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Mizutani RF, Santos UP, Sales RKB, Yuki EFN, Lombardi EMS, del Roio LC, Terra-Filho M. Risk of mycobacterial infections in a cohort of silicosis patients with autoimmune rheumatic diseases. J Bras Pneumol 2024; 50:e20240265. [PMID: 39661841 PMCID: PMC11601091 DOI: 10.36416/1806-3756/e20240265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Accepted: 09/13/2024] [Indexed: 12/13/2024] Open
Abstract
OBJECTIVE To evaluate the incidence rates of mycobacterial infections in silicosis patients with systemic autoimmune rheumatic disease (ARD). METHODS This was a retrospective cohort of silicosis patients between January of 1999 and December of 2023. We compared the incidence of tuberculosis and nontuberculous mycobacterial disease (NTM) in patients with silicosis with and without ARD. We also compared the tuberculosis incidence in the overall cohort with general Brazilian population estimates. RESULTS The study comprised 369 silicosis patients, of whom 35 (9.5%) had ARD. Having ARD did not affect the cumulative incidence of mycobacterial diseases. The risk of tuberculosis was higher in the cohort when compared with that in the adult Brazilian male population (age-adjusted incidence rate ratio = 20.46; 95% CI 14.89-28.13). CONCLUSIONS In this cohort of patients with silicosis, ARD was not associated with the incidence of mycobacterial diseases.
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Affiliation(s)
- Rafael Futoshi Mizutani
- . Divisão de Pneumologia, Instituto do Coracao - InCor - Hospital das Clinicas -HCFMUSP - Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo (SP) Brasil
| | - Ubiratan Paula Santos
- . Divisão de Pneumologia, Instituto do Coracao - InCor - Hospital das Clinicas -HCFMUSP - Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo (SP) Brasil
| | - Roberta Karla Barbosa Sales
- . Divisão de Pneumologia, Instituto do Coracao - InCor - Hospital das Clinicas -HCFMUSP - Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo (SP) Brasil
| | - Emily Figueiredo Neves Yuki
- . Divisão de Reumatologia, Hospital das Clinicas -HCFMUSP - Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo (SP) Brasil
| | - Elisa Maria Siqueira Lombardi
- . Divisão de Pneumologia, Instituto do Coracao - InCor - Hospital das Clinicas -HCFMUSP - Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo (SP) Brasil
| | - Lavinia Clara del Roio
- . Divisão de Pneumologia, Instituto do Coracao - InCor - Hospital das Clinicas -HCFMUSP - Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo (SP) Brasil
| | - Mario Terra-Filho
- . Divisão de Pneumologia, Instituto do Coracao - InCor - Hospital das Clinicas -HCFMUSP - Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo (SP) Brasil
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Lee H, Jang JG, Kim Y, Min KH, Ahn JH, Yoo KH, Kang MG, Kim JS, Moon JY. Prevalence of Chronic Obstructive Pulmonary Disease in Patients with Nontuberculous Mycobacterial Pulmonary Disease: A Systemic Review and Meta-Analysis. J Pers Med 2024; 14:1089. [PMID: 39590581 PMCID: PMC11595912 DOI: 10.3390/jpm14111089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Revised: 10/11/2024] [Accepted: 10/25/2024] [Indexed: 11/28/2024] Open
Abstract
BACKGROUND/OBJECTIVES Nontuberculous mycobacterial pulmonary disease (NTM-PD) is an important comorbidity of COPD. Although many studies have reported an association between COPD and NTM-PD, no clear estimate of the prevalence of COPD and its effects on survival times in patients with NTM-PD is available. This study aimed to investigate the prevalence of COPD and its impact on survival in patients with NTM-PD. METHODS All studies reporting the prevalence of COPD in patients with NTM between 1952 and 2021 were searched using PubMed in May 2023. The inclusion criteria were studies about patients with NTM and COPD. A random-effects meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS The pooled overall prevalence of COPD in patients with NTM-PD was 28% (95% confidence interval [CI], 22-35). Patients with NTM-PD were six times more likely to have COPD than those without NTM-PD (pooled odds ratio [OR], 6.26; 95% CI, 3.37-11.65). Male patients with NTM-PD had a four-fold higher risk of COPD than females (OR, 3.81; 95% CI, 1.18-12.35). The co-existence of COPD and NTM-PD was significantly associated with an increased risk of mortality compared with NTM-PD without COPD (OR, 3.65; 95% CI, 1.28-10.40). CONCLUSIONS COPD is common in patients with NTM-PD, and patients with NTM-PD had a six-fold increase in the odds of having COPD than those without NTM-PD. The presence of COPD and NTM-PD had a significant negative effect on survival. These findings may support the need to assess the presence of COPD in patients with NTM-PD and the potential negative effects associated with the co-existence of COPD and NTM-PD.
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Affiliation(s)
- Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Republic of Korea;
| | - Jong Geol Jang
- Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea; (J.G.J.); (J.H.A.)
| | - Youlim Kim
- Division of Pulmonary and Allergy, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea; (Y.K.); (K.H.Y.)
| | - Kyung Hoon Min
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea;
| | - June Hong Ahn
- Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea; (J.G.J.); (J.H.A.)
| | - Kwang Ha Yoo
- Division of Pulmonary and Allergy, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea; (Y.K.); (K.H.Y.)
| | - Min Gu Kang
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea;
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea
| | - Jong Seung Kim
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea;
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea
| | - Ji-Yong Moon
- Division of Pulmonary and Allergy, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea; (Y.K.); (K.H.Y.)
