences, Qingdao 266071, China
| | - Kangsen Mai
- Key Laboratory of Aquaculture Nutrition and Feed (Ministry of Agriculture and Rural Affairs) & Laboratory of Mariculture (Ministry of Education), Ocean University of China, Qingdao 266003, China
| | - Yanjiao Zhang
- Key Laboratory of Aquaculture Nutrition and Feed (Ministry of Agriculture and Rural Affairs) & Laboratory of Mariculture (Ministry of Education), Ocean University of China, Qingdao 266003, China
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2
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KOMINE T, IHARA H, ONO K, YOSHIDA M, SUGIMOTO Y, INOHANA M, FUKANO H, KURATA O, WADA S. A case of mycobacteriosis associated with Mycobacterium pseudoshottsii in aquarium-reared fish in Japan. J Vet Med Sci 2022; 84:1617-1620. [PMID: 36273872 PMCID: PMC9791231 DOI: 10.1292/jvms.22-0318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In 2019, several aquarium-reared fish died at a sea life park in Japan. Necropsy revealed micronodules on the spleen in the dotted gizzard shad (Konosirus punctatus). Seven of 16 fish exhibited microscopic multifocal granulomas associated with acid-fast bacilli in the spleen, kidney, liver, alimentary tract, mesentery, gills, and/or heart. Bacterial cultures yielded isolates from the dotted gizzard shad and a Japanese sardine (Sardinops melanostictus). Microbiological and molecular biological examinations revealed the isolates as Mycobacterium pseudoshottsii. To our knowledge, this is the first isolation of M. pseudoshottsii from aquarium-reared fish.
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Affiliation(s)
- Takeshi KOMINE
- Laboratory of Aquatic Medicine, School of Veterinary
Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan,Correspondence to: Komine T: , Laboratory of Aquatic
Medicine, School of Veterinary Medicine, Nippon Veterinary and Life Science University,
1-7-1 Kyonan-cho, Musashino, Tokyo 180-8602, Japan
| | - Hyogo IHARA
- Laboratory of Aquatic Medicine, School of Veterinary
Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Kentaro ONO
- Laboratory of Aquatic Medicine, School of Veterinary
Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Mitsumi YOSHIDA
- Laboratory of Aquatic Medicine, School of Veterinary
Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | | | - Mari INOHANA
- Laboratory of Aquatic Medicine, School of Veterinary
Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Hanako FUKANO
- Department of Mycobacteriology, Leprosy Research Center,
National Institute of Infectious Diseases, Tokyo, Japan
| | - Osamu KURATA
- Laboratory of Aquatic Medicine, School of Veterinary
Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Shinpei WADA
- Laboratory of Aquatic Medicine, School of Veterinary
Medicine, Nippon Veterinary and Life Science University, Tokyo, Japan
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3
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Mycobacterium pseudoshottsii in Mediterranean Fish Farms: New Trouble for European Aquaculture? Pathogens 2020; 9:pathogens9080610. [PMID: 32726963 PMCID: PMC7459456 DOI: 10.3390/pathogens9080610] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/22/2020] [Accepted: 07/24/2020] [Indexed: 11/17/2022] Open
Abstract
Mycobacterium pseudoshottsii, a slow-growing mycobacterium closely related to M. marinum, has been isolated only in wild fish in the United States and in Japanese fish farms to date. Here, we report cases of mortality in three farmed fish species (Dicentrarchus labrax, Sparus aurata, and Sciaenops ocellatus) caused by M. pseudoshottsii in Italy. Samples underwent necropsy, histology, and culture with pathogen identification based on PCR and sequencing of housekeeping genes (16S rRNA, hsp65, rpoB). Multifocal to coalescing granulomatous and necrotizing inflammation with acid-fast bacilli were observed in the parenchymatous organs, from which M. pseudoshottsii was isolated and identified. Phylogenetic analysis confirmed the results of gene sequencing and allowed subdivision of the isolates into three distinct groups. M. pseudoshottsii poses a potential threat for Mediterranean aquaculture. Its origin in the area under study needs to be clarified, as well as the threat to the farmed fish species.
