River Sediments Downstream of Villages in a Karstic Watershed Exhibited Increased Numbers and Higher Diversity of Nontuberculous Mycobacteria

The impact of residential villages on the nontuberculous mycobacteria (NTM) in streams flowing through them has not been studied in detail. Water and sediments of streams are highly susceptible to anthropogenic inputs such as surface water flows. This study investigated the impact of seven residential villages in a karst watershed on the prevalence and species spectrum of NTM in water and sediments. Higher NTM species diversity (i.e., 19 out of 28 detected) was recorded downstream of the villages and wastewater treatment plants (WWTPs) compared to sampling sites upstream (i.e., 5). Significantly, higher Zn and lower silicon concentrations were detected in sediments inside the village and downstream of the WWTP's effluents. Higher phosphorus concentration in sediment was downstream of WWTPs compared to other sampling sites. The effluent from the WWTPs had a substantial impact on water quality parameters with significant increases in total phosphorus, anions (Cl-and N-NH3-), and cations (Na+ and K+). The results provide insights into NTM numbers and species diversity distribution in a karst watershed and the impact of urban areas. Although in this report the focus is on the NTM, it is likely that other water and sediment microbes will be influenced as well.

Disinfection and cleaning of heater-cooler units: suspension- and biofilm-killing

BACKGROUND

Non-tuberculous mycobacteria (NTM) infections in cardiac surgery patients, caused by Mycobacterium chimaera or Mycobacterium abscessus, have been traced to NTM-aerosols produced by heater-cooler units of cardiopulmonary bypass equipment.

AIM

To develop a protocol to disinfect the water reservoir(s) of heater-coolers to reduce NTM numbers and thereby prevent potential NTM aerosolization; and to devise an approach to disrupt surface biofilms of heater-coolers to reduce reinoculation of the heater-cooler reservoir(s) after disinfection.

METHODS

A laboratory-scale Centers for Disease Control and Prevention bioreactor and a heater-cooler were inoculated with M. chimaera or M. abscessus to measure the ability of different disinfection protocols to reduce NTM colony-forming units in water and biofilm samples and to delay the reappearance of NTM after disinfection.

FINDINGS

The combination of an enzyme detergent cleaning agent and Clorox® were equivalent to Clorox alone in reducing M. chimaera cfu in heater-cooler water reservoir samples. However, reappearance of those bacteria was delayed by 12 weeks by the combination of enzyme detergent cleaning agent and Clorox exposure compared to Clorox disinfection alone.

CONCLUSION

A combination of an enzyme detergent and Clorox was an effective disinfection treatment and significantly delayed the reappearance of M. chimaera in the heater-cooler reservoir.

Nitrate and nitrite reductase activities of Mycobacterium avium

Background

In spite of the fact that the standard test for nitrate reductase activity is negative for Mycobacterium avium, it can grow in a defined minimal medium with either nitrate (NO₃) or nitrite (NO₂) as sole nitrogen sources.

Methods

NO₃-and NO₂-reductase activities were measured in soluble and membrane fractions of aerobically grown cells of M. avium and those grown aerobically and shifted to anaerobiosis.

Results

NO₃- and NO₂-reductase activities were only detected in the membrane fractions and the two enzyme activities were significantly reduced if cells were grown aerobically in the presence of ammonia (NH₄). The NO₂-reductase activity of membrane fractions was 2-fold higher than that of NO₃-reductase consistent with the fact that NO₃-reductase activity of M. avium cannot be detected if measured by nitrite formation. Membrane fractions of M. avium cells grown 1 week aerobically and then 2 weeks under anaerobic conditions had NO₃-and NO₂-reductase activities.

Conclusion

The results are consistent with the presence of assimilatory NO₃-and NO₂-reductase activities in cells of M. avium grown under aerobic conditions. Further, the data suggest that a shift to anaerobic conditions results in the appearance of ammonium-insensitive NO₃-and NO₂-reductase activities; quite possibly that function in a dissimilatory role (redox balancing).

Surrounded by mycobacteria: nontuberculous mycobacteria in the human environment

A majority of the Mycobacterium species, called the nontuberculous mycobacteria (NTM), are natural inhabitants of natural waters, engineered water systems, and soils. As a consequence of their ubiquitous distribution, humans are surrounded by these opportunistic pathogens. A cardinal feature of mycobacterial cells is the presence of a hydrophobic, lipid-rich outer membrane. The hydrophobicity of NTM is a major determinant of aerosolization, surface adherence, biofilm-formation, and disinfectant- and antibiotic resistance. The NTM are oligotrophs, able to grow at low carbon levels [>50 microg assimilable organic carbon (AOC) l(-1)], making them effective competitors in low nutrient, and disinfected environments (drinking water). Biofilm formation and oligotrophy lead to survival, persistence, and growth in drinking water distribution systems. In addition to their role as human and animal pathogens, the widespread distribution of NTM in the environment, coupled with their ability to degrade and metabolize a variety of complex hydrocarbons including pollutants, suggests that NTM may be agents of nutrient cycling.

Microbial-mediated release of bisphenol A from polycarbonate vessels

AIM

To identify the source of bisphenol A (BPA) [2,2'-bis(4-hydroxyphenyl) propane] in cultures of an antibiotic-producing Bacillus sp. strain grown in polycarbonate flasks.

