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Seidelman JL, Baker AW, Lewis SS, Warren BG, Barrett A, Graves A, King C, Taylor B, Engel J, Bonnadonna D, Milano C, Wallace RJ, Stiegel M, Anderson DJ, Smith BA. A cluster of three extrapulmonary Mycobacterium abscessus infections linked to well-maintained water-based heater-cooler devices. Infect Control Hosp Epidemiol 2024; 45:644-650. [PMID: 38124539 PMCID: PMC11027075 DOI: 10.1017/ice.2023.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/02/2023] [Accepted: 11/12/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Various water-based heater-cooler devices (HCDs) have been implicated in nontuberculous mycobacteria outbreaks. Ongoing rigorous surveillance for healthcare-associated M. abscessus (HA-Mab) put in place following a prior institutional outbreak of M. abscessus alerted investigators to a cluster of 3 extrapulmonary M. abscessus infections among patients who had undergone cardiothoracic surgery. METHODS Investigators convened a multidisciplinary team and launched a comprehensive investigation to identify potential sources of M. abscessus in the healthcare setting. Adherence to tap water avoidance protocols during patient care and HCD cleaning, disinfection, and maintenance practices were reviewed. Relevant environmental samples were obtained. Patient and environmental M. abscessus isolates were compared using multilocus-sequence typing and pulsed-field gel electrophoresis. Smoke testing was performed to evaluate the potential for aerosol generation and dispersion during HCD use. The entire HCD fleet was replaced to mitigate continued transmission. RESULTS Clinical presentations of case patients and epidemiologic data supported intraoperative acquisition. M. abscessus was isolated from HCDs used on patients and molecular comparison with patient isolates demonstrated clonality. Smoke testing simulated aerosolization of M. abscessus from HCDs during device operation. Because the HCD fleet was replaced, no additional extrapulmonary HA-Mab infections due to the unique clone identified in this cluster have been detected. CONCLUSIONS Despite adhering to HCD cleaning and disinfection strategies beyond manufacturer instructions for use, HCDs became colonized with and ultimately transmitted M. abscessus to 3 patients. Design modifications to better contain aerosols or filter exhaust during device operation are needed to prevent NTM transmission events from water-based HCDs.
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Affiliation(s)
- Jessica L. Seidelman
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Arthur W. Baker
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Sarah S. Lewis
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Bobby G. Warren
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
- Disinfection, Resistance, Transmission and Epidemiology Laboratory, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Aaron Barrett
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
- Disinfection, Resistance, Transmission and Epidemiology Laboratory, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Amanda Graves
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
- Disinfection, Resistance, Transmission and Epidemiology Laboratory, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Carly King
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Bonnie Taylor
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Jill Engel
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Desiree Bonnadonna
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| | - Carmelo Milano
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Richard J. Wallace
- Mycobacteria/Nocardia Laboratory, University of Texas Health Science Center, Tyler, Texas
| | - Matthew Stiegel
- Occupational and Environmental Safety Office, Laboratory Safety, Duke University and Health System, Durham, North Carolina
| | - Deverick J. Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
- Disinfection, Resistance, Transmission and Epidemiology Laboratory, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Becky A. Smith
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
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Schlotthauer U, Hennemann K, Gärtner BC, Schäfers HJ, Becker SL. Microbiological Surveillance of Heater-Cooler Units Used in Cardiothoracic Surgery for Detection of Mycobacterium chimaera. Thorac Cardiovasc Surg 2024; 72:59-62. [PMID: 36167329 DOI: 10.1055/s-0042-1756630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Mycobacterium chimaera is a nontuberculous mycobacterium that was identified as causative agent in a global outbreak of severe infections following open-chest cardiothoracic surgery. Heater-cooler units (HCUs), which were contaminated during the manufacturing process, were elucidated as the origin of this outbreak. Regular surveillance of water-containing HCUs used for cardiac surgery was recommended as one preventive measure. We present data on the occurrence of M. chimaera and other mycobacterial pathogens in different HCUs from one surgical center in Germany over a 42-month period. Water samples and swabs from seven different HCUs were taken between 2015 and 2018, and mycobacteria were detected in 50.6% (78/154) of water samples and 21.1% (4/19) of swabs. M. chimaera accounted for the majority of detected pathogens (77/83 isolates in water samples), but other species such as Mycobacterium gordonae were also found. Despite strict adherence to an intensified, regular disinfection procedure, the majority of HCUs remained positive for mycobacteria until the end of the study. In conclusion, additional measures are needed to reduce the risk of intraoperative transmission of M. chimaera, and our observations underscore the inherent infections risks associated with water-containing medical devices.
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Affiliation(s)
- Uwe Schlotthauer
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany
| | - Kai Hennemann
- Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg/Saar, Germany
| | - Barbara C Gärtner
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany
| | - Hans-Joachim Schäfers
- Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg/Saar, Germany
| | - Sören L Becker
- Institute of Medical Microbiology and Hygiene, Saarland University, Homburg/Saar, Germany
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Schnetzinger M, Heger F, Indra A, Kimberger O. Bacterial contamination of water used as thermal transfer fluid in fluid-warming devices. J Hosp Infect 2023; 141:49-54. [PMID: 37385452 DOI: 10.1016/j.jhin.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION Recent reports implicated heater-cooler units (HCUs), which are used for warming infusions, blood or in extracorporeal membrane oxygenation devices, as a possible origin of healthcare-associated infections (HAIs) with potentially pathogenic bacteria, such as non-tuberculous mycobacteria [1]. This represents a source of contamination in a usually sterile setting. AIM To analyse water from infusion heating devices (IHDs) for bacterial contamination, and to determine if IHDs are a potential source in the transmission of HAIs. METHODS Thermal transfer fluid (TTF; 300-500 mL) was collected from the reservoirs of 22 independent IHDs and processed on different selective and non-selective media for colony count and identification of bacteria. Strains of Mycobacterium spp. were analysed by whole-genome sequencing. RESULTS Bacterial growth was observed in all 22 TTF samples after cultivation at 22 °C and 36 °C. Pseudomonas aeruginosa was the most frequent pathogen identified, present in 13.64% (3/22) of samples at >100 colony-forming units/100 mL. Colonization with Mycobacterium chimaera, Ralstonia pickettii and Ralstonia mannitolilytica was detectable in 9.09% (2/22) of samples. Primary sequencing of the detected M. chimaera suggests a close relationship with a M. chimaera strain detected in an outbreak in Switzerland which led to the death of two patients. DISCUSSION Contamination of TTF represents a germ reservoir in a sensitive setting. Handling errors of IHDs may lead to the distribution of opportunistic or facultative bacterial pathogens, increasing the risk of transmission of nosocomial infections.
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Affiliation(s)
- M Schnetzinger
- Medical University of Vienna, Department of Anaesthesiology and Intensive Care, Vienna, Austria.
| | - F Heger
- Austrian Agency for Health and Food Safety, Department of Medical Microbiology, Vienna, Austria
| | - A Indra
- Austrian Agency for Health and Food Safety, Department of Medical Microbiology, Vienna, Austria
| | - O Kimberger
- Medical University of Vienna, Department of Anaesthesiology and Intensive Care, Vienna, Austria
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Wetzstein N, Kohl TA, Diricks M, Mas-Peiro S, Holubec T, Kessel J, Graf C, Koch B, Herrmann E, Vehreschild MJGT, Hogardt M, Niemann S, Stephan C, Wichelhaus TA. Clinical characteristics and outcome of Mycobacterium chimaera infections after cardiac surgery: systematic review and meta-analysis of 180 heater-cooler unit-associated cases. Clin Microbiol Infect 2023; 29:1008-1014. [PMID: 36918144 DOI: 10.1016/j.cmi.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/13/2023] [Accepted: 03/05/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVES Since 2013, heater-cooler unit (HCU) associated Mycobacterium chimaera infections linked to a global outbreak have been described. These infections were characterised by high morbidity and mortality due to delayed diagnosis, as well as challenges in antimycobacterial and surgical therapy. This study aimed to investigate the clinical characteristics and outcome of published cases of HCU-associated M. chimaera infections. METHODS We searched PubMed and the Web of Science until 15 June 2022 for case reports, case series, and cohort studies, without language restriction, on patients with M. chimaera infection and a prior history of cardiac surgery. In this systematic review of case reports, no risk of bias assessment could be performed. Clinical, microbiological, and radiological features were recorded. Logistic regression and time-to-event analyses were performed to identify the potential factors associated with better survival. RESULTS One hundred eighty patients from 54 publications were included. Most patients underwent surgical aortic valve (67.0%; 118/176 of patients with available data) or combined aortic valve and root replacement (15.3%; 27/176). The median period between the time point of surgery and the first symptoms was 17 months (interquartile range 13-26 months). The overall case fatality rate was 45.5% (80/176), with a median survival of 24 months after the initiation of antimycobacterial therapy or diagnosis. A reoperation (including the removal or exchange of foreign material) was associated with better survival in multivariate logistic regression (OR 0.32 for lethal events; 95% CI 0.12-0.79; p 0.015) and in time-to-event analysis (p 0.0094). DISCUSSION This systematic review and meta-analysis confirm the high overall mortality of HCU -associated disseminated M. chimaera infections after cardiac surgery. A reoperation seems to be associated with better survival. Physicians have to stay aware of this infection, as patients might still be present today due to the long latency period.