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Tsai MA, Wang PC, Yoshida S, Aono A, Mitarai S, Wada T, Chen SC. Establishment of loop-mediated isothermal amplification for rapid and convenient detection of Mycobacterium marinum complex. J Microbiol Methods 2019; 164:105671. [PMID: 31326444 DOI: 10.1016/j.mimet.2019.105671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/16/2019] [Accepted: 07/16/2019] [Indexed: 12/24/2022]
Abstract
Mycobacterium marinum is a zoonotic pathogen that can cause dermatological infection mainly from contaminated water or fish. Some well-known genetically similar species and subspecies are M. lifrandii and M. pseudoshottsii from amphibians and fish in aquaculture, and M. ulcerans, a causative agent of a neglected tropical disease (NTD), Buruli ulcer. They are believed to survive in water as their major niche, which might be related to their source of infection, but detailed ecological surveillance of the species complex remains to be done. Herein, we present a new detection system for M. marinum complex based on isothermal DNA amplification that can be conducted conveniently with high sensitivity and specificity. The target was a chromosomal gene, mrsA, including a restriction polymorphism between M. ulcerans (except for the most ancestral subspecies, M. ulcerans subsp. shinshuense) and the other species. The system was able to detect less than 500 fg (approximately 70 copies) of genomic DNA of M. marinum, within 60 min, and caused no amplification from mycobacterial species other than M. marinum complex species. It was also verified that restriction of the amplified DNA fragments was able to discriminate M. ulcerans as expected. This easy, quick, and convenient system is expected to facilitate detection of M. marinum complex from various resources.
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Affiliation(s)
- Ming-An Tsai
- Department of Biology, National Museum of Marine Biology and Aquarium, Checheng, Pingtung, Taiwan, Republic of China; Graduate Institute of Marine Biology, National Dong Hwa University, Checheng, Pingtung, Taiwan, Republic of China
| | - Pei-Chi Wang
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Neipu, Pingtung, Taiwan, Republic of China
| | - Shiomi Yoshida
- Clinical Research Center, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Osaka, Japan; Department of International Health, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Akio Aono
- Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Anti-tuberculosis Association, Kiyose, Tokyo, Japan
| | - Satoshi Mitarai
- Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Anti-tuberculosis Association, Kiyose, Tokyo, Japan
| | - Takayuki Wada
- Department of International Health, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
| | - Shih-Chu Chen
- Department of Veterinary Medicine, College of Veterinary Medicine, National Pingtung University of Science and Technology, Neipu, Pingtung, Taiwan, Republic of China.
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Hashish E, Merwad A, Elgaml S, Amer A, Kamal H, Elsadek A, Marei A, Sitohy M. Mycobacterium marinum infection in fish and man: epidemiology, pathophysiology and management; a review. Vet Q 2018; 38:35-46. [PMID: 29493404 PMCID: PMC6831007 DOI: 10.1080/01652176.2018.1447171] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Mycobacterium marinum is an opportunistic pathogen inducing infection in fresh and marine water fish. This pathogen causes necrotizing granuloma like tuberculosis, morbidity and mortality in fish. The cell wall-associated lipid phthiocerol dimycocerosates, phenolic glycolipids and ESAT-6 secretion system 1 (ESX-1) are the conserved virulence determinant of the organism. Human infections with Mycobacterium marinum hypothetically are classified into four clinical categories (type I–type IV) and have been associated with the exposure of damaged skin to polluted water from fish pools or contacting objects contaminated with infected fish. Fish mycobacteriosis is clinically manifested and characterized in man by purple painless nodules, liable to develop into superficial crusting ulceration with scar formation. Early laboratory diagnosis of M. marinum including histopathology, culture and PCR is essential and critical as the clinical response to antibiotics requires months to be attained. The pathogenicity and virulence determinants of M. marinum need to be thoroughly and comprehensively investigated and understood. In spite of accumulating information on this pathogen, the different relevant data should be compared, connected and globally compiled. This article is reviewing the epidemiology, virulence factors, diagnosis and disease management in fish while casting light on the potential associated public health hazards.