METHODS AND RESULTS

Although a culture of an antibiotic-producing Bacillus sp. strain grown in a new, rinsed polycarbonate flask yielded BPA, duplicate cultures grown in thoroughly washed polycarbonate flasks did not. Cells of Escherichia coli strain C were grown in new polycarbonate flasks rinsed three-times with 100 ml distilled H2O. BPA was only recovered from cultures grown in new polycarbonate flasks, but not from the autoclaved medium incubated in parallel.

CONCLUSIONS

BPA was present in either Bacillus or E. coli cultures, probably due to its release from inadequately washed polycarbonate flasks. Standard autoclaving did not result in BPA appearance; microbial growth was required. Polycarbonate vessels for microbial cultures should be thoroughly washed to avoid the appearance of BPA in culture medium.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study rigorously demonstrates that the presence of BPA in culture medium was a consequence of microbial growth or metabolism in inadequately washed polycarbonate flasks. As BPA exhibits antimicrobial and oestrogenic activity, searches for novel drugs or production of recombinant chemotherapeutic agents could be derailed by the artefactual appearance of BPA.

Effect of different cell fractions of Mycobacterium avium and vaccination regimens on Mycobacterium avium infection

Because of the availability of uniform genetic stocks and the ability to modulate stress levels, chickens were investigated as a host for the development of an antimycobacterial vaccine. The imposition and the timing of stress significantly influenced the outcome of Mycobacterium avium infection in chickens. Simple, whole cell or lysate vaccines and combinations of vaccine preparations were identified that led to high levels of protection. In addition, short-term stress at the time of vaccination significantly increased the protective efficacy of M. avium vaccine preparations. Post-infection vaccination of M. avium-infected chickens was also shown to significantly reduce the number of lesions and colony counts.

Fluorescent acid-fast microscopy for measuring phagocytosis of Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum by Tetrahymena pyriformis and their intracellular growth

Fluorescent acid-fast microscopy (FAM) was used to enumerate intracellular Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum in the ciliated phagocytic protozoan Tetrahymena pyriformis. There was a linear relationship between FAM and colony counts of M. avium cells both from cultures and within protozoa. The Ziehl-Neelsen acid-fast stain could not be used to enumerate intracellular mycobacteria because uninfected protozoa contained acid-fast, bacterium-like particles. Starved, 7-day-old cultures of T. pyriformis transferred into fresh medium readily phagocytized M. avium, M. intracellulare, and M. scrofulaceum. Phagocytosis was rapid and reached a maximum in 30 min. M. avium, M. intracellulare, and M. scrofulaceum grew within T. pyriformis, increasing by factors of 4- to 40-fold after 5 days at 30 degrees C. Intracellular M. avium numbers remained constant over a 25-day period of growth (by transfer) of T. pyriformis. Intracellular M. avium cells also survived protozoan encystment and germination. The growth and viability of T. pyriformis were not affected by mycobacterial infection. The results suggest that free-living phagocytic protozoa may be natural hosts and reservoirs for M. avium, M. intracellulare, and M. scrofulaceum.

A luciferase-based method for assessing chlorine-susceptibility of Mycobacterium avium

A rapid and quantitative assay for the disinfection of the water-borne pathogen, Mycobacterium avium, was developed using firefly luciferase as a reporter gene. There was a correlation between the quantity of light produced and the number of colony-forming units. In chlorine-disinfection studies of a luciferase-carrying derivative of M. avium, there was a strong correlation (r2=0.96) between colony forming units and relative light units. It was discovered that chlorine was rapidly lost from suspensions containing 10(6) M. avium cells/ml. The luciferase-based test can be used to rapidly measure susceptibility of M. avium to different disinfectants used in water treatment.

Factors influencing numbers of Mycobacterium avium, Mycobacterium intracellulare, and other Mycobacteria in drinking water distribution systems

Eight water distribution systems were sampled over an 18-month period (528 water and 55 biofilm samples) to measure the frequency of recovery and number of mycobacteria, particularly Mycobacterium avium and Mycobacterium intracellulare, in raw source waters before and after treatment and within the distribution system. The systems were chosen to assess the influence of source water, treatment, and assimilable organic carbon levels on mycobacterial numbers. Overall, mycobacterial recovery from the systems was low (15% of samples). Numbers of mycobacteria ranged from 10 to 700,000 CFU liter(-1). The number of M. avium in raw waters was correlated with turbidity. Water treatment substantially reduced the number of mycobacteria in raw waters by 2 to 4 log units. Mycobacterial numbers were substantially higher in the distribution system samples (average, 25,000-fold) than in those collected immediately downstream from the treatment facilities, indicating that mycobacteria grow in the distribution system. The increase in mycobacterial numbers was correlated with assimilable organic carbon and biodegradable organic carbon levels (r(2) = 0.65, P = 0.03). Although M. intracellulare was seldom recovered from water samples, it was frequently recovered (six of eight systems) in high numbers from biofilms (average, 600 CFU/cm(2)). Evidently, the ecological niches of M. avium and M. intracellulare are distinct.

Rapid coliphage detection assay

A rapid coliphage detection assay was developed, based on the phage-induced release of beta-galactosidase from cells of Escherichia coli. The assay could detect as few as five coliphage per sample without an overnight incubation period. The range of acceptable assay parameters was identified.

Identification and characteristics of a novel Burkholderia strain with broad-spectrum antimicrobial activity

A Burkholderia strain isolated from soil is capable of inhibiting the growth of bacteria, plant-pathogenic fungi, pathogenic yeasts, and protozoa. Inhibition does not involve cell contact or the presence of living cells, suggesting that at least a substantial portion of the antimicrobial activity is due to the excretion of extracellular compounds.