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Xu N, Li L, Wu S. Epidemiology and laboratory detection of non-tuberculous mycobacteria. Heliyon 2024; 10:e35311. [PMID: 39166010 PMCID: PMC11334812 DOI: 10.1016/j.heliyon.2024.e35311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 08/22/2024] Open
Abstract
The global incidence of non-tuberculous mycobacteria (NTM) infections is on the rise. This study systematically searched several databases, including PubMed, Web of Science, Google Scholar, and two Chinese libraries (Chinese National Knowledge Infrastructure and Wanfang) to identify relevant published between 2013 and 2023 related to the isolation of NTM in clinical specimens from various countries and provinces of China. Furthermore, a comprehensive literature review was conducted in PubMed and Google Scholar to identify randomized clinical trials, meta-analyses, systematic reviews, and observational studies that evaluated the diagnostic accuracy and impact of laboratory detection methods on clinical outcomes. This review presented the most recent epidemiological data and species distributions of NTM isolates in several countries and provinces of China. Moreover, it provided insights into laboratory bacteriological detection, including the identified strains, advantages and disadvantages, recent advancements, and the commercial Mycobacterium identification kits available for clinical use. This review aimed to aid healthcare workers in understanding this aspect, enhance the standards of clinical diagnosis and treatment, and enlighten them on the existing gaps and future research priorities.
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Affiliation(s)
- Nuo Xu
- The 4th Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Lihong Li
- The 4th Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Shenghai Wu
- The 4th Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
- Department of Laboratory, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, 310006, China
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Kim SH, Moon JY, Min KH, Lee H. Proposed Etiotypes for Chronic Obstructive Pulmonary Disease: Controversial Issues. Tuberc Respir Dis (Seoul) 2024; 87:221-233. [PMID: 38317417 PMCID: PMC11222089 DOI: 10.4046/trd.2023.0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/19/2024] [Accepted: 02/02/2024] [Indexed: 02/07/2024] Open
Abstract
The 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) revised the definition of chronic obstructive pulmonary disease (COPD) to broadly include a variety of etiologies. A new taxonomy, composed of etiotypes, aims to highlight the heterogeneity in causes and pathogenesis of COPD, allowing more personalized management strategies and emphasizing the need for targeted research to understand and manage COPD better. However, controversy arises with including some diseases under the umbrella term of COPD, as their clinical presentations and treatments differ from classical COPD, which is smoking-related. COPD due to infection (COPD-I) and COPD due to environmental exposure (COPD-P) are classifications within the new taxonomy. Some disease entities in these categories show distinct clinical features and may not benefit from conventional COPD treatments, raising questions about their classification as COPD subtypes. There is also controversy regarding whether bronchiectasis with airflow limitations should be classified as an etiotype of COPD. This article discusses controversial issues associated with the proposed etiotypes for COPD in terms of COPD-I, COPD-P, and bronchiectasis. While the updated COPD definition by GOLD 2023 is a major step towards recognizing the disease's complexity, it also raises questions about the classification of related respiratory conditions. This highlights the need for further research to improve our understanding and approach to COPD management.
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Affiliation(s)
- Sang Hyuk Kim
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Republic of Korea
| | - Ji-Yong Moon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Kyung Hoon Min
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
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Oliveira RSD, Chimara E, Brandão AP, Simeão FCDS, Souza ARD, Gallo JF, Pinhata JMW. Non-tuberculous mycobacteria hybridisation profiles in the GenoType MTBDR plus assay: experience from a diagnostic routine of a high-throughput laboratory. J Med Microbiol 2024; 73. [PMID: 38305283 DOI: 10.1099/jmm.0.001794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
Introduction. Disease caused by non-tuberculous mycobacteria (NTM) is an emergent problem. Because NTM pulmonary disease and tuberculosis (TB) have similar clinical presentations, many cases of NTM may be misdiagnosed as TB before laboratory identification of the NTM species.Hypothesis/Gap Statement. Clinical laboratories should always perform differentiation between Mycobacterium tuberculosis complex (MTBC) and NTM to guide patients' correct treatment.Aim. To describe the characteristics and to identify mycobacterial isolates presumptively classified as MTBC by macroscopic characteristics in culture media that tested negative in GenoType MTBDRplus.Methodology. All cultures from February 2019 to December 2021 showing MTBC macroscopic characteristics were processed by GenoType MTBDRplus. MTBC-negative cultures underwent species identification by immunochromatography, line probe assays and PRA-hsp65. Patients' data were obtained from Brazilian surveillance systems.Results. Only 479 (3.1%) of 15 696 isolates presumptively identified as MTBC were not confirmed by GenoType MTBDRplus and were then subjected to identification. A total of 344 isolates were shown to be NTM, of which 309 (64.5%) and 35 (7.3%) were identified to the species and genus levels, respectively. Of the 204 NTM isolates with MTBC characteristics, the most frequent species were M. fortuitum (n=52, 25.5%), M. abscessus complex (MABC; n=27, 13.2%) and M. avium complex (MAC; n=26, 12.7%). Regarding the GenoType MTBDRplus results from NTM isolates, there were diverse hybridisation profiles with rpoB gene's different wild-type (WT) probes. Seventy-six (16.1%) of the 473 patients were classified as having NTM disease, the most frequent being MAC (n=15, 19.7%), MABC (n=13, 17.1%), M. kansasii (n=10, 13.2%) and M. fortuitum (n=6, 7.9%).Conclusion. Because the signs and symptoms of pulmonary TB are similar to those of pulmonary mycobacteriosis and treatment regimens for TB and NTM are different, identifying the disease-causing species is paramount to indicate the correct management. Thus, in the laboratory routine, when an isolate presumptively classified as MTBC is MTBC-negative, it is still essential to perform subsequent identification.