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Affiliation(s)
- Nils Wetzstein
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
| | - Thomas A Kohl
- The German Centre for Infection Research (DZIF), partner site Hamburg-Lübeck-Borstel-Riems, Germany; Molecular and Experimental Mycobacteriology, Research Centre Borstel, Borstel, Germany
| | - Margo Diricks
- The German Centre for Infection Research (DZIF), partner site Hamburg-Lübeck-Borstel-Riems, Germany; Molecular and Experimental Mycobacteriology, Research Centre Borstel, Borstel, Germany
| | - Silvia Mas-Peiro
- Department of Internal Medicine, Cardiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Tomas Holubec
- Department of Cardiovascular Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Johanna Kessel
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Christiana Graf
- Department of Internal Medicine, Gastroenterology and Hepatology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Benjamin Koch
- Department of Internal Medicine, Nephrology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Eva Herrmann
- Institute of Biostatistics and Mathematical Modelling, Goethe University, Frankfurt am Main, Germany
| | - Maria J G T Vehreschild
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Michael Hogardt
- Institute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Stefan Niemann
- The German Centre for Infection Research (DZIF), partner site Hamburg-Lübeck-Borstel-Riems, Germany; Molecular and Experimental Mycobacteriology, Research Centre Borstel, Borstel, Germany
| | - Christoph Stephan
- Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Thomas A Wichelhaus
- Institute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
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Mani BI, Kishore PV, Khine WY, Thottacherry DJ, Chong PL, Abdullah MS, Asli R, Momin NR, Rahman NA, Chong CF, Chong VH. COVID-19 and Mycobacterium coinfection in Brunei Darussalam: case series. Western Pac Surveill Response J 2023; 14:1-7. [PMID: 37955034 PMCID: PMC10632094 DOI: 10.5365/wpsar.2023.14.3.1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Affiliation(s)
- Babu Ivan Mani
- National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
- Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital, Tutong, Brunei Darussalam
| | | | - Wai Yan Khine
- Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam
| | | | - Pui Lin Chong
- National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
- Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital, Tutong, Brunei Darussalam
| | - Muhamad Syafiq Abdullah
- National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
- Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital, Tutong, Brunei Darussalam
| | - Rosmonaliza Asli
- National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
- Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital, Tutong, Brunei Darussalam
| | - Natalie Raimiza Momin
- National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
- Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam
| | - Noor Affizan Rahman
- National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
- Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital, Tutong, Brunei Darussalam
- Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam
| | - Chee Fui Chong
- National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
| | - Vui Heng Chong
- National Isolation Centre, Ministry of Health, Tutong, Brunei Darussalam
- Pengiran Muda Mahkota Pengiran Muda Haji Al-Muhtadee Billah Hospital, Tutong, Brunei Darussalam
- Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam
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Bisognin F, Messina F, Butera O, Nisii C, Mazzarelli A, Cristino S, Pascale MR, Lombardi G, Cannas A, Dal Monte P. Investigating the Origin of Mycobacterium chimaera Contamination in Heater-Cooler Units: Integrated Analysis with Fourier Transform Infrared Spectroscopy and Whole-Genome Sequencing. Microbiol Spectr 2022; 10:e0289322. [PMID: 36222693 PMCID: PMC9769643 DOI: 10.1128/spectrum.02893-22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/20/2022] [Indexed: 01/09/2023] Open
Abstract
Mycobacterium chimaera is ubiquitously spread in the environment, including factory and hospital water systems. Invasive cases of M. chimaera infection have been associated with aerosols produced by the use of heater-cooler units (HCU) during cardiac surgery. The aim of this study was to evaluate for the first time the performance of IR-Biotyper system on a large number of M. chimaera isolates collected from longitudinal environmental HCUs samples and water sources from hospitals located in three Italian provinces. In addition, IR-Biotyper results were compared with whole-genome sequencing (WGS) analysis, the reference method for molecular epidemiology, to investigate the origin of M. chimaera contamination of HCUs. From November 2018 to May 2021, 417 water samples from 52 HCUs (Stockert 3T, n = 41 and HCU40, n = 11) and 23 hospital taps (used to fill the HCU tanks) were concentrated, decontaminated, and cultured for M. chimaera. Positive cultures (n = 53) were purified by agar plate subcultures and analyzed by IR-Biotyper platform and Ion Torrent sequencing system. IR-Biotyper spectra results were analyzed using a statistical approach of dimensionality reduction by linear discriminant analysis (LDA), generating three separate clusters of M. chimaera, ascribable to each hospital. Furthermore, the only M. chimaera-positive sample from tap water clustered with the isolates from the HCUs of the same hospital, confirming that the plumbing system could represent the source of HCU contamination and, potentially, of patient infection. According to the genome-based phylogenies and following the classification proposed by van Ingen and collaborators in 2017, three distinct M. chimaera groups appear to have contaminated the HCU water systems: subgroups 1.1, 2.1, and branch 2. Most of the strains isolated from HCUs at the same hospital share a highly similar genetic profile. The nonrandom distribution obtained with WGS and IR-Biotyper leads to the hypothesis that M. chimaera subtypes circulating in the local plumbing colonize HCUs through the absolute filter, in addition with the current hypothesis that contamination occurs at the HCU production site. This opens the possibility that other medical equipment, such as endoscope reprocessing device or hemodialysis systems, could be contaminated by M. chimaera. IMPORTANCE Our manuscript focuses on interventions to reduce waterborne disease transmission, improve sanitation, and control infection. Sanitary water can be contaminated by nontuberculous Mycobacteria, including M. chimaera, a causative agent of invasive infections in immunocompromised patients. We found highly similar genetic and phenotypic profiles of M. chimaera isolated from heater-cooler units (HCU) used during surgery to thermo-regulate patients' body temperature, and from the same hospital tap water. These results lead to the hypothesis that M. chimaera subtypes circulating in the local plumbing colonize HCUs through the absolute filter, adding to the current hypothesis that contamination occurs at the HCU production site. In addition, this opens the possibility that other medical equipment using sanitized water, such as endoscope reprocessing devices or hemodialysis systems, could be contaminated by nontuberculous Mycobacteria, suggesting the need for environmental surveillance and associated control measures.
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Affiliation(s)
- F. Bisognin
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - F. Messina
- UOC Microbiology and Bio-repository, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, Rome, Italy
| | - O. Butera
- UOC Microbiology and Bio-repository, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, Rome, Italy
- UOS Technical Health Professions, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, Rome, Italy
| | - C. Nisii
- UOC Microbiology and Bio-repository, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, Rome, Italy
| | - A. Mazzarelli
- UOC Microbiology and Bio-repository, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, Rome, Italy
| | - S. Cristino
- Department of Biological, Geological, and Environmental Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - M. R. Pascale
- Department of Biological, Geological, and Environmental Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - G. Lombardi
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - A. Cannas
- UOC Microbiology and Bio-repository, National Institute for Infectious Diseases “Lazzaro Spallanzani”-IRCCS, Rome, Italy
| | - P. Dal Monte
- Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum-University of Bologna, Bologna, Italy
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Schmidt V, Köhler H, Heenemann K, Möbius P. Mycobacteriosis in Various Pet and Wild Birds from Germany: Pathological Findings, Coinfections, and Characterization of Causative Mycobacteria. Microbiol Spectr 2022; 10:e0045222. [PMID: 35852339 PMCID: PMC9430480 DOI: 10.1128/spectrum.00452-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
A total of 50 birds diagnosed with mycobacteriosis were examined for pathomorphological lesions, coinfections, and causative agents. Mycobacterial species were identified and isolates differentiated using multilocus sequence typing (MLST) and mycobacterial interspersed repetitive-unit variable-number of tandem-repeat (MIRU-VNTR) analysis. Possible associations between mycobacterial species, pathomorphological findings, coinfections, bird orders, and husbandry conditions were evaluated statistically. Mycobacteria were isolated from 34 birds (13 of 22 Psittaciformes, 12 of 18 Passeriformes, five of six Columbiformes, and four other orders) belonging to 26 species in total. Mycobacterium genavense (Mg) was cultured from 15 birds, Mycobacterium avium subsp. avium (Maa) from 20 birds, and Mycobacterium avium subsp. hominissuis (Mah) from three birds; hence, four birds had mixed infections. About equal numbers of psittacines and passerines were infected with Ma and Mg. The genetic diversity differed; Mg isolates belonged to one MLST type, Maa to six, and Mah to three combined genotypes. Several coinfections were detected; viruses and/or endoparasites affected 44%, fungi 38%, and bacteria 29% of the birds. Pathological findings and mycobacteriosis-affected organs were independent of coinfections. Overall, gross pathological findings were more often seen in mycobacteriosis caused by Ma (95%) compared with Mg (66%). Organ distribution of mycobacteriosis was independent of the mycobacterial species. Pathomorphological changes were seen in the small intestine of 71% and the lung of 65% of the birds, suggesting oral or pulmonal ingestion of mycobacteria. There were no associations between mycobacterial species and bird orders or bird husbandry conditions. Not only Mg, but also Maa and Mah, were clearly identified as primary cause of mycobacteriosis in pet birds. IMPORTANCE In this study, the causative agents and confounding factors of mycobacteriosis in a set of pet and some wild birds from Germany were examined. Not only Mycobacterium genavense, but also M. avium subsp. avium and M. avium subsp. hominissuis, contributed to mycobacteriosis in these birds. Various coinfections did not affect the manifestation of mycobacteriosis. Due to different gross necropsy findings, however, a different pathogenicity of the two species was assumed. New strains of M. avium subsp. hominissuis originating from birds were identified and characterized, which is important for epidemiological studies and for understanding the zoonotic role of this pathogen, as the subsp. hominissuis represents an increasing public health concern. The study provides some evidence of correlation between M. avium subsp. avium genotypes and virulence which will have to be confirmed by broader studies.