Chlorine, chloramine, chlorine dioxide, and ozone susceptibility of Mycobacterium avium

Environmental and patient isolates of Mycobacterium avium were resistant to chlorine, monochloramine, chlorine dioxide, and ozone. For chlorine, the product of the disinfectant concentration (in parts per million) and the time (in minutes) to 99.9% inactivation for five M. avium strains ranged from 51 to 204. Chlorine susceptibility of cells was the same in washed cultures containing aggregates and in reduced aggregate fractions lacking aggregates. Cells of the more slowly growing strains were more resistant to chlorine than were cells of the more rapidly growing strains. Water-grown cells were 10-fold more resistant than medium-grown cells. Disinfectant resistance may be one factor promoting the persistence of M. avium in drinking water.

Humic and fulvic acids stimulate the growth of Mycobacterium avium

Mycobacterium avium, an environmental, opportunistic pathogenic mycobacterium, has been isolated frequently and in high numbers from waters in Finland and from acid, brown water swamps of the southeastern coastal USA. M. avium has also been recovered in high numbers from Finnish drinking water and frequently isolated from Finnish AIDS patients. Boreal forests and brown water swamps are similar in that they are rich in humic and fulvic acids and of low pH and dissolved oxygen. Growth of representative isolates of M. avium in natural water was stimulated markedly by the addition of humic and fulvic acids. Further, the M. avium isolates grew at pH levels as low at 4.0 and at oxygen levels equal to 4% of atmospheric levels. The high numbers of M. avium in boreal waters and brown water swamps are likely due to their ability to proliferate in those humic- and fulvic-rich, acidic, micro-aerobic environments.

High rates of disseminated infection due to non-tuberculous mycobacteria among AIDS patients in Finland

OBJECTIVE

to determine the rate of disseminated infection due to non-tuberculous mycobacteria (NTM) among Finnish AIDS patients, and to analyse the epidemiology of these infections.

METHODS

in a prospective cohort study HIV-infected patients with CD4 counts < 200 x 10(6)/l were interviewed, and had mycobacterial blood cultures performed at baseline and at 6 months, then subsequently for clinical indications; autopsies were performed on patients who died. The cohort was followed at least for 24 months or to death. Water samples were collected from the homes of patients and from the environment and cultured for organisms of the Myobacterium avium complex (MAC). Environmental and clinical isolates were compared using pulsed field gel electrophoresis (PFGE).

RESULTS

NTM infection occurred in 22 (43%) of 51, 19 isolates were Mycobacterium avium, two M. genavense and one M. intracellulare. Multivariate analysis identified urban residence (P=0.04) and eating raw fish (P=0.04) as independent risk factors. Molecular analysis revealed two clusters of related isolates (three M. avium, two M. genavense) among urban residents.

CONCLUSION

AIDS patients in Finland have high rates of disseminated infection due to NTM. Clusters of identical organisms and association with urban residence suggests that these are newly acquired infections in advanced AIDS.

The international epidemiology of disseminated Mycobacterium avium complex infection in AIDS. International MAC Study Group

OBJECTIVE

To determine rates of disseminated Mycobacterium avium complex (MAC) infection among AIDS patients in developed and developing countries, and to determine whether different rates reflect differences in exposure or immunity, or both.

DESIGN

Prospective cohort study.

SETTING

University hospitals and outpatient AIDS programs.

METHODS

HIV-infected subjects with CD4 counts < 200 x 10(6)/l were interviewed and had CD4 lymphocyte counts, blood cultures for mycobacteria (baseline and at 6 months), and skin tests with purified protein derivative (PPD) and M. avium sensitin.

RESULTS

Among 566 study patients rates of disseminated MAC were 10.5-21.6% in New Hampshire, Boston and Finland compared to 2.4-2.6% in Trinidad and Kenya (P < 0.001). PPD skin test reactions > or = 5 mm were present in 20% of patients from Kenya compared to 1% at other sites (P < 0.001). Among patients from the United States and Finland, multiple logistic regression indicated that occupational exposure to soil and water was associated with a decreased risk of disseminated MAC, whereas the following were associated with an increased risk of disseminated MAC: low CD4 count, swimming in an indoor pool, history of bronchoscopy, regular consumption of raw or partially cooked fish/shellfish and treatment with granulocyte colony-stimulating factor.

CONCLUSIONS

Rates of disseminated MAC in AIDS are higher in developed than developing countries and are due to both differences in exposure and differences in immunity. These data provide a rationale for prevention of MAC through both active immunization and reduction in exposure to the organism.

Isolation and characteristics of Mycobacterium avium complex from water and soil samples in Uganda

SETTING

Mycobacterium avium complex organisms have not been isolated from late stage AIDS patients in Uganda. This could possibly be due to the absence of M. avium complex in the Uganda environment.

OBJECTIVE AND DESIGN

Determine whether M. avium complex organisms could be isolated from water and soils collected in the living environment of Ugandan AIDS patients.

RESULTS

Representatives of the M avium complex were isolated from 3 of 7 (43%) water and 3 of 7 (43%) soil samples collected in Kampala, Uganda. The average number of colony-forming units per ml water was 3.3 and average colony-forming units per gram of soil was 7825. In terms of growth characteristics, antimicrobial susceptibility patterns, and the presence or absence of plasmids and IS901, Ugandan M. avium complex isolates were similar to those isolated from the US and European AIDS patients and their environment.