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Affiliation(s)
- Rosângela Siqueira de Oliveira
- Núcleo de Tuberculose e Micobacterioses, Centro de Bacteriologia, Instituto Adolfo Lutz (IAL), Av. Dr. Arnaldo, 351, 9º andar, 01246-000, São Paulo, SP, Brazil
| | - Erica Chimara
- Núcleo de Tuberculose e Micobacterioses, Centro de Bacteriologia, Instituto Adolfo Lutz (IAL), Av. Dr. Arnaldo, 351, 9º andar, 01246-000, São Paulo, SP, Brazil
| | - Angela Pires Brandão
- Núcleo de Tuberculose e Micobacterioses, Centro de Bacteriologia, Instituto Adolfo Lutz (IAL), Av. Dr. Arnaldo, 351, 9º andar, 01246-000, São Paulo, SP, Brazil
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Av. Brasil, 4365, 21040-360, Rio de Janeiro, RJ, Brazil
| | - Fernanda Cristina Dos Santos Simeão
- Núcleo de Tuberculose e Micobacterioses, Centro de Bacteriologia, Instituto Adolfo Lutz (IAL), Av. Dr. Arnaldo, 351, 9º andar, 01246-000, São Paulo, SP, Brazil
| | - Andreia Rodrigues de Souza
- Núcleo de Tuberculose e Micobacterioses, Centro de Bacteriologia, Instituto Adolfo Lutz (IAL), Av. Dr. Arnaldo, 351, 9º andar, 01246-000, São Paulo, SP, Brazil
| | - Juliana Failde Gallo
- Núcleo de Tuberculose e Micobacterioses, Centro de Bacteriologia, Instituto Adolfo Lutz (IAL), Av. Dr. Arnaldo, 351, 9º andar, 01246-000, São Paulo, SP, Brazil
| | - Juliana Maira Watanabe Pinhata
- Núcleo de Tuberculose e Micobacterioses, Centro de Bacteriologia, Instituto Adolfo Lutz (IAL), Av. Dr. Arnaldo, 351, 9º andar, 01246-000, São Paulo, SP, Brazil
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de Souza MQ, Bierhals DV, Reis AJ, Chimara E, Vianna JS, von Groll A, da Silva PA, Ramis IB. 2,3,5-triphenyl tetrazolium chloride as colorimetric indicator for drug susceptibility testing against nontuberculous mycobacteria. Diagn Microbiol Infect Dis 2024; 108:116096. [PMID: 37931387 DOI: 10.1016/j.diagmicrobio.2023.116096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/04/2023] [Accepted: 09/22/2023] [Indexed: 11/08/2023]
Abstract
This study aimed to propose and evaluate a drug susceptibility testing (DST) using the 2,3,5-triphenyl tetrazolium chloride (TTC) as a colorimetric indicator against Mycobacterium abscessus complex (MABC), M. avium complex (MAC), and M. kansasii strains, main nontuberculous mycobacteria (NTM) of clinical relevance. Our results demonstrated that the assay using TTC and the broth microdilution method recommended by the Clinical and Laboratory Standards Institute had essential agreement above 91%, 92%, and 100%, for drugs tested against MABC, MAC, and M. kansasii strains, respectively. Categorical agreement above 91% was obtained for most drugs tested against MABC, except to cefoxitin (76.5%). For drugs tested against MAC and M. kansasii, categorical agreement above 92% and 100% was observed, respectively. TTC showed to be a promising colorimetric indicator of growth to be used in DST for NTM, allowing an easier reading of results.
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Affiliation(s)
- Mariana Quaresma de Souza
- Laboratório de Micobactérias, Núcleo de Pesquisa em Microbiologia Médica, Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Dienefer Venske Bierhals
- Laboratório de Micobactérias, Núcleo de Pesquisa em Microbiologia Médica, Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Ana Julia Reis
- Laboratório de Micobactérias, Núcleo de Pesquisa em Microbiologia Médica, Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Erica Chimara
- Núcleo de Tuberculose e Micobacterioses, Instituto Adolfo Lutz, São Paulo, Brazil
| | - Júlia Silveira Vianna
- Laboratório de Micobactérias, Núcleo de Pesquisa em Microbiologia Médica, Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Andrea von Groll
- Laboratório de Micobactérias, Núcleo de Pesquisa em Microbiologia Médica, Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Pedro Almeida da Silva
- Laboratório de Micobactérias, Núcleo de Pesquisa em Microbiologia Médica, Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil.
| | - Ivy Bastos Ramis
- Laboratório de Micobactérias, Núcleo de Pesquisa em Microbiologia Médica, Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
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7
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Barboza GCS, de Almeida IN, dos Santos LB, Augusto CJ, Leal ÉA, de Pádua CAM, Cesar ALA, Kritski AL, Carvalho WDS, de Miranda SS, Figueredo LJDA. Nontuberculous mycobacteria in patients of a specialty hospital. Rev Inst Med Trop Sao Paulo 2023; 65:e42. [PMID: 37403880 PMCID: PMC10313315 DOI: 10.1590/s1678-9946202365042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/22/2023] [Indexed: 07/06/2023] Open
Abstract
The incidence and clinical characteristics of NTM diseases in Brazil remain relatively unknown. The present study describes the diagnosis of NTM isolates, the clinical presentation and treatment outcomes. We analyzed NTM isolates in patients of a tertiary hospital in the Southeast region of Brazil, from January 2008 to July 2019. The ATS/IDSA criteria for diagnosis and treatment of these patients was applied. Mycobacterium kansasii were identified in 13/113 (11.5%) patients. In 59/113 (52.2%) patients who met the ATS criteria for disease, 29/59 (49.1%) received treatment, and 22/29 (75.8%) were cured. The major species identified was M. kansasii. The most frequent symptoms among the treated patients were dyspnea and cough, and the proportion of cured patients was high.