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Affiliation(s)
- Emad Hashish
- a Department of Clinical Pathology, Faculty of Veterinary Medicine , Zagazig University , Egypt
| | - Abdallah Merwad
- b Department of Zoonoses, Faculty of Veterinary Medicine , Zagazig University , Egypt
| | - Shimaa Elgaml
- a Department of Clinical Pathology, Faculty of Veterinary Medicine , Zagazig University , Egypt
| | - Ali Amer
- c Tuberculosis Unit , Animal Health Research Institute (AHRI) , Giza , Egypt
| | - Huda Kamal
- d Department of Meat Hygiene , National Research Center (NRC) , Zagazig , Egypt
| | - Ahmed Elsadek
- e Immunology Research Lab, Immunology Division, Department of Microbiology and Immunology, Faculty of Medicine , Zagazig University , Egypt
| | - Ayman Marei
- e Immunology Research Lab, Immunology Division, Department of Microbiology and Immunology, Faculty of Medicine , Zagazig University , Egypt
| | - Mahmoud Sitohy
- f Department of Biochemistry, Faculty of Agriculture , Zagazig University , Egypt
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Gcebe N, Michel AL, Hlokwe TM. Non-tuberculous Mycobacterium species causing mycobacteriosis in farmed aquatic animals of South Africa. BMC Microbiol 2018; 18:32. [PMID: 29653505 PMCID: PMC5899368 DOI: 10.1186/s12866-018-1177-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 04/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mycobacteriosis caused by non-tuberculous mycobacteria (NTM), is among the most chronic diseases of aquatic animals. In addition, fish mycobacteriosis has substantial economic consequences especially in the aquaculture and fisheries industry as infections may significantly decrease production and trade. Some fish NTM pathogens are highly virulent and zoonotic; as such, infection of aquaria with these pathogens is a public health concern. In this study, we report isolation of nine different NTM species from sixteen aquatic animals including different fish species, frogs and a crocodile. Given the clinical significance of Mycobacterium marinum and its close relation to Mycobacterium tuberculosis, as well as the significance of ESAT 6 and CFP-10 secretion in mycobacterial virulence, we analysed the esxA and esxB nucleotide sequences of M. marinum isolates identified in this study as well as other mycobacteria in the public databases. RESULTS Mycobacterium shimoidei, Mycobacterium marinum, Mycobacterium chelonae, Mycobacterium septicum /M. peregrinum and Mycobacterium porcinum were isolated from gold fish, Guppy, exotic fish species in South Africa, koi and undefined fish, Knysna seahorse, as well Natal ghost frogs respectively, presenting tuberculosis like granuloma. Other NTM species were isolated from the studied aquatic animals without any visible lesions, and these include Mycobacterium sp. N845 T, Mycobacterium fortuitum, a member of the Mycobacterium avium complex, and Mycobacterium szulgai. Phylogenetic analysis of mycobacteria, based on esxA and esxB genes, separated slow growing from rapidly growing mycobacteria as well as pathogenic from non-pathogenic mycobacteria in some cases. CONCLUSIONS Isolation of the different NTM species from samples presenting granuloma suggests the significance of these NTM species in causing mycobacteriosis in these aquatic animals. The study also revealed the potential of esxA and esxB sequences as markers for phylogenetic classification of mycobacteria. Observations regarding use of esxA and esxB sequences for prediction of potential pathogenicity of mycobacteria warrants further investigation of these two genes in a study employing NTM species with well-defined pathogenicity.
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Affiliation(s)
- Nomakorinte Gcebe
- Tuberculosis Laboratory, Agricultural Research Council - Onderstepoort Veterinary Research, Onderstepoort, South Africa.
| | - Anita L Michel
- Department of Veterinary Tropical Diseases, Bovine Tuberculosis and Brucellosis Research Programme, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
| | - Tiny Motlatso Hlokwe
- Tuberculosis Laboratory, Agricultural Research Council - Onderstepoort Veterinary Research, Onderstepoort, South Africa
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Antuofermo E, Pais A, Polinas M, Cubeddu T, Righetti M, Sanna MA, Prearo M. Mycobacteriosis caused by Mycobacterium marinum in reared mullets: first evidence from Sardinia (Italy). JOURNAL OF FISH DISEASES 2017; 40:327-337. [PMID: 27368155 DOI: 10.1111/jfd.12515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 05/14/2016] [Accepted: 05/16/2016] [Indexed: 06/06/2023]
Abstract
Mycobacterium marinum is a slow-growing non-tuberculous mycobacterium, and it is considered the most common aetiologic agent of mycobacteriosis in wild and cultured fish. The diagnosis is principally made by histology when positive Ziehl-Neelsen stain granulomas are detected. The aim of this study was to investigate the occurrence of mycobacteriosis in extensively cultured Mugilidae of two lagoons (Cabras and San Teodoro) from Sardinia by the use of histology, microbiology, PCR and DNA sequencing. Nine of 106 mullets examined were affected by mycobacteriosis, and the spleen was the most affected organ. The histology detected higher rate (100%) of infection in spleen than the culture and PCR (75% and 62.5%, respectively). The sequencing of hsp65 gene identified M. marinum as the primary cause of mycobacteriosis in the mullets examined. Mullets affected by mycobacteriosis were mainly fished in the San Teodoro lagoon characterized by critical environmental conditions. Histology remains the most common method in detecting fish affected by mycobacteriosis, and PCR-based methods are essential for species identification. Our finding are worthy of attention because mycobacteriosis caused by M. marinum in reared mullets was evidenced for the first time in Sardinia, suggesting that this disease may be underestimated also in other cultured fish species.