CONCLUSIONS

M. avium complex organisms sharing genetic and physiological characteristics of M. avium complex isolates recovered from patients with AIDS can be isolated from water and soil samples in Uganda.

Recovery of Mycobacterium avium from cigarettes

Mycobacterium avium was recovered from tobacco, cigarette paper, and cigarette filters. M. avium could also be recovered from cigarette filters after the cigarettes had been smoked.

Persistent colonisation of potable water as a source of Mycobacterium avium infection in AIDS

The source of Mycobacterium avium infection in AIDS has not been identified and it is not known whether most patients with AIDS acquire the organism from recent infection or by reactivation of previous infection. As part of a prospective epidemiological study, we isolated multiple colonies of M avium from patients with AIDS and from potable water to which they had been exposed. All isolates were analysed with pulsed field gel electrophoresis (PFGE). As judged by PFGE, 29 (81%) of 36 patients were infected with one or more unique clinical strains of M avium. 7 patients (19%) were infected with three groups of common strains. Group 1 included 3 patients who lived in separate rural areas and had no common exposures apart from treatment at hospital A. The same strain was isolated repeatedly during 41 months from a recirculating hot water system at hospital A; residential water cultures were negative. Group 2 included 2 patients with no common exposures apart from treatment at hospital B; the same strain was isolated repeatedly over a period of 24 months from a recirculating hot water system at hospital B. Patients in groups 1 and 2 had numerous possible exposures to hospital hot water. Group 3 included 2 patients treated at the same methadone treatment facility. In an institution the hot water system may be persistently colonised with a particular strain of M avium. HIV-infected patients exposed to these water sources can develop disseminated M avium infection.

Field Evaluation of Two Colorimetric Coliphage Detection Methods

Two new methods for coliphage detection, a colorimetric agar-based (CAB) method and a liquid colorimetric presence-absence (LCPA) method, were compared to the coliphage method proposed by the American Public Health Association (APHA; Standard Methods for the Examination of Water and Wastewater , 18th ed., American Public Health Association, Washington, D.C., 1992). Both new methods are based on the induction of β-galactosidase in Escherichia coli and the release of the enzyme through a lytic cell infection. The released enzyme then cleaves a chromogenic substrate which produces a colored reaction product. Ninety split water samples from four different sources were tested. A total of 52 samples were positive by the CAB method, 52 were positive by the LCPA method, and 53 were positive by the APHA method. Results indicated that (i) the CAB and LCPA methods were as sensitive in coliphage detection as the APHA method, (ii) both the CAB and LCPA methods were easier to read and interpret than the APHA method, and (iii) the CAB method detected more coliphages in a positive sample than the APHA method in two of the four types of water sources. Importantly, the rapid and simple LCPA method was as reliable and sensitive as either of the two agar-based methods in coliphage detection.

Comparison of virulence of Mycobacterium avium complex (MAC) strains isolated from AIDS and non-AIDS patients

Mycobacterium avium complex (MAC) strains from AIDS and non-AIDS patients and from the environment were studied for their colony morphology and virulence in beige mice. The majority of the MAC isolates from AIDS patients, in contrast to those from non-AIDS patients and the environment, showed increased virulence. Similarly, the majority of the MAC isolates from AIDS patients formed smooth transparent (ST) colonies, whereas most of the non-AIDS isolates formed smooth opaque (SO) or intermediate (IM) type of colonies. MAC isolates from the same AIDS patient obtained at different times were found to be heterogenic with respect to serotype, RFLP and glycolipid patterns, suggesting that these patients might be infected with more than one strain of MAC.

A liquid, colorimetric presence-absence coliphage detection method

A liquid, colorimetric presence-absence coliphage detection method based on the induction of beta-galactosidase by Escherichia coli is described. The release of beta-galactosidase in the medium due to lytic cell infections by coliphages permits the hydrolysis of a yellow chromogenic substrate that develops into a distinct red coliphage positive sample, while a coliphage negative sample remains yellow. This method has proven to be rapid, simpler to perform than an agar medium assay, easy to read and interpret, inexpensive, and highly sensitive.

Genetic diversity among strains of Mycobacterium avium causing monoclonal and polyclonal bacteremia in patients with AIDS

To define the genetic diversity among Mycobacterium avium isolates from human immunodeficiency virus-infected patients, specimens were cultured prospectively, and isolates obtained from 14 patients (4 with positive blood, stool, and sputum; 6 with positive blood and stool; 3 with positive blood only; and 1 with positive stool only) were studied. Both serotyping and ribotyping had limited ability to discriminate among isolates from different patients, whereas the distinctive restriction fragment profiles resolved by pulsed-field gel electrophoresis indicated that each patient was infected by a unique strain. Of the 13 bacteremic patients, 2 were bacteremic concurrently with 2 distinct strains. The fact that M. avium isolates from AIDS patients exhibit considerable genetic diversity supports the hypothesis that the infection is acquired from various environmental sources. Further, individual patients are not infrequently bacteremic with > 1 strain simultaneously, which may need to be considered in protocols for the diagnosis and management of M. avium disease.