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Affiliation(s)
- Grazielle Conceição Sousa Barboza
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
| | | | - Lucas Benício dos Santos
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
| | - Claudio José Augusto
- Fundação Ezequiel Dias, Laboratório de Serviço de Doenças Bacterianas e Fúngicas, Belo Horizonte, Minas Gerais, Brazil
| | - Élida Aparecida Leal
- Fundação Ezequiel Dias, Laboratório de Serviço de Doenças Bacterianas e Fúngicas, Belo Horizonte, Minas Gerais, Brazil
| | - Cristiane Aparecida Menezes de Pádua
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Laboratório de Saúde Pública e Biologia Molecular, Belo Horizonte, Minas Gerais, Brazil
| | - Aina Liz Alves Cesar
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
| | - Afrânio Lineu Kritski
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Wânia da Silva Carvalho
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Laboratório de Saúde Pública e Biologia Molecular, Belo Horizonte, Minas Gerais, Brazil
| | - Silvana Spíndola de Miranda
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
| | - Lida Jouca de Assis Figueredo
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
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8
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Echeverria G, Rueda V, Espinoza W, Rosero C, Zumárraga MJ, de Waard JH. First Case Reports of Nontuberculous Mycobacterial (NTM) Lung Disease in Ecuador: Important Lessons to Learn. Pathogens 2023; 12:pathogens12040507. [PMID: 37111393 PMCID: PMC10142742 DOI: 10.3390/pathogens12040507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 04/29/2023] Open
Abstract
Nontuberculous mycobacteria (NTM) lung infections are often misdiagnosed as tuberculosis, which can lead to ineffective antibiotic treatments. In this report, we present three cases of NTM lung infections in Ecuador that were initially diagnosed and treated as tuberculosis based on the results of sputum smear microscopy. The patients, all male, included two immunocompetent individuals and one HIV-positive subject. Unfortunately, sputum culture was not initiated until late in the course of the disease and the cause of the lung infection, Mycobacterium avium complex (MAC), was only identified after the patients had either passed away or were lost to follow-up. These cases are the first documented cases of NTM lung infections in the English medical literature from Ecuador. We emphasize the importance of accurate diagnosis of NTM infections by culture and identification to species level. Sputum smear staining alone cannot differentiate between mycobacterial species, which can lead to misidentification and ineffective treatments. Additionally, reporting NTM pulmonary disease as a notifiable disease to national TB control programs is recommended to obtain accurate prevalence data. These data are critical in determining the importance of this public health problem and the necessary actions needed to address it.
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Affiliation(s)
- Gustavo Echeverria
- Instituto de Investigación en Zoonosis-CIZ, Universidad Central del Ecuador, Quito 170518, Ecuador
- Programa de Doctorado, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires C1063ACV, Argentina
- División Investigación y Desarrollo, BioGENA, Quito 170509, Ecuador
| | - Veronica Rueda
- Instituto de Investigación en Zoonosis-CIZ, Universidad Central del Ecuador, Quito 170518, Ecuador
| | - Wilson Espinoza
- Departamento de Tuberculosis, Hospital de Especialidades Eugenio Espejo, Quito 170401, Ecuador
| | - Carlos Rosero
- Departamento de Tuberculosis, Hospital de Especialidades Eugenio Espejo, Quito 170401, Ecuador
| | - Martín J Zumárraga
- Instituto de Agrobiotecnología y Biología Molecular, IABIMO, INTA-CONICET, Buenos Aires C1063ACV, Argentina
| | - Jacobus H de Waard
- Departamento de Tuberculosis, Instituto de Biomedicina "Jacinto Convit", Universidad Central de Venezuela, Caracas 1010, Venezuela
- One Health Research Group, Facultad de Ciencias de la Salud, Universidad de Las Américas (UDLA), Quito 180602, Ecuador
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9
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Morais FCL, Bello GL, Costi C, Schmid KB, Soares TDS, Barcellos RB, Unis G, Dias CF, da Silva PEA, Rossetti ML. Detection of non-tuberculosus mycobacteria (NTMs) in lung samples using 16S rRNA. Mem Inst Oswaldo Cruz 2022; 117:e220031. [PMID: 35920498 PMCID: PMC9337835 DOI: 10.1590/0074-02760220031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Non-tuberculous mycobacteria (NTMs) cause diseases known as mycobacteriosis
and are an important cause of morbidity and mortality. The diagnosis of
pulmonary disease caused by NTM is hampered by its clinical similarity with
tuberculosis (TB) and by the lack of an accurate and rapid laboratory
diagnosis. OBJECTIVES Detect DNA from NTMs directly from lung samples using real-time polymerase
chain reaction (qPCR) for amplification of 16S rRNA. Additionally, DNA
sequencing (hsp65 and rpoB genes) was used
to identify the species of MNTs. METHODS A total of 68 sputum samples (54 with suspected NTMs and 14 with TB) from
patients treated at a referral hospital were used. FINDINGS Of these, 27/54 (50%) were qPCR positive for NTMs and 14/14 TB patients
(controls) were qPCR negative with an almost perfect concordance
(Kappa of 0.93) with the Mycobacterium
spp. culture. Sequencing confirmed the presence of NTM in all positive
samples. The most common species was Mycobacterium gordonae
(33%), followed by Mycobacterium abscessus (26%),
Mycobacterium fortuitum (22%), Mycobacterium
avium (15%) and Mycobacterium peregrinum
(4%). MAIN CONCLUSIONS The qPCR technique for detecting NTMs targeting 16S rRNA has the potential
to detect NTMs and rapidly differentiate from Mycobacterium
tuberculosis. However, it is necessary to identify the species
to help in the differential diagnosis between disease and contamination, and
to guide the choice of the therapeutic scheme.
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Affiliation(s)
- Franciele Costa Leite Morais
- Universidade Luterana do Brasil, Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Canoas, RS, Brasil
| | - Graziele Lima Bello
- Instituto Nacional de Ciência e Tecnologia em Tuberculose, Programa Institutos Nacionais de Ciência e Tecnologia, Porto Alegre, RS, Brasil
| | - Cíntia Costi
- Secretaria da Saúde do Rio Grande do Sul, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil.,Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Biologia Celular e Molecular, Porto Alegre, RS, Brasil
| | - Karen Barros Schmid
- Secretaria da Saúde do Rio Grande do Sul, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil.,Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Biologia Celular e Molecular, Porto Alegre, RS, Brasil
| | - Tainá Dos Santos Soares
- Universidade Luterana do Brasil, Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Canoas, RS, Brasil.,Secretaria da Saúde do Rio Grande do Sul, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil
| | - Regina Bones Barcellos
- Secretaria da Saúde do Rio Grande do Sul, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil.,Universidade Federal do Rio de Janeiro, Programa de Pós-Graduação em Clínica Médica, Rio de Janeiro, RJ, Brasil
| | - Gisela Unis
- Secretaria da Saúde do Rio Grande do Sul, Hospital Sanatório Partenon, Porto Alegre, RS, Brasil
| | - Claudia Fontoura Dias
- Secretaria da Saúde do Rio Grande do Sul, Hospital Sanatório Partenon, Porto Alegre, RS, Brasil
| | - Pedro Eduardo Almeida da Silva
- Universidade Federal do Rio Grande, Faculdade de Medicina, Centro de Pesquisas em Microbiologia Médica, Rio Grande, RS, Brasil
| | - Maria Lucia Rossetti
- Universidade Luterana do Brasil, Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Canoas, RS, Brasil.,Instituto Nacional de Ciência e Tecnologia em Tuberculose, Programa Institutos Nacionais de Ciência e Tecnologia, Porto Alegre, RS, Brasil.,Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Biologia Celular e Molecular, Porto Alegre, RS, Brasil
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10
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Moore RR, Holder D, Earnest S. Diagnosing and treating Mycobacterium kansasii. JAAPA 2022; 35:32-34. [PMID: 35762953 DOI: 10.1097/01.jaa.0000824932.43060.3f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT This article describes an 18-year-old immunocompetent patient who developed Mycobacterium kansasii, manifested with shortness of breath and a cavitary lung lesion seen on radiograph. Initial sputum smears were negative; however, after 2 weeks, the cultures grew M. kansasii and the patient was started on an antimycobacterial regimen.