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Grants
- Clinic for Birds and Reptiles, University of Leipzig, Germany
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institut (Federal Research Institute for Animal Health), Jena, Germany
- Institute for Virology, University of Leipzig, Germany
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institut (Federal Research Institute for Anmial Health), Jena, Germany
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Affiliation(s)
- Volker Schmidt
- Clinic for Birds and Reptiles, University of Leipzig, Leipzig, Germany
| | - Heike Köhler
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institute (Federal Research Institute for Animal Health), Jena, Germany
| | | | - Petra Möbius
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institute (Federal Research Institute for Animal Health), Jena, Germany
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Phillips Savage ACN, Blake L, Suepaul R, McHugh O, Rodgers R, Thomas C, Oura C, Soto E. Piscine mycobacteriosis in the ornamental fish trade in Trinidad and Tobago. J Fish Dis 2022; 45:547-560. [PMID: 35000204 DOI: 10.1111/jfd.13580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
The freshwater ornamental fish trade represents a major contributor to the livelihoods of many producers in Trinidad and Tobago, with stocks destined for local, regional and international markets. A review of clinical cases presented to the Aquatic Animal Health Unit at the University of the West Indies, School of Veterinary Medicine for the period September 2010 to December 2012 suggested that piscine mycobacteriosis may be widespread throughout the local ornamental fish industry. Thus, to determine the prevalence of mycobacteriosis in ornamental fish sold in pet stores, a total of 122 specimens were sourced from 24 retail suppliers across Trinidad. Fish were killed and internal organs were examined for lesions suggestive of granulomas. All wet-mount slides were acid-fast stained, regardless of the presence or absence of observed granuloma-like lesions. Histological analysis was performed on one randomly selected whole specimen from each facility. Mycobacterium sp. was identified using real-time PCR detecting the 16S rRNA gene in tissue samples. Associations between parasitism, facility biosecurity and presence of positive animals were determined. The prevalence of Mycobacterium sp. infection was 61 ± 7% (74/122), with positive specimens being acquired from 54.2% (13/24) of facilities examined. Further, 100% of facilities did not employ optimum biosecurity measures.
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Affiliation(s)
- Ayanna Carla N Phillips Savage
- Department of Clinical Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Lemar Blake
- Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Rod Suepaul
- Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - O'Shane McHugh
- Department of Clinical Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Ray Rodgers
- Department of Clinical Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Calvern Thomas
- Department of Clinical Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Christopher Oura
- Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Esteban Soto
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
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Janik AJ, Whipps CM. Differences in susceptibility to Mycobacterium chelonae in zebrafish (Danio rerio) lines commonly used in scientific research. J Fish Dis 2022; 45:435-443. [PMID: 34905233 PMCID: PMC8828697 DOI: 10.1111/jfd.13572] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/13/2021] [Accepted: 10/17/2021] [Indexed: 06/14/2023]
Abstract
Mycobacteriosis is one of the most common diseases encountered in laboratory zebrafish. These infections can present a problem to researchers using zebrafish because they may introduce unknown experimental variables. Whilst differences in severity of infections between species of Mycobacterium infecting zebrafish have been well documented, little is known about differences in susceptibility between zebrafish lines. Previous surveys have found higher prevalence in the TU zebrafish line relative to other lines, suggesting that there may be underlying genetic differences in susceptibility. This study investigates Mycobacterium chelonae H1E2-GFP infections in four different zebrafish lines commonly used in research (AB, 5D, casper and TU). Fish were exposed to a labelled (green-fluorescent protein (GFP)) strain of M. chelonae by intraperitoneal injection, and infection status was evaluated after 10 weeks. Visualization of GFP in euthanized fish and histology were used as endpoints. In GFP images, severity was assessed by image analysis, and in histological sections, counts of granulomas containing acid-fast bacteria were used. Results indicated differences in severity of infections between lines, but no significant differences in prevalence.
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Affiliation(s)
- Andrew J Janik
- SUNY-ESF, State University of New York College of Environmental Science and Forestry, Environmental and Forest Biology, Syracuse, NY, USA
| | - Christopher M Whipps
- SUNY-ESF, State University of New York College of Environmental Science and Forestry, Environmental and Forest Biology, Syracuse, NY, USA
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10
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Abstract
INTRODUCTION AND OBJECTIVE Fish mycobacteriosis is a chronic granulomatous disease caused by several species of bacteria from the genus Mycobacterium, described as nontuberculous mycobacteria (NTM). The most important species causing fish mycobacterioses are M. chelonae, M. fortuitum, and M. marinum. Mycobacteria infecting fish also include zoonotic pathogens. M. marinum is the cause of most cases of fish-related mycobacterial infection in humans. The disease occurs more frequently in workers in the fishing industry, people whose hobbies involve water activities, and aquarists. The aim of the present study was to examine the occurrence of different species of mycobacteria in freshwater ornamental fish. MATERIAL AND METHODS The occurrence of Mycobacterium spp. in freshwater ornamental fish was studied from January 2015 - December 2016. Material isolated from skin scrapings, contents of the digestive tracts, and internal organs of ornamental fish was stained with Ziehl-Neelsen (ZN) and inoculated on Lowenstein-Jensen medium. All isolates found positive by ZN were identified by amplification of the gene encoding the Hsp65 protein. A total of 408 samples obtained from 136 ornamental fish from 36 species were tested. RESULTS Using the culture method Mycobacterium was isolated from 69 fish (50.1%) and 99 samples (24.3%). Sequence analysis of gene fragments coding for the Hsp65 protein of 99 isolates revealed occurrence of 13 species of mycobacteria: M. abscessus, M. chelonae, M. fortuitum, M. gordonae, M. marinum, M. mucogenicum, M. neoaurum, M. peregrinum, M. salmoniphilum, M. saopaulense, M. senegalense, M. septicum, and M. szulgai. CONCLUSIONS The obtained results indicate a significant role of ornamental fish as a source of mycobacteria which are potentially dangerous,especially to humans.
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Affiliation(s)
- Krzysztof Puk
- Department of Fish Diseases and Biology, Faculty of Veterinary Medicine, University of Life Sciences, Lublin, Poland
| | - Leszek Guz
- Department of Fish Diseases and Biology, Faculty of Veterinary Medicine, University of Life Sciences, Lublin, Poland
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11
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Gu CH, Zhao C, Hofstaedter C, Tebas P, Glaser L, Baldassano R, Bittinger K, Mattei LM, Bushman FD. Investigating hospital Mycobacterium chelonae infection using whole genome sequencing and hybrid assembly. PLoS One 2020; 15:e0236533. [PMID: 33166284 PMCID: PMC7652343 DOI: 10.1371/journal.pone.0236533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/20/2020] [Indexed: 11/21/2022] Open
Abstract
Mycobacterium chelonae is a rapidly growing nontuberculous mycobacterium that is a common cause of nosocomial infections. Here we describe investigation of a possible nosocomial transmission of M. chelonae at the Hospital of the University of Pennsylvania (HUP). M. chelonae strains with similar high-level antibiotic resistance patterns were isolated from two patients who developed post-operative infections at HUP in 2017, suggesting a possible point source infection. The isolates, along with other clinical isolates from other patients, were sequenced using the Illumina and Oxford Nanopore technologies. The resulting short and long reads were hybrid assembled into draft genomes. The genomes were compared by quantifying single nucleotide variants in the core genome and assessed using a control dataset to quantify error rates in comparisons of identical genomes. We show that all M. chelonae isolates tested were highly dissimilar, as indicated by high pairwise SNV values, consistent with environmental acquisition and not a nosocomial point source. Our control dataset determined a threshold for evaluating identity between strains while controlling for sequencing error. Finally, antibiotic resistance genes were predicted for our isolates, and several single nucleotide variants were identified that have the potential to modulated drug resistance.
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Affiliation(s)
- Christopher H. Gu
- Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Chunyu Zhao
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Casey Hofstaedter
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Pablo Tebas
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Laurel Glaser
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Robert Baldassano
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Kyle Bittinger
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Lisa M. Mattei
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Frederic D. Bushman
- Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
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12
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Xie B, Chen Y, Wang J, Gao W, Jiang H, Sun J, Jin X, Sang X, Yu X, Wang H. Mycobacterium marseillense Infection in Human Skin, China, 2018. Emerg Infect Dis 2020; 25:1991-1993. [PMID: 31538923 PMCID: PMC6759254 DOI: 10.3201/eid2510.190695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe a case of facial skin infection and sinusitis caused by Mycobacterium marseillense in an immunocompetent woman in China in 2018. The infection was cleared with clarithromycin, moxifloxacin, and amikacin. Antimicrobial drug treatments could not be predicted by genetic analyses; further genetic characterization would be required to do so.