Epidemiology of infection by nontuberculous mycobacteria. Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum in acid, brown-water swamps of the southeastern United States and their association with environmental variables

Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum (MAIS) organisms were isolated and identified from waters, soils, aerosols, and droplets ejected from water collected from four geographically separate aquatic environments (Okefenokee Swamp, GA; Dismal Swamp, VA; Claytor Lake, VA; and Cranberry Glades, WV) during several seasons. Recovery of MAIS was significantly higher from waters, soils, and aerosols collected from the two acid, brown-water swamps located in the southeastern coastal plain. High MAIS numbers correlated with warmer temperature, low pH, low dissolved oxygen, high soluble zinc, high humic acid, and high fulvic acid. This research, in relation to previous findings for the geographic distribution and physiologic ecology of MAIS, supports the conclusion that waters, soils, and aerosols of the acid, brown-water swamps of the southeastern United States coastal plain represent major environmental sources likely connected with the higher incidence of human infection in this region.

Isolation of restriction fragments from large plasmids recovered from bacteria with multiple plasmids

A rapid and simple method for isolation of restriction DNA fragments from large plasmids is described. The loss of large plasmids is avoided by restriction endonuclease cleavage in an agarose gel before DNA precipitation. Plasmids were separated in low-melting-point agarose by electrophoresis, the desired plasmid DNA band was cut from the gel and digested with a restriction endonuclease in the agarose. Restriction fragments in agarose were recovered by a modified phenol-extraction, concentrated with 2-butanol and precipitated with ethanol. The procedure simplifies the task of cloning genes from large plasmids, resulting in high yields of restriction fragments from a desired plasmid in a short time.

Epidemiology of infection by nontuberculous mycobacteria IX. Evidence for two DNA homology groups among small plasmids in Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum

A 12.9 kb plasmid, pVT2, from a clinical Mycobacterium avium isolate, MD1, was cloned and radiolabeled for use as a DNA probe to examine the relatedness of plasmids in M. avium complex. That probe hybridized with plasmids isolated from M. avium complex strains from the environment (7 of 16) and from non-acquired immunodeficiency syndrome (AIDS) (10 of 17) and AIDS (5 of 6) clinical isolates. The similarity of plasmids from the environment with those from patients supports the hypothesis that the environment is a source of human M. avium complex infection. More striking was the observation that pVT2 hybridized with every plasmid (13 of 13 clinical and 5 of 5 environmental isolates) of 13.5 kb or smaller. A second probe, consisting of a 15.3 kb plasmid (pLR7) from another clinical isolate of the M. avium complex, hybridized with plasmids of 15.3 to 25 kb from environmental and clinical (AIDS and non-AIDS) isolates. There was no hybridization between pVT2 and pLR7. Thus, these two probes define two different groups of small mycobacterial plasmids.

Arylsulfatase activity of Mycobacterium avium, M. intracellulare, and M. scrofulaceum

A rapid (3-h) arylsulfatase assay for cell suspensions of mycobacteria, in which p-nitrophenyl sulfate is used as the substrate, was developed. Arylsulfatase activity was found in cell suspensions of representative strains of Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum grown without the substrate in either Middlebrook 7H9 medium containing 0.2% (wt/vol) glucose and 0.05% (vol/vol) Tween 80 or Dubos broth medium, but was absent in cells grown in a low-pH, minimal medium containing 1% (vol/vol) Tween 80 as the sole carbon source. The levels of arylsulfatase activity of representatives of all three species were equal whether the activity was measured at pH 5.5, 6.5, or 7.5 and whether the cells were suspended in phosphate or Tris buffer. The addition of high levels of sulfate (present in the low-pH, Tween 80-containing medium) to Middlebrook 7H9 medium resulted in significantly lower levels of arylsulfatase activity in strains of M. scrofulaceum, but did not affect the levels in either M. avium or M. intracellulare. The levels of arylsulfatase activity were highest in M. avium, intermediate in M. intracellulare, and lowest in M. scrofulaceum strains. Polyacrylamide gel electrophoresis of crude extracts from late-log-phase cells of representatives of each species produced activity bands of unique mobility (one in M. avium, three in M. intracellulare [82, 5, and 13%], and two in M. scrofulaceum [60 and 40%]).

Differences in antimicrobial susceptibility of pigmented and unpigmented colonial variants of Mycobacterium avium

Unpigmented colonial variants were isolated from pigmented Mycobacterium avium isolates recovered from patients with acquired immunodeficiency syndrome and the environment. The variants were interconvertible: the rate of transition from unpigmented to pigmented type was 4.0 x 10(-5) variants per cell per generation. The unpigmented variants were more tolerant to antibiotics, especially beta-lactams, and Cd2+ and Cu2+ salts than were their pigmented parents. Both pigmented and unpigmented variants of the strains produced beta-lactamase, although beta-lactamase did not appear to be a determinant of beta-lactam susceptibility. Pigmented variants grew more rapidly in a number of commonly used mycobacterial media, were more hydrophobic, and had higher carotenoid contents than their unpigmented segregants.

Enzyme activities and antibiotic susceptibility of colonial variants of Bacillus subtilis and Bacillus licheniformis

A nonmucoid colonial variant of a mucoid Bacillus subtilis strain produced less amylase activity and a transparent colonial variant of a B. licheniformis strain produced less protease activity compared with their parents. Antibiotic susceptibility patterns of the colonial variants differed, and increased resistance to beta-lactam antibiotics was correlated with increased production of extracellular beta-lactamase.