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Affiliation(s)
- Randy R Moore
- Randy R. Moore practices in family medicine at Wellness Pointe Family Health in Longview, Tex., and is a major in the Texas Army National Guard. Douglas Holder is a radiologist at Red River Valley Radiology Associates and Open Imaging of Longview, Tex. Sarah Earnest is a family nurse practitioner at Special Health Resources in Longview, Tex. The authors have disclosed no potential conflicts of interest, financial or otherwise
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11
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Chohan A, Choudhury S, Taweesedt PT, Dadhwal R, Vakil AP, Ali Z, Franco R. A Case Report on Mycobacterium abscessus: An Emerging Pathogen. Cureus 2022; 14:e23072. [PMID: 35419221 PMCID: PMC8995077 DOI: 10.7759/cureus.23072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 11/12/2022] Open
Abstract
The incidence of infections by rapidly growing mycobacteria has increased in recent decades. nontuberculous mycobacteria(NTM) represent over 190 species and subspecies and can cause both pulmonary and extrapulmonary symptoms. The Mycobacterium abscessus complex (MABC)is among the most drug-resistant mycobacterial species, and prompt diagnosis and effective eradication are burdensome. We present the clinical course of a 55-year-old female who was diagnosed with M. abscessus and explore her clinical diagnosis and possible treatment options. This case report emphasizes the challenges clinicians face in the prompt diagnosis of M. abscessus and discusses the treatment options in light of the recent guidelines.
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Affiliation(s)
- Asad Chohan
- Department of Pulmonology, Corpus Christi Medical Center Bay Area, Corpus Christi, USA
| | - Saiara Choudhury
- Department of Pulmonology, Corpus Christi Medical Center Bay Area, Corpus Christi, USA
| | - Pahnwat T Taweesedt
- Department of Pulmonology, Corpus Christi Medical Center Bay Area, Corpus Christi, USA
| | - Rahul Dadhwal
- Department of Pulmonology, Corpus Christi Medical Center Bay Area, Corpus Christi, USA
| | - Abhay P Vakil
- Department of Pulmonology, Corpus Christi Medical Center Bay Area, Corpus Christi, USA
| | - Zuhair Ali
- Department of Pulmonology, Corpus Christi Medical Center Bay Area, Corpus Christi, USA
| | - Rene Franco
- Department of Pulmonology, Corpus Christi Medical Center Bay Area, Corpus Christi, USA
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12
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Coelho AGV, Chiou AC, Pedro HDSP, Nardi SMT, Chimara E. Epidemiological profile and follow-up of patients with pulmonary disease by non-tuberculous mycobacteria in Baixada Santista area, São Paulo. EINSTEIN-SAO PAULO 2022; 20:eAO5510. [PMID: 35170707 PMCID: PMC8827356 DOI: 10.31744/einstein_journal/2022ao5510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 07/15/2020] [Indexed: 11/05/2022] Open
Abstract
Objective To present the frequency and species diversity of non-tuberculous mycobacteria, estimate the prevalence of non-tuberculous mycobacterial pulmonary disease, describe the epidemiological profile, and determine the follow-up of patients with non-tuberculous mycobacterial pulmonary disease living in a region with a high burden of tuberculosis. Methods This a retrospective cohort observational study using data records obtained from the Instituto Adolfo Lutz - Santos and from the São Paulo Sistema de Vigilância de Tuberculose do Estado de São Paulo in the period between 2000 and 2009. The studied variables were: socio-demographic characteristics, current and past history of tuberculosis, aspects related to diagnosis, and treatment and associated diseases. Results We included 319 non-tuberculous mycobacteria isolates in the study, corresponding to 257 patients. The species Mycobacterium kansasii (28.5%) and Mycobacterium fortuitum (16.6%) presented the higher occurrence. In 10.9% (24) of the patients, there was a criterion for confirming a case of pulmonary disease due to non-tuberculous mycobacteria. In relation to gender and age, male and individuals over 50 years old were the most frequent. Considering the confirmed cases, 47.8% had a past history of tuberculosis. Conclusion The lack of information about the cases is evident, since pulmonary disease due to non-tuberculous mycobacteria is not mandatory. The therapeutic regimen according to the identified species is fundamental for success in combating the infections caused by non-tuberculous mycobacteria. Besides that, information about the regional epidemiology of pulmonary disease caused by non-tuberculous mycobacteria and the search for associations with other comorbidities are important to establish the correct treatment. In order to improve surveillance of pulmonary diseases by non-tuberculous mycobacteria, we suggest the implantation of a sentinel surveillance and of population-based studies.