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13
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Abstract
Recently, multiple infectious organisms have been identified as the cause of emerging diseases in lagomorphs. The most important of these emerging diseases is rabbit hemorrhagic disease virus (RHDV) type 2, a new variant with differences in pathogenicity to classical RHDV. Hepatitis E is considered an emerging zoonotic infectious disease, with widespread prevalence in many different rabbit populations. Mycobacteriosis has been recently reported in other captive domestic rabbit populations. This article provides a recent review of the published literature on emerging infectious diseases in rabbits, including farmed, laboratory, and pet rabbits, some of which have zoonotic potential.
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Affiliation(s)
- Molly Gleeson
- Department of Avian and Exotic Pets, ACCESS Specialty Animal Hospital, 9599 Jefferson Boulevard, Culver City, CA 90232, USA
| | - Olivia A Petritz
- Department of Clinical Sciences, North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, NC 27607, USA.
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14
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Affiliation(s)
- Jean-Francois Jabbour
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Amal Hamieh
- Division of Infectious Diseases, Department of Internal Medicine, Al Rassoul Al Azam Hospital, Beirut, Lebanon
| | - Sima L. Sharara
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Souha S. Kanj
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- * E-mail:
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15
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Delghandi MR, Menanteau-Ledouble S, Waldner K, El-Matbouli M. Renibacterium salmoninarum and Mycobacterium spp.: two bacterial pathogens present at low levels in wild brown trout (Salmo trutta fario) populations in Austrian rivers. BMC Vet Res 2020; 16:40. [PMID: 32013968 PMCID: PMC6998173 DOI: 10.1186/s12917-020-2260-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 01/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Renibacterium salmoninarum and Mycobacterium sp. are important bacterial pathogens of fish. R. salmoninarum is the causative agent of bacterial kidney disease, a Gram-positive bacterium mostly known for causing chronic infections in salmonid fish, while multiple species belonging to the Mycobacterium genus have been associated with mycobacteriosis in fish as well as in human. The objective of this study was to determine the prevalence of these two bacterial pathogens in populations of wild brown trout (Salmo trutta fario) in four rivers (Kamp, Wulka, Traun and Ybbs) in Austria. RESULTS A total of 457 kidney samples were examined for both bacterial agents using nested and conventional PCR as well as bacterial cultivation on KDM-2, histological examination and immunohistochemistry. Molecular evidence showed an estimated prevalence level of 0.94% for R. salmoninarum in 2017 while the bacterium could not be detected in 2018 and histology showed signs consistent with a low-level chronic inflammation in the kidney of infected fish. Similarly, no fish were found positive for Mycobacterium in 2017 but in 2018, the prevalence was found to be 37.03% in the Kamp river (4.08% across all rivers). The sequencing data confirmed that these fish carried Mycobacterium sp. although the precise species of Mycobacterium could not be ascertained. CONCLUSIONS This survey constitutes the first insight into the prevalence rate of R. salmoninarum and Mycobacterium sp. in wild brown trout (Salmo trutta fario) populations in Austria. Both of these pathogens were only detected in the summer months (June and July), which might suggest that the stress linked to increased water temperature could act as stressor factor and contribute to the outbreak of these diseases. The age of the fish might also play a role, especially in the case of Mycobacterium sp. as all the infected fish were in their first summer (June).
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Affiliation(s)
- M. R. Delghandi
- Clinical Division of Fish Medicine, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
| | - S. Menanteau-Ledouble
- Clinical Division of Fish Medicine, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
| | - K. Waldner
- Clinical Division of Fish Medicine, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
| | - M. El-Matbouli
- Clinical Division of Fish Medicine, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria
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16
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Sakhaee F, Vaziri F, Bahramali G, Taremian K, Siadat SD, Fateh A. Pulmonary Infection Associated with Mycobacterium canariasense in Suspected Tuberculosis Patient, Iran. Emerg Infect Dis 2019; 25:1984-1986. [PMID: 31538933 PMCID: PMC6759235 DOI: 10.3201/eid2510.190156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mycobacterium canariasense had only been isolated in humans from blood and contaminated catheters. We report a case of pulmonary disease associated with M. canariasense infection that was identified by multilocus sequence analysis; the illness was initially ascribed to M. tuberculosis. M. canariasense should be considered a cause of respiratory infection.
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17
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Hasan NA, Epperson LE, Lawsin A, Rodger RR, Perkins KM, Halpin AL, Perry KA, Moulton-Meissner H, Diekema DJ, Crist MB, Perz JF, Salfinger M, Daley CL, Strong M. Genomic Analysis of Cardiac Surgery-Associated Mycobacterium chimaera Infections, United States. Emerg Infect Dis 2019; 25:559-563. [PMID: 30789131 PMCID: PMC6390774 DOI: 10.3201/eid2503.181282] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A surgical heater–cooler unit has been implicated as the source for Mycobacterium chimaera infections among cardiac surgery patients in several countries. We isolated M. chimaera from heater–cooler units and patient infections in the United States. Whole-genome sequencing corroborated a risk for these units acting as a reservoir for this pathogen.
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18
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Sommerstein R, Hasse B, Marschall J, Sax H, Genoni M, Schlegel M, Widmer AF. Global Health Estimate of Invasive Mycobacterium chimaera Infections Associated with Heater-Cooler Devices in Cardiac Surgery. Emerg Infect Dis 2019; 24:576-578. [PMID: 29460746 PMCID: PMC5823345 DOI: 10.3201/eid2403.171554] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Investigations of a worldwide epidemic of invasive Mycobacterium chimaera associated with heater-cooler devices in cardiac surgery have been hampered by low clinical awareness and challenging diagnoses. Using data from Switzerland, we estimated the burden of invasive M. chimaera to be 156-282 cases/year in 10 major cardiac valve replacement market countries.
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19
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Jarashow MC, Terashita D, Balter S, Schwartz B. Notes from the Field: Mycobacteria chimaera Infections Associated with Heater-Cooler Unit Use During Cardiopulmonary Bypass Surgery - Los Angeles County, 2012-2016. MMWR Morb Mortal Wkly Rep 2019; 67:1428-1429. [PMID: 30605444 PMCID: PMC6334825 DOI: 10.15585/mmwr.mm675152a4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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20
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Pourakbari B, Hosseinpour Sadeghi R, Mahmoudi S, Parvaneh N, Keshavarz Valian S, Mamishi S. Evaluation of interleukin-12 receptor β1 and interferon gamma receptor 1 deficiency in patients with disseminated BCG infection. Allergol Immunopathol (Madr) 2019; 47:38-42. [PMID: 30268380 DOI: 10.1016/j.aller.2018.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 06/09/2018] [Accepted: 06/26/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Disseminated BCG infections among other complications of Bacillus Calmette-Guérin (BCG) vaccine are rare and have occurred in children with immunodeficiency disorders such as mendelian susceptibility to mycobacterial disease (MSMD) which could be due to defects in some elements of IL-12/IFN-γ axis. MSMD-causing mutations have been identified in 10 genes during the last two decades. Among them, mutations in the IL12Rβ1 and IFNγR1 genes constitute about 80% of recorded cases of MSMD syndrome. The aim of this study was to investigate IL-12Rβ1 and IFN-γR1 deficiencies in patients with disseminated BCG infection. METHODS This study was performed on 31 children with disseminated BCG infections who referred to children's medical center. Whole blood cell culture was performed in presence of BCG, IL-12 and IFN-γ stimulators. The supernatants were assayed for IFN-γ and IL-12p70 by ELISA method. In order to evaluate IL12Rβ1 and IFN-γR1 receptors expression, flow cytometry staining was performed on the patients' T-cells stimulated with PHA. RESULTS Flow cytometry staining of 31 Iranian patients with disseminated BCG infections with the average age of 43 months showed lack of the expression of IL-12Rβ1 and IFN-γR1 genes in PHA-T-cells of the nine and one patients, respectively in whom the incomplete production of IFN-γ and IL-12 was reported by ELISA. Among these 10 patients, eight cases had related parents (80%). CONCLUSION It is recommended that to avoid BCG complications, screening be performed for MSMD before BCG inoculation in individuals with positive family history of primary immunodeficiency diseases and inhabitants of areas with high frequency of consanguinity.