Plasmid-influenced changes in Mycobacterium avium catalase activity

A virulent Mycobacterium avium strain, LR25, which carries three plasmids (18, 28, and 165 kilobases) and grows at 43 degrees C was compared with its plasmid-free, avirulent segregant, strain LR163, to identify the basis for the latter's inability to grow at 43 degrees C. The failure of mid-log-phase cultures of strain LR163 to grow at 43 degrees C was dependent on the presence of high levels of culture aeration. In addition, highly aerated cultures of strain LR163 failed to grow at 37 degrees C. Mid-log-phase cultures of strain LR163 had 30% of the catalase activity of strain LR25 and were more hydrogen peroxide (0.08%, wt/vol) susceptible. Catalase activity of strain LR25 was higher in cultures grown with high aeration than in those grown with almost no aeration. These data support the contention that plasmid-encoded genes influence M. avium catalase activity.

Epidemiology of infection by nontuberculous mycobacteria. VIII. Absence of mycobacteria in chicken litter

Overlap in the geographic distributions of (1) higher frequencies of persons reacting to antigens prepared from the Mycobacterium avium, M. intracellulare, and M. scrofulaceum (MAIS) group; (2) higher frequencies of isolation from natural waters and soils; (3) higher densities of farms producing broilers (chicken) in the southeastern United States raises the question of whether MAIS organisms occur abundantly in chicken litter (pine bark shavings containing avian fecal material) and whether litter may be a potential source of animal or human infection through its subsequent use as a fertilizer or feed supplement. We show here that potentially pathogenic mycobacteria were seldom recovered from chicken litter containing avian fecal material. Further, litter appears bactericidal to these organisms in that less than 1% of cells inoculated survived more than 6 wk, probably because of the high pH of litters.

Identification of cytoplasmic membrane protein antigens of Mycobacterium avium, M. intracellulare, and M. scrofulaceum

The cytoplasmic membrane isolated from representative strains of the Mycobacterium avium, M. intracellulare, and M. scrofulaceum (MAIS) group contained approximately 20 proteins, as identified by SDS - polyacrylamide gel electrophoresis. One membrane protein predominated, comprising up to 50% of the total membrane protein. This major cytoplasmic membrane protein (MCMP) had a molecular weight of 31,000 and was surface accessible based on its susceptibility to proteinase digestion. The composition of the culture medium strongly influenced the amount of MCMP in the membrane fraction. Western blot analysis revealed that the MCMP and several other membrane proteins reacted with serum samples from patients infected with M. avium-intracellulare, M. tuberculosis, or other mycobacteria.

Accumulation and transport of cadmium by tolerant and susceptible strains of Mycobacterium scrofulaceum

Cadmium accumulation and transport were studied in two strains of Mycobacterium scrofulaceum differing in their susceptibility to Cd2+ toxicity. A 10-fold excess of either Zn2+ or Mn2+ partially antagonized inhibition of growth by Cd2+. 109Cd2+ uptake by both the tolerant and susceptible strains was temperature dependent and inhibited by a 10-fold excess of either Zn2+ or Mn2+. There were no significant differences in either the kinetics of 109Cd2+ uptake or the retention of accumulated 109Cd2+ by the tolerant and susceptible strains. Both tolerant and susceptible strains removed most of the cadmium from the culture medium, but significantly more was removed by cells of the tolerant strain. Most of the accumulated Cd2+ in the tolerant strain was in the particulate fraction, rather than in the soluble fraction. Intracellular accumulated Cd2+ was primarily in the soluble fraction of the susceptible strain. Increased Cd2+ in culture medium resulted in decreased Mn2+ and Zn2+ in cells of the susceptible strain but did not reduce the Mn2+ and Zn2+ content of cells of the tolerant strain.

Plasmid-encoded copper resistance and precipitation by Mycobacterium scrofulaceum

A copper-tolerant Mycobacterium scrofulaceum strain was able to remove copper from culture medium by sulfate-dependent precipitation as copper sulfide. Such precipitation of copper sulfide was not observed in a derivative that lacks a 173-kilobase plasmid. In addition, the plasmid-carrying strain has a sulfate-independent copper resistance mechanism.

Epidemiology of infection by nontuberculous mycobacteria. VII. Absence of mycobacteria in southeastern groundwaters

Using the fluorochrome auramine-O, direct microscopic counts of log phase cells of Mycobacterium avium, M. intracellulare, and M. scrofulaceum (MAIS) group showed excellent correlations with viable spread-plate counts. Accordingly, an enumeration of total acid-fast and MAIS cells by stain and culture (respectively) in groundwaters from three United States regions that differ in their incidence of human infection by MAIS was undertaken. Of 30 state-monitored, undisinfected wells, 11 were in Georgia coastal plain (high incidence), 10 were in the Virginia coastal plain (intermediate incidence), and 9 were in Montgomery County, Virginia (low incidence). Total acid-fast cells ranged widely between 280 to 5,367 per ml among the groundwaters, and with one exception showed no correlations or trends between regions of different incidence of human infection, or to total bacterial cell counts or colony-forming units. The exception was that the proportions of acid-fast cells relative to total cells were higher in the Georgia groundwaters. However, despite the relatively high auramine-O counts, few mycobacteria were recovered by culture. Of 12 wells yielding mycobacteria, 9 yielded rapidly growing and 4 slowly growing mycobacteria. Only one well in Montgomery County, Virginia (region of low incidence) yielded a MAIS isolate, albeit at low density. This research supports the conclusion that clean groundwaters are unlikely sources of MAIS infection in humans in the southeastern United States.