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13
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Exploring Potential COPD Immunosuppression Pathways Causing Increased Susceptibility for MAC Infections among COPD Patients. Clin Pract 2021; 11:619-630. [PMID: 34563006 PMCID: PMC8482292 DOI: 10.3390/clinpract11030077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 08/31/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
Although there has been a drastic decline in the cases of Tuberculosis in the United States, the prevalence of infections caused by Mycobacterium avium Complex (MAC) has steadily increased in the past decades. Mycobacterium avium (M. avium) is one of the most abundant microorganisms in the MAC species. The mycobacterium genus is divided into two major groups: tuberculosis causing mycobacteria and non-tuberculous mycobacteria. MAC is most prominent among the non-tuberculous mycobacteria. MAC is an opportunistic pathogen that is present in soil, water, and droplets in the air. MAC infections can result in respiratory disease and can disseminate in affected patients. MAC infections are especially prevalent in patients with preexisting respiratory conditions such as Chronic Obstructive Pulmonary Disease (COPD). COPD is one of the most common lung conditions in the world with the primary cause being smoking in developed countries. COPD involves chronic inflammation of lung tissue resulting in increased susceptibility to infection. There is a lack of research regarding the pathophysiology that leads COPD patients to be susceptible to MAC infection. Our review paper therefore aims to investigate how the pathogenicity of MAC bacteria and immune decline seen in COPD patients leads to a greater susceptibility to MAC infection among COPD patients.
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14
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Novel phage display-derived recombinant antibodies recognizing both MPT64 native and mutant (63-bp deletion) are promising tools for tuberculosis diagnosis. Biologicals 2021; 72:54-57. [PMID: 34247914 DOI: 10.1016/j.biologicals.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/10/2021] [Accepted: 07/02/2021] [Indexed: 11/21/2022] Open
Abstract
Tuberculosis (TB) is one of the top 10 causes of death in humans worldwide. The most important causative agents of TB are bacteria from the Mycobacterium tuberculosis complex (MTC), although nontuberculous mycobacteria (NTM) can also cause similar infections. The ability to identify and differentiate MTC isolates from NTM is important for the selection of the correct antimicrobial therapy. Immunochromatographic assays with antibodies anti-MPT64 allow differentiation between MTC and NTM since the MPT64 protein is specific from MTC. However, studies reported false-negative results mainly due to mpt64 63-bp deletion. Considering this drawback, we selected seven human antibody fragments against MPT64 by phage display and produced them as scFv-Fc. Three antibodies reacted with rMPT64 mutant (63-bp deletion) protein and native MPT64 from M. tuberculosis H37Rv in ELISA and Western blot. These antibodies are new biological tools with the potential for the development of TB diagnosis helping to overcome limitations of the MPT64-based immunochromatographic tests currently available.
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15
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Peixoto ADS, Montenegro LML, Lima AS, Melo FL, Barbosa Júnior WL, Neves MMC, Ramos JP, Schindler HC, Medeiros ZM. Identification of nontuberculous mycobacteria species by multiplex real-time PCR with high-resolution melting. Rev Soc Bras Med Trop 2020; 53:e20200211. [PMID: 33174954 PMCID: PMC7670742 DOI: 10.1590/0037-8682-0211-2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/02/2020] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: Nontuberculous mycobacteria (NTM) species, as human pathogens,
are increasing in the world, as is the difficulty of accurately identifying
them. Differential diagnosis, especially between the M.
tuberculosis complex and NTM species, and the characterization
of NTM species is important. This study aimed to evaluate the performance of
a molecular system based on multiplex real-time PCR with high-resolution
melting (HRM) for the identification and differentiation of NTM species of
clinical importance of an endemic area for tuberculosis in northeastern
Brazil. METHODS: The technical protocol of the molecular system was based on multiplex
real-time PCR-HRM, and evaluated the sensitivity and specificity of the
detection of NTM species in mycobacterial clinical isolates from the studied
region. The gold standard method was specific gene sequencing. RESULTS: The sensitivity and specificity of multiplex real-time PCR-HRM modified for
differentiation between NTM and M. tuberculosis were 90%
and 100%, respectively. The PCR-HRM sensitivities for the characterization
of NTM species (M. kansasii, M. abscesses, M. avium, and M.
fortuitum) were 94.59%, 80%, 57.14%, and 54%, respectively.
CONCLUSIONS The multiplex real-time PCR-HRM modified assay has the potential to rapidly
and efficiently identify nontuberculous mycobacteria of clinical importance,
which is crucial for immediate implementation of the appropriate therapy and
thus avoiding complications and sequelae in patients.
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Affiliation(s)
- Aline Dos Santos Peixoto
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Imunologia, Recife, PE, Brasil.,Universidade de Pernambuco, Pós-Graduação em Ciências da Saúde, Recife, PE, Brasil
| | | | - Andrea Santos Lima
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Imunologia, Recife, PE, Brasil
| | - Fábio Lopes Melo
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Parasitologia, Recife, PE, Brasil
| | | | | | - Jesus Pais Ramos
- Centro de Referência Professor Hélio Fraga, Escola Nacional de Saúde Pública, Laboratório Nacional de Referência para Tuberculose, Rio de Janeiro, RJ, Brasil
| | | | - Zulma Maria Medeiros
- Universidade de Pernambuco, Pós-Graduação em Ciências da Saúde, Recife, PE, Brasil.,Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Departamento de Parasitologia, Recife, PE, Brasil
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16
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dos Anjos LRB, Parreira PL, Torres PPTS, Kipnis A, Junqueira-Kipnis AP, Rabahi MF. Non-tuberculous mycobacterial lung disease: a brief review focusing on radiological findings. Rev Soc Bras Med Trop 2020; 53:e20200241. [PMID: 32935786 PMCID: PMC7491562 DOI: 10.1590/0037-8682-0241-2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/29/2020] [Indexed: 12/12/2022] Open
Abstract
The incidence and prevalence of lung disease caused by non-tuberculous mycobacteria (NTM-LD) has increased worldwide and its diagnosis represents a complex challenge. This article aims to review the tomographic findings of NTM-LD in order to facilitate their definitive diagnosis. The search for publications on the subject was performed in PMC and Scielo using the keywords 'non-tuberculous mycobacteria', 'lung disease and computed tomography (CT)' and 'radiological findings'. The radiological findings described by 18 articles on mycobacteriosis were reviewed. In addition, CT images of patients diagnosed with NTM-LD were considered to represent radiological findings. Eighteen publications were used whose main findings were pulmonary cavitation (88.9%), bronchiectasis (77.8%), and pulmonary nodules (55.6%). Despite the overlaps in imaging-related analysis of myocobacterioses with other pulmonary infections, such as tuberculosis, the predominant involvement of the middle lobe and lingula should raise suspicion for NTM-LD.