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Affiliation(s)
- B Pourakbari
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - R Hosseinpour Sadeghi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - S Mahmoudi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - N Parvaneh
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - S Mamishi
- Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
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21
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Carrau T, Garijo MM, Martínez-Carrasco C, Pérez D, Silva LMR, Taubert A, Hermosilla C, Ruiz De Ybáñez R. Parasite prevalence in Mycobacterium spp. infected dairy goats in the region of Murcia (south-east Spain). REV SCI TECH OIE 2018; 36:905-916. [PMID: 30160691 DOI: 10.20506/rst.36.3.2724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Eighty-four Murciano-Granadina dairy goats slaughtered in the region of Murcia (South-East Spain) were necropsied to evaluate parasitic infections. The majority of the animals (94.0%) were parasitised and multiple infections were present. Twenty-one parasite species were found, including 18 nematode species (Muellerius capillaris, Dictyocaulus filaria, Neostrongylus linearis, Cystocaulus ocreatus, Teladorsagia circumcincta, T. occidentalis, T. trifurcata, Marshallagia marshalli, Camelostrongylus mentulatus, Trichostrongylus capricola, Nematodirus abnormalis, N. filicollis, N. spathiger, T. vitrinus, T. colubriformis, Trichuris spp., Chabertia ovina and Skrjabinema ovis); one trematode species (Dicrocoelium dendriticum); one arthropod species (Oestrus ovis); and one protozoa genus (Eimeria spp.). Additionally, 17.85% of the animals were Mycobacterium spp. positive. Therefore, comparison between parasite prevalence, intensity and abundance in tuberculosis-positive and -negative animals was performed. Statistically significant differences between the prevalence of lungworms and gastrointestinal nematodes in Mycobacterium spp. infected and free goats were found. The paper discusses this co-infection between Mycobacteriaceae and endoparasites.
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Hamieh A, Tayyar R, Tabaja H, E. L. Zein S, Bou Khalil P, Kara N, Kanafani ZA, Kanj N, Bou Akl I, Araj G, Berjaoui G, Kanj SS. Emergence of Mycobacterium simiae: A retrospective study from a tertiary care center in Lebanon. PLoS One 2018; 13:e0195390. [PMID: 29617415 PMCID: PMC5884548 DOI: 10.1371/journal.pone.0195390] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 03/21/2018] [Indexed: 11/19/2022] Open
Abstract
Objective The objective of this study is to describe the clinical significance of Mycobacterium simiae at a major tertiary care center in Lebanon. Methods This is a retrospective study of patients with positive cultures for M. simiae isolated between 2004 and 2016 at the American University of Beirut Medical Center. Results This study included 103 M. simiae isolates recovered from 51 patients. Their mean age was 62.7 years. The majority were males and smokers. Specimens were mostly from respiratory sources (97%). Common comorbidities included chronic lung disease (such as chronic obstructive pulmonary disease), solid tumor, systemic disease, and diabetes mellitus. Productive cough and dyspnea were the most common symptoms. Frequent radiographic findings were infiltrates and nodules on chest X-ray and nodules, infiltrates, and bronchiectasis on chest computed tomography scan. Among 18 tested isolates, 5.8% were resistant to clarithromycin, 11.7% to amikacin, and 70–100% to other antimicrobials. Out of 13 patients receiving early treatment, 5 noted improvement, one had recurrence of symptoms, two received alternative diagnosis, and five died. Two of those deaths were related to M. simiae. Common treatment regimens included clarithromycin in different combinations with trimethoprim-sulfamethoxazole, moxifloxacin, and amikacin. Moreover, clofazimine was used in only two patients whose isolates were resistant to all but one agent. Duration of treatment ranged from 6–24 months. Conclusion In Lebanon, M. simiae is increasingly encountered with true infection rates of at least 47%. Furthermore, the prevalence of multidrug resistance among the Lebanese M. simiae isolates is very high limiting the treatment options.
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Affiliation(s)
- Amal Hamieh
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ralph Tayyar
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Houssam Tabaja
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Saeed E. L. Zein
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Pierre Bou Khalil
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nathalie Kara
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Zeina A. Kanafani
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nadim Kanj
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Imad Bou Akl
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - George Araj
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghina Berjaoui
- Department of Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Souha S. Kanj
- Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
- * E-mail:
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Schmitz A, Korbel R, Thiel S, Wörle B, Gohl C, Rinder M. High prevalence of Mycobacterium genavense within flocks of pet birds. Vet Microbiol 2018; 218:40-44. [PMID: 29685219 DOI: 10.1016/j.vetmic.2018.03.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/20/2018] [Accepted: 03/20/2018] [Indexed: 11/18/2022]
Abstract
Mycobacterium genavense is regarded as the primary cause of mycobacteriosis in psittaciform and passeriform birds, which are commonly kept as pets. In humans, Mycobacterium genavense is especially pathogenic for young, old, pregnant and immunocompromised people (YOPIs). In birds, only few studies, mainly case reports, exist and there is still little e information about occurrence and relevance of this zoonotic pathogen. In this first pilot study concerning the prevalence of Mycobacterium genavense within flocks of naturally infected pet birds, real-time PCR examinations of 170 individual passeriform and psittaciform birds, including commonly kept budgerigars, lovebirds and zebra finches as well as gold finches and weaver finches, were conducted to determine the infection rate in six different aviaries. Antemortem examinations of faeces and cloacal swabs were compared with postmortem examinations of tissue samples to evaluate the reliability of antemortem diagnostics. Additional ophthalmologic examinations were performed to evaluate their diagnostic potential. Molecular examinations for viral co-infections, including circovirus, polyomavirus and adenovirus, were conducted to identify potential risk factors. PCR results revealed a detection prevalence of Mycobacterium genavense in the flocks varying from 3% to 91% based on postmortem testing, while antemortem diagnostics of faecal samples and swabs showed 64% discrepant (false negative) results. Ophthalmologic examinations were not useful in identifying infected birds within the flocks. Viral co-infections, especially with polyomavirus, were common. It has to be assumed that Mycobacterium genavense infections are widespread and underdiagnosed in companion birds. Viral infections might be an important risk factor. There is urgent need to improve antemortem diagnostics.
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Affiliation(s)
- A Schmitz
- Centre for Clinical Veterinary Medicine, Clinic for Birds, Small Mammals, Reptiles and Ornamental Fish, Ludwig-Maximilians-Universität München, Sonnenstr. 18, 85476, Oberschleißheim, Germany.
| | - R Korbel
- Centre for Clinical Veterinary Medicine, Clinic for Birds, Small Mammals, Reptiles and Ornamental Fish, Ludwig-Maximilians-Universität München, Sonnenstr. 18, 85476, Oberschleißheim, Germany
| | - S Thiel
- Centre for Clinical Veterinary Medicine, Clinic for Birds, Small Mammals, Reptiles and Ornamental Fish, Ludwig-Maximilians-Universität München, Sonnenstr. 18, 85476, Oberschleißheim, Germany
| | - B Wörle
- Max Planck Institute for Ornithology, Eberhard-Gwinner-Straße 5, 82319, Seewiesen (Starnberg), Germany
| | - C Gohl
- Tierpark Hellabrunn, Tierparkstraße 30, 81543, München, Germany
| | - M Rinder
- Centre for Clinical Veterinary Medicine, Clinic for Birds, Small Mammals, Reptiles and Ornamental Fish, Ludwig-Maximilians-Universität München, Sonnenstr. 18, 85476, Oberschleißheim, Germany
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Ji LY, Xu DL, Yin SP, Liu HC, Li GL, Jiang Y, Wei JH, Zeng H, Lou YL, Lyu JX, Wan KL. First Report in China on the Identification and Drug Sensitivity of Mycobacterium elephantis Isolated from the Milk of a Cow with Mastitis. Biomed Environ Sci 2017; 30:501-507. [PMID: 28756809 DOI: 10.3967/bes2017.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 04/26/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE In this study, milk from a cow with mastitis was analyzed to determine the presence of mycobacterial infection. Milk quality and security problems pertaining to the safe consumption of dairy products were also discussed in this study. METHODS Milk was preprocessed with 4% NaOH. Then, mycobacteria were isolated from the milk sample on L-J medium. The isolate was identified using multiple loci Polymerase Chain Reaction (PCR) and multi-locus sequence analysis with 16S rRNA, sodA, hsp65, and ITS genes. The drug sensitivity of the isolate to 27 antibiotics was tested through alamar blue assay. RESULTS Smooth, moist, pale yellow colonies appeared on the L-J medium within a week after inoculation. Based on the results of multiple loci PCR analysis, the isolate was preliminarily identified as non-tuberculous mycobacteria. The 16S rRNA, SodA, hsp65, and ITS gene sequences of the isolate exhibited 99%, 99%, 99%, and 100% similarities, respectively, with those of the published reference strains of Mycobacterium elephantis (M. elephantis). The drug sensitivity results showed that the strain is resistant to isoniazid, p-aminosalicylic acid, and trimesulf but is sensitive to ofloxacin, rifampicin, amikacin, capreomycin, moxifloxacin, kanamycin, levofloxacin, cycloserine, ethambutol, streptomycin, tobramycin, rifabutin, ciprofloxacin, linezolid, cefoxitin, clarithromycin, and minocycline. CONCLUSION To the best of our knowledge, this study is initially to report the isolation of M. elephantis from the milk of a cow with mastitis in China.
