Mycobacterium lentiflavum ileitis using aspirated intestinal fluid during endoscopy in HIV-infected patient

The Endoscopic Submucosal Dissection Surgery in the Whole-Course Antegrade Endoscopic Approach: A More Effective Treatment Strategy for the Siewert II/III Type Mucosal Lesions of Esophagogastric Junction

Objective: The purpose of this study was to investigate the safety and efficacy of endoscopic submucosal dissection (ESD) for treating cardiac mucosal lesions. Methods: A total of 86 patients with cardiac mucosal lesions were treated with ESD in retrograde endoscopic approach or antegrade endoscopic approach. The relationship between the two methods was analyzed according to the size, location, depth of pathological infiltration, classification, and examination results. The main evaluation indexes of intraoperative complications were operation time, bleeding, perforation, and complete resection (R0 resection). Results: Total R0 excision was performed in 85 patients and curative excision in 77 patients. When the diameter of lesion was 2-4 cm or >4 cm, the median treatment time in the antegrade endoscopic approach group was shorter than that in the retrograde group (P < .001, respectively). When the lesion was confined to the mucosa, the median treatment time in the antegrade endoscopic approach group was shorter than that in the retrograde group (P < .001). When the lesion was located in the posterior wall of the cardia, the average treatment time in the antegrade endoscopic approach group was shorter than that in the retrograde group (P < .05). When the lesion was located in the lesser curvature of the cardia, the average treatment time in the antegrade endoscopic approach group was shorter than that in the retrograde group (P < .001). Conclusion: The ESD surgery in the antegrade endoscopic approach is effective and safe for the treatment of cardiac mucosal lesions.

Comparison of O-Type HybridKnife to Conventional Knife in Endoscopic Submucosal Dissection for Gastric Mucosal Lesions

Endoscopic submucosal dissection (ESD) has been accepted as a minimal invasive alternative to surgery for localized superficial gastrointestinal neoplasms recently. However, the procedure remains to be technically challenging and time consuming. A new dissecting knife with partially insulated tip has been recently developed with built-in injection capability. The purpose of this study was to investigate whether the efficiency of ESD procedure could be improved with this new device. A total of 78 patients, who underwent ESD with gastric mucosal lesions including flat type polyps, adenoma or early gastric cancer, were randomly assigned to either ESD with O-type HybridKnife or conventional ESD knives without waterjet. Procedure time and related factors of ESD were analyzed. ESD procedure time was 43.0 (interquartile range, IQR 27.0-60.0) minutes in HybridKnife group compared to 60.5 (IQR 44.0-86.3) minutes in the control group (P = 0.001). There was no difference in the clinical outcome and the adverse event rate. The former demonstrated more favorable results in lesions ≤4 cm of specimen size (P ≤ 0.0001) and when located in the distal stomach (P = 0.001), also in lesions with fibrosis (P = 0.008). Multivariate regression analysis showed that O-type Knife (P ≤ 0.0001), specimen size (P ≤ 0.0001), and fibrosis (P ≤ 0.0001) were independent predictors of procedure time. The O-type HybridKnife yielded faster procedure time compared to the conventional knives in gastric ESD with a similar safety profile.

Prevalence of Mycobacterium lentiflavum in cystic fibrosis patients, France

Background

Mycobacterium lentiflavum is rarely isolated in respiratory tract samples from cystic fibrosis patients. We herein describe an unusually high prevalence of M. lentiflavum in such patients.

Methods

M. lentiflavum, isolated from the respiratory tract of cystic fibrosis patients, was identified using both rpoB partial sequencing and detected directly in the sputum by using real-time PCR targeting the smpB gene.

Results

M. lentiflavum emerged as the third most prevalent nontuberculous mycobacterial species isolated in cystic fibrosis patients in Marseille, France. Six such patients were all male, and two of them may have fulfilled the American Thoracic Society clinical and microbiological criteria for M. lentiflavum potential lung infection.

Conclusions

M. lentiflavum was the third most common mycobacteria isolated in cystic fibrosis patients, particularly in six male patients. M. lentiflavum outbreaks are emerging particularly in cystic fibrosis patients.

Electronic supplementary material

The online version of this article (doi:10.1186/s12890-015-0123-y) contains supplementary material, which is available to authorized users.

Draft Genome Sequence of Mycobacterium lentiflavum CSUR P1491

We announce the draft genome sequence of Mycobacterium lentiflavum strain CSUR P1491, a nontuberculous mycobacterium responsible for opportunistic potentially life-threatening infections in immunocompromised patients. The genome described here comprises a 6,818,507-bp chromosome exhibiting a 65.75% G+C content, 6,354 protein-coding genes, and 75 RNA genes.

Disseminated Mycobacterium lentiflavum responsible for hemophagocytic lymphohistocytosis in a man with a history of heart transplantation

Mycobacterium lentiflavum is a nontuberculous, slowly growing mycobacterium usually recognized as a contaminant. Here, we report a case of disseminated M. lentiflavum infection responsible for hemophagocytic lymphohistocytosis in a heart-transplanted man.

Comparison of Mycobacterium lentiflavum and Mycobacterium avium-intracellulare complex lymphadenitis

BACKGROUND

Mycobacterium lentiflavum is considered a rare pathogen causing nontuberculous mycobacterial (NTM) lymphadenitis.

METHODS

A multicenter, retrospective study was performed in immunocompetent children <14 years of age with microbiologically confirmed NTM lymphadenitis treated at 6 hospitals in Madrid, Spain, during 2000-2010. We compared children with M. lentiflavum and Mycobacterium avium-intracellulare complex infection.

RESULTS

Forty-five microbiologically confirmed NTM lymphadenitis patients were identified: 19 (45.2%) caused by M. avium-intracellulare complex, 17 (40.5%) by M. lentiflavum, 1 by both and 5 by other mycobacteria. Out of 17 M. lentiflavum cases, 14 were diagnosed in the past 5 years. Regarding M. lentiflavum cases, median age was 23 months. Submandibular nodes were the most frequently involved (76.5%), with multiple locations seen in 41% of the children and spontaneous drainage in 41% of them. Drug susceptibility tests were performed in 14 isolates and showed a complete susceptibility to clarithromycin and cycloserine, whereas 93% were resistant to rifampin, 33% to quinolones and full resistance to other tested antimycobacterial drugs was detected. All but 1 child required surgery and 11 were treated additionally with various drug combinations. Total resolution was achieved in 50% of children within 6 months.Compared with M. avium-intracellulare complex cases, children were younger and laterocervical nodes were significantly less frequently involved. No statistically significant differences were found related to clinical characteristics, treatment and outcome.

CONCLUSIONS

M. lentiflavum is an emerging pathogen producing NTM lymphadenitis in Madrid.