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Affiliation(s)
- Laura Raniere Borges dos Anjos
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Departamento de Biociências e Tecnologia, Goiânia, GO, Brasil
| | - Poliana Lopes Parreira
- Universidade Federal de Goiás, Faculdade de Medicina, Departamento de Clínica Médica, Goiânia, GO, Brasil
| | | | - André Kipnis
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Departamento de Biociências e Tecnologia, Goiânia, GO, Brasil
| | - Ana Paula Junqueira-Kipnis
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Departamento de Biociências e Tecnologia, Goiânia, GO, Brasil
| | - Marcelo Fouad Rabahi
- Universidade Federal de Goiás, Faculdade de Medicina, Departamento de Clínica Médica, Goiânia, GO, Brasil
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17
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Chang CL, Chen LC, Yu CJ, Hsueh PR, Chien JY. Different clinical features of patients with pulmonary disease caused by various Mycobacterium avium–intracellulare complex subspecies and antimicrobial susceptibility. Int J Infect Dis 2020; 98:33-40. [DOI: 10.1016/j.ijid.2020.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 11/15/2022] Open
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18
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Busatto C, Vianna JS, Silva ABS, Basso R, Silveira J, Groll AV, Ramis IB, Silva PEAD. Nontuberculous mycobacteria in patients with suspected tuberculosis and the genetic diversity of Mycobacterium avium in the extreme south of Brazil. ACTA ACUST UNITED AC 2020; 46:e20190184. [PMID: 32402014 PMCID: PMC7462694 DOI: 10.36416/1806-3756/e20190184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/04/2019] [Indexed: 11/26/2022]
Abstract
Objective: Nontuberculous mycobacteria (NTM) are a heterogeneous group of bacteria that are widely distributed in nature and associated with opportunistic infections in humans. The aims of this study were to identify NTM in patients with suspected tuberculosis who presented positive cultures and to evaluate the genetic diversity of strains identified as Mycobacterium avium. Methods: We studied pulmonary and extrapulmonary samples obtained from 1,248 patients. The samples that tested positive on culture and negative for the M. tuberculosis complex by molecular identification techniques were evaluated by detection of the hsp65 and rpoB genes and sequencing of conserved fragments of these genes. All strains identified as M. avium were genotyped using the eight-locus mycobacterial interspersed repetitive unit-variable-number tandem-repeat method. Results: We found that NTM accounted for 25 (7.5%) of the 332 mycobacteria isolated. Of those 25, 18 (72%) were M. avium, 5 (20%) were M. abscessus, 1 (4%) was M. gastri, and 1 (4%) was M. kansasii. The 18 M. avium strains showed high diversity, only two strains being genetically related. Conclusions: These results highlight the need to consider the investigation of NTM in patients with suspected active tuberculosis who present with positive cultures, as well as to evaluate the genetic diversity of M. avium strains.
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Affiliation(s)
- Caroline Busatto
- Núcleo de Pesquisa em Microbiologia Médica, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
| | - Júlia Silveira Vianna
- Núcleo de Pesquisa em Microbiologia Médica, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
| | - Ana Barbara Scholante Silva
- Núcleo de Pesquisa em Microbiologia Médica, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
| | - Rossana Basso
- Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
| | - Jussara Silveira
- Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
| | - Andrea Von Groll
- Núcleo de Pesquisa em Microbiologia Médica, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
| | - Ivy Bastos Ramis
- Núcleo de Pesquisa em Microbiologia Médica, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
| | - Pedro Eduardo Almeida da Silva
- Núcleo de Pesquisa em Microbiologia Médica, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brazil
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19
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Kwon BE, Ahn JH, Park EK, Jeong H, Lee HJ, Jung YJ, Shin SJ, Jeong HS, Yoo JS, Shin E, Yeo SG, Chang SY, Ko HJ. B Cell-Based Vaccine Transduced With ESAT6-Expressing Vaccinia Virus and Presenting α-Galactosylceramide Is a Novel Vaccine Candidate Against ESAT6-Expressing Mycobacterial Diseases. Front Immunol 2019; 10:2542. [PMID: 31736965 PMCID: PMC6830241 DOI: 10.3389/fimmu.2019.02542] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/14/2019] [Indexed: 12/22/2022] Open
Abstract
Early secretory antigenic target-6 (ESAT6) is a potent immunogenic antigen expressed in Mycobacterium tuberculosis as well as in some non-tuberculous mycobacteria (NTM), such as M. kansasii. M. kansasii is one of the most clinically relevant species of NTM that causes mycobacterial lung disease, which is clinically indistinguishable from tuberculosis. In the current study, we designed a novel cell-based vaccine using B cells that were transduced with vaccinia virus expressing ESAT6 (vacESAT6), and presenting α-galactosylceramide (αGC), a ligand of invariant NKT cells. We found that B cells loaded with αGC had increased levels of CD80 and CD86 after in vitro stimulation with NKT cells. Immunization of mice with B/αGC/vacESAT6 induced CD4+ T cells producing TNF-α and IFN-γ in response to heat-killed M. tuberculosis. Immunization of mice with B/αGC/vacESAT6 ameliorated severe lung inflammation caused by M. kansasii infection. We also confirmed that immunization with B/αGC/vacESAT6 reduced M. kansasii bacterial burden in the lungs. In addition, therapeutic administration of B/αGC/vacESAT6 increased IFN-γ+ CD4+ T cells and inhibited the progression of lung pathology caused by M. kansasii infection. Thus, B/αGC/vacESAT6 could be a potent vaccine candidate for the prevention and treatment of ESAT6-expressing mycobacterial infection caused by M. kansasii.