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Affiliation(s)
- Ling Yun Ji
- Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200123, China
| | - Dong Lei Xu
- State Key Laboratory of Infectious Diseases Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention Beijing 102206, China
| | - Shu Peng Yin
- Key Laboratory of Laboratory Medicine, Ministry of Education, College of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, Zhejiang, China
| | - Hai Can Liu
- State Key Laboratory of Infectious Diseases Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention Beijing 102206, China
| | - Gui Lian Li
- State Key Laboratory of Infectious Diseases Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention Beijing 102206, China
| | - Yi Jiang
- State Key Laboratory of Infectious Diseases Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention Beijing 102206, China
| | - Jian Hao Wei
- Department of Clinical Laboratory, Shanghai Public Health Clinical Center, Affiliated to Fudan University, Shanghai 201508, China
| | - Hao Zeng
- Department of Spine Surgery, The Xiangya Hospital of Central South University, Changsha 410008, Hunan, China
| | - Yong Liang Lou
- Key Laboratory of Laboratory Medicine, Ministry of Education, College of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, Zhejiang, China
| | - Jian Xin Lyu
- Key Laboratory of Laboratory Medicine, Ministry of Education, College of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, Zhejiang, China
| | - Kang Lin Wan
- State Key Laboratory of Infectious Diseases Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention Beijing 102206, China; Key Laboratory of Laboratory Medicine, Ministry of Education, College of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325035, Zhejiang, China
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Chao WC, Lin CH, Liao TL, Chen YM, Chen DY, Chen HH. Association between a history of mycobacterial infection and the risk of newly diagnosed Sjögren's syndrome: A nationwide, population-based case-control study. PLoS One 2017; 12:e0176549. [PMID: 28486537 PMCID: PMC5423582 DOI: 10.1371/journal.pone.0176549] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 04/12/2017] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To address the association between a history of tuberculosis (TB) or nontuberculous mycobacterial (NTM) infection and the risk of newly diagnosed Sjögren's syndrome (SS). METHODS Using a nationwide, population-based, claims dataset, and after excluding those who had rheumatoid arthritis or systemic lupus erythematosus, we identified 5,751 newly diagnosed SS cases during 2007-2012, and compared them to 86,265 non-SS controls matched (1:15) for age, sex, and the year of first SS diagnosis date. The association between the risk of incident SS and a history of mycobacterial infection, including TB and NTM, was quantified by calculating odds ratios (ORs) with 95% confidence intervals (CIs) using conditional logistic regression analysis after adjustment for Charlson comorbidity index (CCI) and bronchiectasis. RESULTS The mean age was 55±14 years, and the proportion of female gender was 87.8% in both newly diagnosed SS cases andnon-SS controls. An association was observed between NTM infection (OR, 11.24; 95% CI, 2.37-53.24) and incident SS, but not between TB infection and incident SS (OR, 1.29; 95% CI, 0.97-1.71) after adjustment for CCI and bronchiectasis. The association between NTM and SS risk was remarkably strong among those aged between 45 and 65 years (OR, 39.24; 95% CI, 3.97-387.75) and those without bronchiectasis (OR, 39.98; 95% CI, 3.83-376.92). CONCLUSION The study reveals a significant association of newly diagnosed SS with a history NTM infection, especially among individuals aged 40-65 years or those without bronchiectasis.
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Affiliation(s)
- Wen-Cheng Chao
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Business Administration, National Changhua University of Education, Changhua, Taiwan
| | - Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsai-Ling Liao
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan
| | - Yi-Ming Chen
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Der-Yuan Chen
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
- Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan
- * E-mail: (HHC); (DYC)
| | - Hsin-Hua Chen
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan
- * E-mail: (HHC); (DYC)
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Strike TB, Feltrer Y, Flach E, Macgregor SK, Guillaume S. Investigation and management of an outbreak of multispecies mycobacteriosis in Australian lungfish (Neoceratodus fosteri) including the use of triple antibiotic treatment. J Fish Dis 2017; 40:557-570. [PMID: 27453998 DOI: 10.1111/jfd.12535] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 06/18/2016] [Accepted: 06/20/2016] [Indexed: 06/06/2023]
Abstract
Disease due to non-tuberculous mycobacteria (NTM) is common in fish. Current recommendations focus on outbreak management by depopulating entire fish stocks and disinfecting tanks. Treatment is not advocated. Treatment may be appropriate, however, where individual, valuable fish are concerned. ZSL London Zoo managed an outbreak of mycobacteriosis in a valuable group of imported F1 captive-bred Australian lungfish (Neoceratodus fosteri) by depopulation, isolation, extensive testing and daily oral antibiotic treatment. Four species of Mycobacterium (M. marinum, M. fortuitum, M. chelonae and M. peregrinum) were involved in this outbreak, each with unique antibiotic sensitivities. Triple therapy with rifampicin, doxycycline and enrofloxacin for 8 months was the most effective antibiotic combination, resulting in full disease resolution. No side effects were noted and, more than 18 months post-treatment, no recurrence had occurred. This is the first report of mycobacterial disease in lungfish and the first report of a polymycobacterial outbreak in fish involving these four species of Mycobacterium. This report demonstrates the value of extensive isolation and identification. Also, as therapies currently advised in standard texts did not reflect the antibiotic sensitivity of the NTM found in the fish reported here, we recommend that antibiotic treatment should always be based on sensitivity testing.
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Affiliation(s)
- T B Strike
- London Zoo Veterinary Department, Zoological Society of London (ZSL), London, UK
| | - Y Feltrer
- London Zoo Veterinary Department, Zoological Society of London (ZSL), London, UK
| | - E Flach
- London Zoo Veterinary Department, Zoological Society of London (ZSL), London, UK
| | - S K Macgregor
- London Zoo Veterinary Department, Zoological Society of London (ZSL), London, UK
| | - S Guillaume
- London Zoo Aquarium, Zoological Society of London (ZSL), London, UK
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Abstract
Dangerous
Mycobacterium
strains appear to be spreading.
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Abstract
New treatments, rapid and inexpensive identification methods, and measures to contain nosocomial transmission and outbreaks are urgently needed. Mycobacterium abscessus complex comprises a group of rapidly growing, multidrug-resistant, nontuberculous mycobacteria that are responsible for a wide spectrum of skin and soft tissue diseases, central nervous system infections, bacteremia, and ocular and other infections. M. abscessus complex is differentiated into 3 subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii. The 2 major subspecies, M. abscessus subsp. abscessus and M.abscessus subsp. massiliense, have different erm(41) gene patterns. This gene provides intrinsic resistance to macrolides, so the different patterns lead to different treatment outcomes. M. abscessus complex outbreaks associated with cosmetic procedures and nosocomial transmissions are not uncommon. Clarithromycin, amikacin, and cefoxitin are the current antimicrobial drugs of choice for treatment. However, new treatment regimens are urgently needed, as are rapid and inexpensive identification methods and measures to contain nosocomial transmission and outbreaks.
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Winglee K, Manson McGuire A, Maiga M, Abeel T, Shea T, Desjardins CA, Diarra B, Baya B, Sanogo M, Diallo S, Earl AM, Bishai WR. Whole Genome Sequencing of Mycobacterium africanum Strains from Mali Provides Insights into the Mechanisms of Geographic Restriction. PLoS Negl Trop Dis 2016; 10:e0004332. [PMID: 26751217 PMCID: PMC4713829 DOI: 10.1371/journal.pntd.0004332] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 12/05/2015] [Indexed: 01/05/2023] Open
Abstract
Background Mycobacterium africanum, made up of lineages 5 and 6 within the Mycobacterium tuberculosis complex (MTC), causes up to half of all tuberculosis cases in West Africa, but is rarely found outside of this region. The reasons for this geographical restriction remain unknown. Possible reasons include a geographically restricted animal reservoir, a unique preference for hosts of West African ethnicity, and an inability to compete with other lineages outside of West Africa. These latter two hypotheses could be caused by loss of fitness or altered interactions with the host immune system. Methodology/Principal Findings We sequenced 92 MTC clinical isolates from Mali, including two lineage 5 and 24 lineage 6 strains. Our genome sequencing assembly, alignment, phylogeny and average nucleotide identity analyses enabled us to identify features that typify lineages 5 and 6 and made clear that these lineages do not constitute a distinct species within the MTC. We found that in Mali, lineage 6 and lineage 4 strains have similar levels of diversity and evolve drug resistance through similar mechanisms. In the process, we identified a putative novel streptomycin resistance mutation. In addition, we found evidence of person-to-person transmission of lineage 6 isolates and showed that lineage 6 is not enriched for mutations in virulence-associated genes. Conclusions This is the largest collection of lineage 5 and 6 whole genome sequences to date, and our assembly and alignment data provide valuable insights into what distinguishes these lineages from other MTC lineages. Lineages 5 and 6 do not appear to be geographically restricted due to an inability to transmit between West African hosts or to an elevated number of mutations in virulence-associated genes. However, lineage-specific mutations, such as mutations in cell wall structure, secretion systems and cofactor biosynthesis, provide alternative mechanisms that may lead to host specificity. Mycobacterium africanum consists of two lineages, lineages 5 and 6, within the Mycobacterium tuberculosis complex (MTC) that cause human tuberculosis in West Africa, but are found rarely outside of this region. Our analysis of the whole genome sequences of 26 lineage 5 and 6 isolates, and 66 isolates from other lineages within the MTC, reveal that M. africanum does not meet modern criteria to be considered an independent species. We analyzed drug resistance-associated genes and found that drug resistance evolves within these lineages through similar mechanisms as observed for the rest of the MTC in Mali. Though we did not see an elevated number of mutations in virulence-associated genes in these two lineages, we identified a number of lineage-specific mutations, pseudogenes and changes in gene content that may impact virulence and host specificity, and improve, overall, our understanding of what make these lineages unique.