Superoxide dismutase activity of Mycobacterium avium, M. intracellulare, and M. scrofulaceum

Superoxide dismutase (EC 1.15.1.1) (SOD) activity has been detected in crude cell extracts of representative strains of the Mycobacterium avium, M. intracellulare, and M. scrofulaceum (MAIS) group. Polyacrylamide gel electrophoresis demonstrated a single SOD activity band for each of the MAIS strains, though there were differences in mobility. All M. avium and M. intracellulare and two of five M. scrofulaceum strains demonstrated a single activity band of identical mobility (Rf = 0.83), while the SOD activity band for the three remaining M. scrofulaceum strains migrated farther (Rf = 0.85). The differences in mobility correlated with differences in sensitivity to NaN3 and H2O2. The SOD activities of the majority of the MAIS strains which displayed the slower-migrating activity band were inhibited 22 to 81% after 15 min of exposure to 5 mM H2O2, suggesting that both iron and manganese may be present in a single enzyme. The SOD activities of the three M. scrofulaceum strains which had the faster-migrating activity band were inhibited 100% after only 5 min of exposure to 5 mM H2O2 and exhibited greater sensitivity to 5 and 10 mM NaN3, characteristics of an iron-containing SOD. A concentration of 1 mM KCN did not cause inhibition of enzyme activity in any of the MAIS strains tested. Extracellular SOD activity was detected in four of six MAIS strains and was shown to be identical in mobility to the SOD activity of the crude extracts.

Epidemiology of infection by nontuberculous mycobacteria. VI. Identification and use of epidemiologic markers for studies of Mycobacterium avium, M. intracellulare, and M. scrofulaceum

A comparison of clinical and environmental (e.g., soil, dust, water, and aerosol) isolates of the Mycobacterium avium-intracellulare and M. scrofulaceum (MAIS) group has been made. The frequency of M. avium-intracellulare clinical isolates able to grow without OADC enrichment, able to grow at 43 degrees C, or express resistance to streptomycin or cadmium was significantly higher than those among environmental isolates. Only the frequency of clinical M. scrofulaceum isolates able to grow at 43 degrees C and without OADC enrichment was significantly higher than that of environmental isolates. Because of the high frequency of clinical M. avium-intracellulare isolates able to grow without OADC, grow at 43 degrees C, and resistant to streptomycin, these 3 characteristics are suggested for use as epidemiologic markers for MAIS. There were no significant differences between clinical M. avium-intracellulare isolates from 3 widely separated geographic regions. Among M. avium-intracellulare environmental isolates, only those collected in droplets above bodies of water (i.e., aerosols) shared those characteristics unique to clinical MAIS. That observation suggests that these aerosols are a likely source of human MAIS infection. The ability of isolates to grow at 43 degrees C and without OADC enrichment was highly correlated. Gentamicin-, streptomycin-, and D-cycloserine-resistances were also frequently found together. Isolates carrying plasmids and either able to grow at 43 degrees C, without OADC enrichment, or mercury-resistant were found more frequently than expected as well. This suggests their genetic determinants are plasmid-encoded.

Plasmid DNA profiles as epidemiological markers for clinical and environmental isolates of Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum

Plasmid DNA was isolated, and profiles of a variety of clinical and environmental isolates of Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum (MAIS) were compared to determine whether plasmid DNA content would be useful as an epidemiological marker for these environmental pathogens. Since plasmids are common in clinical isolates and are stable during culture and exposure to NaOH, plasmid DNA analysis appears to be a suitable epidemiological tool. Based on the high frequency of plasmids in only clinical (56%) and aerosol (75%) isolates and low frequencies in soil (5%), dust (7%), sediment (less than 6%), and water (25%) isolates, the data suggest that MAIS-laden aerosols generated over waters of the southeastern United States are a likely source of human infection.

Selective medium for the isolation and enumeration of Mycobacterium avium-intracellulare and M. scrofulaceum

A medium for the selective isolation and enumeration of Mycobacterium avium-intracellulare and M. scrofulaceum (MAIS) was developed, based upon the ability of these mycobacteria to utilize Tween 80 as sole carbon source and grow optimally at pH 5.5 on a simple mineral salts medium. Representative MAIS strains had higher efficiencies of plating on the Tween 80 medium compared with Middlebrook 7H10. It was shown that nonmycobacterial organisms in natural waters had lower efficiencies of plating on the Tween 80 medium and smaller colonies, thus allowing direct isolation and enumeration of the slowly growing mycobacteria without overgrowth.

Epidemiology of infection by nontuberculous mycobacteria. V. Numbers in eastern United States soils and correlation with soil characteristics

Organisms of the Mycobacterium avium, M. intracellulare, and M. scrofulaceum (MAIS) group were recovered in significant numbers from 63 soil samples collected from the floodplains of 4 major rivers in the eastern United States: Hudson (NY), James (VA), Savannah (GA, SC), and Tombigbee (AL, MS). The mean numbers of M. avium-intracellulare, M. scrofulaceum, and MAIS-intermediate biovars recovered increased significantly from the Hudson to the James to the Tombigbee and Savannah soil samples, agreeing reasonably well with previous findings on MAIS distribution in eastern U.S. waters and with the geographic distribution of naval recruits reacting to PPD-B and PPD-G, which is higher in the southeastern United States. From the Savannah and Tombigbee rivers, soils were collected throughout their lengths. The number of total MAIS and biovars recovered from the different soil sites varied widely and showed no obvious trends. However, statistical analysis revealed a highly significant correlation between high numbers of MAIS recovered and high acidity of the soils. Other soil characteristics, such as high total organic matter, high conductivity, and reduced moisture, were only weakly, if at all, correlated with high MAIS numbers. Whereas the general distribution of MAIS in these soils of the Northeast (NY), mid-Atlantic (VA), and Southeast (GA, SC, AL, and MS) might explain the geographic distribution of the naval recruits reacting to PPD-B and PPD-G, the distribution of MAIS in soils along the stretches of the 2 southeastern rivers was not correlated with the county-by-county frequency of PPD-B reactive naval recruits in Georgia, South Carolina, Alabama, and Mississippi.