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Affiliation(s)
- E Antuofermo
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - A Pais
- Laboratory of Aquaculture and Aquatic Resources Management, Section of Animal Sciences, Department of Agriculture, University of Sassari, Sassari, Italy
| | - M Polinas
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - T Cubeddu
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - M Righetti
- Fish Disease Laboratory, State Veterinary Institute of Piedmont, Liguria and Aosta Valley, Torino, Italy
| | - M A Sanna
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - M Prearo
- Fish Disease Laboratory, State Veterinary Institute of Piedmont, Liguria and Aosta Valley, Torino, Italy
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Righetti M, Favaro L, Antuofermo E, Caffara M, Nuvoli S, Scanzio T, Prearo M. Mycobacterium salmoniphilum infection in a farmed Russian sturgeon, Acipenser gueldenstaedtii (Brandt & Ratzeburg). JOURNAL OF FISH DISEASES 2014; 37:671-674. [PMID: 23952784 DOI: 10.1111/jfd.12143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 05/16/2013] [Accepted: 05/17/2013] [Indexed: 06/02/2023]
Affiliation(s)
- M Righetti
- Istituto Zooprofilattico Sperimentale del Piemonte Liguria e Valle d'Aosta, Torino, Italy
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Varello K, Prearo M, Serracca L, Meloni D, Rossini I, Righetti M, Pezzolato M, Fioravanti ML, Ercolini C, Bozzetta E. Granulomatous lesions in a wild mullet population from the eastern Ligurian Sea (Italy): mycobacteriosis vs. pseudotuberculosis. JOURNAL OF FISH DISEASES 2014; 37:553-558. [PMID: 23944162 DOI: 10.1111/jfd.12155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Revised: 06/13/2013] [Accepted: 06/17/2013] [Indexed: 06/02/2023]
Abstract
Mycobacterium spp. and Photobacterium damselae subsp. piscicida are recognized as the most frequent causative agents of granulomatous lesions in fish. Although frequent episodes of mycobacterial infections have been reported in wild fish worldwide, only sporadic cases have been documented to date in Italy. To investigate for the presence of lesions referable to mycobacteriosis and to identify the mycobacterial species involved, a total of 159 wild mullets were fished from the eastern coast of the Ligurian Sea, killed and necropsied. Liver and spleen samples were collected from all fish for histopathological and microbiological analyses. Molecular investigations for identification of Photobacterium damselae subsp. piscicida were performed. Gross examination revealed granulomatous lesions in one animal; microscopically, 42.14% of fish displayed granulomas with various histological features, 19.50% resulted positive at Ziehl-Neelsen staining, and were confirmed as mycobacterial lesions by culture. The identified colonies were characterized as M. fortuitum, M. abscessus, M. flavescens, M. chelonae, M. septicum and M. nonchromogenicum. In all, 35% of animals resulted positive for Photobacterium damselae subsp. piscicida. These data suggest widespread mycobacterial infection also by Photobacterium damselae subsp. piscicida infections in wild fish. Moreover, the pathogenicity of some mycobacterial species, previously considered as saprophytic, was demonstrated.
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Affiliation(s)
- K Varello
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Turin, Italy
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Genetic diversity and population structure of Mycobacterium marinum: new insights into host and environmental specificities. J Clin Microbiol 2012; 50:3627-34. [PMID: 22952269 DOI: 10.1128/jcm.01274-12] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Mycobacterium marinum causes a systemic tuberculosis-like disease in fish and skin infections in humans that can spread to deeper structures, resulting in tenosynovitis, arthritis, and osteomyelitis. However, little information is available concerning (i) the intraspecific genetic diversity of M. marinum isolated from humans and animals; (ii) M. marinum genotype circulation in the different ecosystems, and (iii) the link between M. marinum genetic diversity and hosts (humans and fish). Here, we conducted a genetic study on 89 M. marinum isolates from humans (n = 68) and fish (n = 21) by using mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) typing. The results show that the M. marinum population is genetically structured not only according to the host but also according to the ecosystem as well as to tissue tropism in humans. This suggests the existence of different genetic pools in the function of the biological and ecological compartments. Moreover, the presence of only certain M. marinum genotypes in humans suggests a different zoonotic potential of the M. marinum genotypes. Considering that the infection is linked to aquarium activity, a significant genetic difference was also detected when the human tissue tropism of M. marinum was taken into consideration, with a higher genetic polymorphism in strains isolated from patients with cutaneous forms than from individuals with deeper-structure infection. It appears that only few genotypes can produce deeper infections in humans, suggesting that the immune system might play a filtering role.
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