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Affiliation(s)
- Kathryn Winglee
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Abigail Manson McGuire
- Genome Sequencing and Analysis Program, The Broad Institute of MIT & Harvard, Cambridge, Massachusetts, United States of America
| | - Mamoudou Maiga
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
- Project SEREFO (Centre de Recherche et de Formation sur le VIH/Sida et la Tuberculose)/University of Sciences, Technics and Technologies of Bamako (USTTB), Bamako, Mali
| | - Thomas Abeel
- Genome Sequencing and Analysis Program, The Broad Institute of MIT & Harvard, Cambridge, Massachusetts, United States of America
- Delft Bioinformatics Lab, Delft University of Technology, Delft, The Netherlands
| | - Terrance Shea
- Genome Sequencing and Analysis Program, The Broad Institute of MIT & Harvard, Cambridge, Massachusetts, United States of America
| | - Christopher A. Desjardins
- Genome Sequencing and Analysis Program, The Broad Institute of MIT & Harvard, Cambridge, Massachusetts, United States of America
| | - Bassirou Diarra
- Project SEREFO (Centre de Recherche et de Formation sur le VIH/Sida et la Tuberculose)/University of Sciences, Technics and Technologies of Bamako (USTTB), Bamako, Mali
| | - Bocar Baya
- Project SEREFO (Centre de Recherche et de Formation sur le VIH/Sida et la Tuberculose)/University of Sciences, Technics and Technologies of Bamako (USTTB), Bamako, Mali
| | - Moumine Sanogo
- Project SEREFO (Centre de Recherche et de Formation sur le VIH/Sida et la Tuberculose)/University of Sciences, Technics and Technologies of Bamako (USTTB), Bamako, Mali
| | - Souleymane Diallo
- Project SEREFO (Centre de Recherche et de Formation sur le VIH/Sida et la Tuberculose)/University of Sciences, Technics and Technologies of Bamako (USTTB), Bamako, Mali
| | - Ashlee M. Earl
- Genome Sequencing and Analysis Program, The Broad Institute of MIT & Harvard, Cambridge, Massachusetts, United States of America
- * E-mail: (AME); (WRB)
| | - William R. Bishai
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
- * E-mail: (AME); (WRB)
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Berg V, Kraugerud M, Nourizadeh-Lillabadi R, Olsvik PA, Skåre JU, Alestrøm P, Ropstad E, Zimmer KE, Lyche JL. Endocrine effects of real-life mixtures of persistent organic pollutants (POP) in experimental models and wild fish. J Toxicol Environ Health A 2016; 79:538-548. [PMID: 27484136 DOI: 10.1080/15287394.2016.1171980] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A series of studies have assessed the occurrence, levels, and potential adverse effects of persistent organic pollutants (POP) in fish from Lake Mjøsa. In this lake, high levels of various POP were detected in biota. Fish from the nearby Lake Losna contain background levels of POP and served as reference (controls) in these studies. Significantly higher prevalence of mycobacteriosis and pathological changes were documented in burbot (Lota lota) from Mjøsa compared to burbot from Losna. Further, transcriptional profiling identified changes in gene expression in burbot from Mjøsa compared to burbot from Losna associated with drug metabolism enzymes and oxidative stress. POP extracted from burbot liver oil from the two lakes was used to expose zebrafish (Danio rerio) during two consecutive generations. During both generations, POP mixtures from both lakes increased the rate of mortality, induced earlier onset of puberty, and skewed sex ratio toward males. However, opposite effects on weight gain were found in exposure groups compared to controls during the two generations. Exposure to POP from both lakes was associated with suppression of ovarian follicle development. Analyses of genome-wide transcription profiling identified functional networks of genes associated with weight homeostasis, steroid hormone functions, and insulin signaling. In human cell studies using adrenocortical H295R and primary porcine theca and granulosa cells, exposure to lake extracts from both populations modulated steroid hormone production with significant difference from controls. The results suggest that POP from both lakes may possess the potential to induce endocrine disruption and may adversely affect health in wild fish.
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Affiliation(s)
- Vidar Berg
- a Department of Food Safety and Infection Biology , Norwegian University of Life Sciences , Oslo , Norway
| | - Marianne Kraugerud
- b Department of Basic Sciences and Aquatic Medicine , Norwegian University of Life Sciences , Oslo , Norway
| | | | - Pål A Olsvik
- c National Institute of Nutrition and Seafood Research , Bergen , Norway
| | | | - Peter Alestrøm
- b Department of Basic Sciences and Aquatic Medicine , Norwegian University of Life Sciences , Oslo , Norway
| | - Erik Ropstad
- e Department of Production Animal Clinical Sciences , Norwegian University of Life Sciences , Oslo , Norway
| | - Karin Elisabeth Zimmer
- b Department of Basic Sciences and Aquatic Medicine , Norwegian University of Life Sciences , Oslo , Norway
| | - Jan L Lyche
- a Department of Food Safety and Infection Biology , Norwegian University of Life Sciences , Oslo , Norway
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Abstract
Mycobacterium abscessus complex comprises a group of rapidly growing, multidrug-resistant, nontuberculous mycobacteria that are responsible for a wide spectrum of skin and soft tissue diseases, central nervous system infections, bacteremia, and ocular and other infections. M. abscessus complex is differentiated into 3 subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii. The 2 major subspecies, M. abscessus subsp. abscessus and M. abscessus subsp. massiliense, have different erm(41) gene patterns. This gene provides intrinsic resistance to macrolides, so the different patterns lead to different treatment outcomes. M. abscessus complex outbreaks associated with cosmetic procedures and nosocomial transmissions are not uncommon. Clarithromycin, amikacin, and cefoxitin are the current antimicrobial drugs of choice for treatment. However, new treatment regimens are urgently needed, as are rapid and inexpensive identification methods and measures to contain nosocomial transmission and outbreaks.
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Wright HL, Thomson RM, Reid AB, Carter R, Bartley PB, Newton P, Coulter C. Rapidly growing mycobacteria associated with laparoscopic gastric banding, Australia, 2005-2011. Emerg Infect Dis 2015; 20:1612-9. [PMID: 25279450 PMCID: PMC4193274 DOI: 10.3201/eid2010.140077] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Laparoscopic gastric banding is a common bariatric procedure worldwide. Rapidly growing mycobacteria are environmental organisms increasingly seen as pathogens,often in infected prosthetic material. We report 18 cases of infection associated with laparoscopic gastric banding caused by Mycobacterium fortuitum and M. abscessus in Australia during 2005–2011. We identified cases by reviewing positive cultures at the Queensland state reference laboratory or through correspondence with clinicians, and we obtained clinical and epidemiologic data. Eleven cases of M. fortuitum and 7 cases of M. abscessus infection were identified. The port was thought to be the primary site of infection in 10 of these cases. Complications included peritonitis,band erosion, and chronic ulceration at the port site.Rapidly growing mycobacteria can infect both port and band and can occur as either an early perioperative or late infection.Combination antimicrobial therapy is used on the basis of in vitro susceptibilities. Device removal seems to be vital to successful therapy.
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Grottola A, Roversi P, Fabio A, Antenora F, Apice M, Tagliazucchi S, Gennari W, Serpini GF, Rumpianesi F, Fabbri LM, Magnani R, Pecorari M. Pulmonary disease caused by Mycobacterium marseillense, Italy. Emerg Infect Dis 2015; 20:1769-70. [PMID: 25271594 PMCID: PMC4193172 DOI: 10.3201/eid2010.140309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Chayakulkeeree M, Naksanguan T. Epidemiology and clinical characteristic of mycobacterial infections in human immunodeficiency virus-infected patients in Siriraj Hospital. J Med Assoc Thai 2015; 98:238-244. [PMID: 25920293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacteria (NTM) infections are major health problems in Human Immunodeficiency Virus (HIV)-infected patients. Most previous studies focused mainly on tuberculosis (TB) rather than NTM infections. OBJECTIVE To determine clinical features of mycobacterial infections, from both MTB and NTM in HIV-infected patients in Siriraj Hospital. MATERIAL AND METHOD A retrospective study of adult HIV-infected patients in Infectious Disease Clinic, Siriraj Hospital, was conducted. Clinical characteristics and factors associated with mycobacterial infections were analyzed. RESULTS Of 253 patients enrolled, 65 (25.7%) developed mycobacterial infections, in which 56 patients (86%) were tuberculosis (TB), whereas NTM was diagnosed in 9 (14%). Of these 65 patients, 45 (69.2%) were culture-proven, 14 (21.6%) were diagnosed TB by positive acid-fast bacilli smears and 6 (9.2%) were diagnosed TB by clinical response to anti-tuberculosis treatment only. Among culture-positive patients, MTB was found in 36 (80%) and NTM in 9 (20%), in which Mycobacterium avium complex (MAC) was the most common among NTMisolates (n = 5),followed by unidentifiable slowly-growing mycobacteria (n = 3) and M. fortuitum (n = 1). Among patients with MTB infection, 58.3% were disseminated. The most affected organ in patients with mycobacterial infections was lung (75%), followed by lymph node (66.7%). Factors associated with mycobacterial infections included male gender (64.6% vs. 54.3%; p = 0.026), higher HIV Viral load (1.04 x 10(6) VS. 0.3 x 10(6); p = 0.004), lower hematocrit (32.7% vs. 35.3%; p = 0.032) and higher alkaline phosphatase (ALP) (146 U/L vs. 107 U/L;p = 0.032). In contrast, Pneumocystis pneumonia (PCP) was negatively associated with mycobacterial infections in HIV-infected individuals (28.8% vs. 10.9%; p = 0.004). Favorable treatment response was 86.1% and 77.8% for MTB and NTM infection, respectively, and the 6-month mortality rates were 2.78% and 11.1% for MTB and NTM infection, respectively. In patients who received treatment for TB, 22.2% had hepatitis, 13.9% had drug allergy and 8.3% had immune reconstitution inflammatory syndrome. CONCLUSION Disseminated infection is the most common form of mycobacterial infection in HIV-infected patients, resulting in anemia and high ALP levels. PCP was negatively associated with mycobacterial infection. MAC is the most common of the NTM isolates in HIV-infected patients.