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Affiliation(s)
- Bo-Eun Kwon
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, South Korea
| | - Jae-Hee Ahn
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, South Korea
| | - Eun-Kyoung Park
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, South Korea
| | - Hyunjin Jeong
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, South Korea
| | - Hyo-Ji Lee
- Department of Biological Sciences, Kangwon National University, Chuncheon, South Korea
| | - Yu-Jin Jung
- Department of Biological Sciences, Kangwon National University, Chuncheon, South Korea
| | - Sung Jae Shin
- Department of Microbiology, Institute for Immunology and Immunological Disease, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye-Sook Jeong
- Division of Vaccine Research, Center for Infectious Disease Research, Korea National Institute of Health (KNIH), Korea Centers for Disease Control and Prevention (KCDC), Cheongju, South Korea
| | - Jung Sik Yoo
- Division of Vaccine Research, Center for Infectious Disease Research, Korea National Institute of Health (KNIH), Korea Centers for Disease Control and Prevention (KCDC), Cheongju, South Korea
| | - EunKyoung Shin
- Division of Vaccine Research, Center for Infectious Disease Research, Korea National Institute of Health (KNIH), Korea Centers for Disease Control and Prevention (KCDC), Cheongju, South Korea
| | - Sang-Gu Yeo
- Sejong Institute of Health and Environment, Sejong, South Korea
| | - Sun-Young Chang
- Laboratory of Microbiology, College of Pharmacy and Research Institute of Pharmaceutical Science and Technology (RIPST), Ajou University, Suwon, South Korea
| | - Hyun-Jeong Ko
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, South Korea
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20
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Marques LRM, Ferrazoli L, Chimara É. Pulmonary nontuberculous mycobacterial infections: presumptive diagnosis based on the international microbiological criteria adopted in the state of São Paulo, Brazil, 2011-2014. J Bras Pneumol 2019; 45:e20180278. [PMID: 31038648 PMCID: PMC6733752 DOI: 10.1590/1806-3713/e20180278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/20/2019] [Indexed: 11/26/2022] Open
Abstract
Objective: Pulmonary nontuberculous mycobacterial infections are caused by nontuberculous mycobacteria (NTM), the microbiological diagnosis of which involves the isolation and identification of the same species in at least two sputum samples, one BAL fluid sample, or one lung biopsy sample. The objective of the present study was to determine the frequency at which the various NTM species are identified among selected individuals and in potential cases of pulmonary nontuberculous mycobacterial infection. Methods: This was a retrospective analysis of the data on species isolated from respiratory specimens collected from 2,843 individuals between 2011 and 2014. Potential NTM infection cases were identified on the basis of the international microbiological criteria adopted in the state of São Paulo. Results: A total of 50 species were identified using the molecular method PCR-restriction enzyme analysis. Samples collected from 1,014 individuals were analyzed in relation to the microbiological criteria, and 448 (44.18%) had a presumptive diagnosis of pulmonary nontuberculous mycobacterial infection, the species identified most frequently being, in descending order, Mycobacterium kansasii, M. abscessus, M. intracellulare, M. avium, and M. szulgai. Conclusions: Although various NTM species were identified among the individuals studied, those presumptively identified most frequently on the basis of the microbiological criteria adopted in the state of São Paulo were the ones that are most commonly associated with pulmonary nontuberculous mycobacterial infection worldwide or in specific geographic regions.
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Affiliation(s)
| | - Lucilaine Ferrazoli
- . Núcleo de Tuberculose e Micobacterioses, Centro de Bacteriologia, Instituto Adolfo Lutz, São Paulo (SP) Brasil
| | - Érica Chimara
- . Núcleo de Tuberculose e Micobacterioses, Centro de Bacteriologia, Instituto Adolfo Lutz, São Paulo (SP) Brasil
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21
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Malacarne J, Heirich AS, Cunha EAT, Kolte IV, Souza-Santos R, Basta PC. Performance of diagnostic tests for pulmonary tuberculosis in indigenous populations in Brazil: the contribution of Rapid Molecular Testing. J Bras Pneumol 2019; 45:e20180185. [PMID: 31017227 PMCID: PMC6733740 DOI: 10.1590/1806-3713/e20180185] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 12/07/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the accuracy of rapid molecular testing as a diagnostic tool and estimate the incidence of smear-positive pulmonary tuberculosis among the indigenous population. METHODS This is an epidemiological study based on secondary data. We calculated the incidence of smear-positive pulmonary tuberculosis between January 1st, 2011 and December 31, 2016, and the performance of bacilloscopy and rapid molecular testing in diagnosing pulmonary tuberculosis compared to sputum culture (standard test). RESULTS We included 4,048 cases of indigenous people with respiratory symptoms who provided sputum samples for analysis. Among them, 3.7%, 6.7%, and 3.7% had positive results for bacilloscopy, sputum culture, and rapid molecular testing, respectively. The mean incidence of pulmonary tuberculosis was 269.3/100 thousand inhabitants. Rapid molecular testing had 93.1% sensitivity and 98.2% specificity, compared to sputum culture. Bacilloscopy showed 55.1% sensitivity and 99.6% specificity. CONCLUSIONS Rapid molecular testing can be useful in remote areas with limited resources and a high incidence of tuberculosis, such as indigenous villages in rural regions of Brazil. In addition, the main advantages of rapid molecular testing are its easy handling, fast results, and the possibility of detecting rifampicin resistance. Together, these attributes enable the early start of treatment, contributing to reduce the transmission in communities recognized as vulnerable to infection and disease.
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Affiliation(s)
- Jocieli Malacarne
- . Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz − Rio de Janeiro (RJ), Brazil
| | | | | | - Ida Viktoria Kolte
- . Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz − Rio de Janeiro (RJ), Brazil
| | - Reinaldo Souza-Santos
- . Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz − Rio de Janeiro (RJ), Brazil
| | - Paulo Cesar Basta
- . Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz − Rio de Janeiro (RJ), Brazil
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