Recovery and survival of nontuberculous mycobacteria under various growth and decontamination conditions

The survival of microorganisms of the Mycobacterium avium, M. intracellulare, and M. scrofulaceum (MAIS) complex was evaluated after various soil and water decontamination regimens. Survival was reduced by growing cells in natural waters compared with laboratory media and by inclusion of malachite green in media as an antifungal agent. Decontamination with benzalkonium chloride, while reducing survival significantly less than 1% NaOH, failed to eliminate many fungi. Recovery from soil was further reduced by transfer losses and by irreversible cell adsorption onto particulates.

Unique developmental characteristics of the swarm and short cells of Proteus vulgaris and Proteus mirabilis

Swarming cells of Proteus mirabilis and Proteus vulgaris could be distinguished from their short-cell counterparts by virtue of their synthesis (or lack of synthesis) of certain enzymes and outer membrane proteins. Urease synthesis was constitutive in swarm cells and uninducible in short cells. In contrast, phenylalanine deaminase was inducible in both short and swarm cells, demonstrating that transcriptional and translational processes were functional. During swarm cell development, the amount of one outer membrane protein (45 kilodaltons) fell and the amounts of two others (50 and 28.3 kilodaltons) rose significantly, the level of cytochrome b decreased, and the synthesis of cytochromes a and d were repressed. Respiratory activities of swarm cells were greatly diminished, suggesting that energy for swarming came from fermentation rather than from respiration. Widespread changes in the pattern of enzyme activities, in cytochrome composition, and in the composition and type of outer membrane proteins suggest that they are due to transcriptional regulation.

Plasmid-encoded mercuric reductase in Mycobacterium scrofulaceum

A Chesapeake Bay water isolate of Mycobacterium scrofulaceum containing a 115-megadalton plasmid (pVT1) grew in the presence of 100 microM HgCl2 and converted soluble 203Hg2+ to volatile mercury at a rate of 50 pmol/10(8) cells per min. Cell extracts contained a soluble mercuric reductase whose activity was not dependent on exogenously supplied thiol compounds. The enzyme displayed nearly identical activity when either NADH or NADPH served as the electron donor. A spontaneously cured derivative lacking pVT1 failed to grow in the presence of 100 microM HgCl2 and possessed no detectable mercuric reductase activity.

In vitro susceptibility of human and environmental isolates of Mycobacterium avium, M. intracellulare, and M. scrofulaceum to heavy-metal salts and oxyanions

Because of the widespread distribution of Mycobacterium intracellulare and M. scrofulaceum in southeastern U.S. waters, the susceptibility of members of these species to heavy-metal salts and oxyanions was investigated. Isolates with abnormally high tolerance to mercuric chloride or cadmium chloride were identified.

Epidemiology of infection by nontuberculous mycobacteria. IV. Preferential aerosolization of Mycobacterium intracellulare from natural waters

We report here the first laboratory studies simulating the conditions for natural aerosolization of Mycobacterium intracellulare and M. scrofulaceum and estimate the yields for this pathway of transfer of pathogenic mycobacteria from water to air; M. intracellulare and M. scrofulaceum were both concentrated in droplets ejected from cell suspensions of densities comparable to those found in natural freshwaters (100 to 2,000 colony-forming units per ml). The enrichment factor (defined as the concentration of cells per droplet volume divided by the concentration of cells in the bulk suspension per equivalent volume) for M. intracellulare isolates ranged from 68 to 15,000, with an average of 2,922; for M. scrofulaceum it ranged from 35 to 550, with an average of 177. One factor responsible for the greater aerosolization of M. intracellulare was their aggregation. However, after vortexing, M. intracellulare were still aerosolized more (enrichment factor, 325) than M. scrofulaceum. Increasing salt concentrations enriched the aerosolization of both species, but the number of organisms transferred from water to air did not increase proportionately because the salt decreased the droplet volume. Other waterborne pathogens such as Legionella pneumophila were also enriched and transferred from water to air, indicating that this pathway for possible infection of humans may also be significant for other respiratory diseases.

Uric acid utilization by Mycobacterium intracellulare and Mycobacterium scrofulaceum isolates

Forty-nine human and environmental isolates of Mycobacterium intracellulare and Mycobacterium scrofulaceum were tested for their ability to grow on uric acid and a number of its degradation products. Nearly all (88 to 90%) strains used uric acid or allantoin as a sole nitrogen source; fewer (47 to 69%) used allantoate, urea, or possibly ureidoglycollate. Enzymatic activities of one representative isolate demonstrated the existence of a uric acid degradation pathway resembling that in other aerobic microorganisms.

Induction of tryptophanase in short cells and swarm cells of Proteus vulgaris

Tryptophanase was noninducible in swarm cells of Proteus vulgaris despite transport of the inducer tryptophan. Further, cyclic AMP, which stimulated increased levels of tryptophanase in short cells, had no effect on swarm cells.