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Tettelin H, Davidson RM, Agrawal S, Aitken ML, Shallom S, Hasan NA, Strong M, de Moura VCN, De Groote MA, Duarte RS, Hine E, Parankush S, Su Q, Daugherty SC, Fraser CM, Brown-Elliott BA, Wallace RJ, Holland SM, Sampaio EP, Olivier KN, Jackson M, Zelazny AM. High-level relatedness among Mycobacterium abscessus subsp. massiliense strains from widely separated outbreaks. Emerg Infect Dis 2015; 20:364-71. [PMID: 24565502 PMCID: PMC3944860 DOI: 10.3201/eid2003.131106] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Three recently sequenced strains isolated from patients during an outbreak of Mycobacterium abscessus subsp. massiliense infections at a cystic fibrosis center in the United States were compared with 6 strains from an outbreak at a cystic fibrosis center in the United Kingdom and worldwide strains. Strains from the 2 cystic fibrosis outbreaks showed high-level relatedness with each other and major-level relatedness with strains that caused soft tissue infections during an epidemic in Brazil. We identified unique single-nucleotide polymorphisms in cystic fibrosis and soft tissue outbreak strains, separate single-nucleotide polymorphisms only in cystic fibrosis outbreak strains, and unique genomic traits for each subset of isolates. Our findings highlight the necessity of identifying M. abscessus to the subspecies level and screening all cystic fibrosis isolates for relatedness to these outbreak strains. We propose 2 diagnostic strategies that use partial sequencing of rpoB and secA1 genes and a multilocus sequence typing protocol.
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Abstract
AbstractNosocomial pseudoepidemics may be detected when clustering of pseudoinfections occur or when artificial clusters of real infection are observed. Nontuberculous mycobacteria were reportedly isolated from specimens obtained from seven patients at one hospital from October 1980 to January 1981. Because the patients' clinical illnesses were not uniformly consistent with mycobacterial disease, we hypothesized that pseudoinfections had occurred and searched for a common source of contamination. The investigation suggested that specimen contamination was associated with one microbiology laboratory technician: 6 of 22 (27%) specimens processed by that person were positive compared with 1 of 103 (1%) specimens processed by the other five technicians. However, a specific mechanism of contamination was not identified. Nosocomial pseudoepidemics associated with false infections should be suspected and investigated when clinical features and laboratory findings do not agree.
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Conger NG, O'Connell RJ, Laurel VL, Olivier KN, Graviss EA, Williams-Bouyer N, Zhang Y, Brown-Elliott BA, Wallace RJ. Mycobacterium simiaeOutbreak Associated With a Hospital Water Supply. Infect Control Hosp Epidemiol 2015; 25:1050-5. [PMID: 15636291 DOI: 10.1086/502342] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AbstractObjective:Mycobacterium simiaeis found primarily in the southwestern United States, Israel, and Cuba, with tap water as its suspected reservoir. Our institution saw an increase inM. simiaeisolates in 2001. An investigation into possible contaminated water sources was undertaken.Design:Environmental cultures were performed from water taps in the microbiology laboratory, patient rooms, points in the flow of water to the hospital, and patients' homes. Patient and environmentalM. simiaewere compared by PFGE.Setting:Military treatment facility in San Antonio, Texas.Patients:All patients with cultures positive forM. simiaebetween January 2001 and April 2002. Medical records were reviewed.Results:M. simiaewas recovered from water samples from the hospital, patients' home showers, and a well supplying the hospital. A single PFGE clone was predominant among water isolates (9 of 10) and available patient isolates (14 of 19). There was an association between exposure to hospital water and pulmonary samples positive for the clonalM. simiaestrain (P= .0018). Only 3 of 22 culture-positive patients met criteria forM. simiaepulmonary disease. Of them, two had indistinguishableM. simiaestrains from tap water to which they were routinely exposed.Conclusions:This represents an outbreak ofM. simiaecolonization with one nosocomial infection. It is only the second time thatM. simiaehas been recovered from hospital tap water and its first presentation in municipal water. This study raises issues about the need and feasibility of eliminating or avoiding exposure toM. simiaefrom tap water.
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Affiliation(s)
- Nicholas G Conger
- Department of Infectious Disease, Wilford Hall Medical Center, Lackland AFB, Texas, USA
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Ichijo T, Izumi Y, Nakamoto S, Yamaguchi N, Nasu M. Distribution and respiratory activity of mycobacteria in household water system of healthy volunteers in Japan. PLoS One 2014; 9:e110554. [PMID: 25350137 PMCID: PMC4211706 DOI: 10.1371/journal.pone.0110554] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 09/24/2014] [Indexed: 11/29/2022] Open
Abstract
The primary infectious source of nontuberculous mycobacteria (NTM), which are known as opportunistic pathogens, appears to be environmental exposure, and it is important to reduce the frequency of exposure from environmental sources for preventing NTM infections. In order to achieve this, the distribution and respiratory activity of NTM in the environments must be clarified. In this study, we determined the abundance of mycobacteria and respiratory active mycobacteria in the household water system of healthy volunteers using quantitative PCR and a fluorescent staining method, because household water has been considered as one of the possible infectious sources. We chose healthy volunteer households in order to lessen the effect of possible residential contamination from an infected patient. We evaluated whether each sampling site (bathroom drain, kitchen drain, bath heater pipe and showerhead) have the potential to be the sources of NTM infections. Our results indicated that drains in the bathroom and kitchen sink are the niche for Mycobacterium spp. and M. avium cells were only detected in the bathtub inlet. Both physicochemical and biologic selective pressures may affect the preferred habitat of Mycobacterium spp. Regional differences also appear to exist as demonstrated by the presence (US) or absence (Japan) of Mycobacterium spp. on showerheads. Understanding of the country specific human activities and water usage will help to elucidate the infectious source and route of nontuberculous mycobacterial disease.
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Affiliation(s)
- Tomoaki Ichijo
- Environmental Science and Microbiology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan
- Research Institute for Humanity and Nature, Kyoto, Japan
| | - Yoko Izumi
- Environmental Science and Microbiology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan
| | - Sayuri Nakamoto
- Environmental Science and Microbiology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan
| | - Nobuyasu Yamaguchi
- Environmental Science and Microbiology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan
- * E-mail:
| | - Masao Nasu
- Environmental Science and Microbiology, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan
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Aznar I, Frankena K, More SJ, Whelan C, Martin W, Gormley E, Corner LAL, Murphy D, De Jong MCM. Optimising and evaluating the characteristics of a multiple antigen ELISA for detection of Mycobacterium bovis infection in a badger vaccine field trial. PLoS One 2014; 9:e100139. [PMID: 24983473 PMCID: PMC4077709 DOI: 10.1371/journal.pone.0100139] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 05/13/2014] [Indexed: 12/03/2022] Open
Abstract
A long-term research programme has been underway in Ireland to evaluate the usefulness of badger vaccination as part of the national bTB (bovine tuberculosis) control strategy. This culminated in a field trial which commenced in county Kilkenny in 2009 to determine the effects of badger vaccination on Mycobacterium bovis transmission in badgers under field conditions. In the present study, we sought to optimise the characteristics of a multiplex chemiluminescent assay for detection of M. bovis infection in live badgers. Our goal was to maximise specificity, and therefore statistical power, during evaluation of the badger vaccine trial data. In addition, we also aimed to explore the effects of vaccination on test characteristics. For the test optimisation, we ran a stepwise logistic regression with analytical weights on the converted Relative Light Units (RLU) obtained from testing blood samples from 215 badgers captured as part of culling operations by the national Department of Agriculture, Food and the Marine (DAFM). The optimised test was applied to two other datasets obtained from two captive badger studies (Study 1 and Study 2), and the sensitivity and specificity of the test was attained separately for vaccinated and non-vaccinated badgers. During optimisation, test sensitivity was maximised (30.77%), while retaining specificity at 99.99%. When the optimised test was then applied to the captive badger studies data, we observed that test characteristics did not vary greatly between vaccinated and non-vaccinated badgers. However, a different time lag between infection and a positive test result was observed in vaccinated and non-vaccinated badgers. We propose that the optimized multiplex immunoassay be used to analyse the vaccine trial data. In relation to the difference in the time lag observed for vaccinated and non-vaccinated badgers, we also present a strategy to enable the test to be used during trial evaluation.
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Affiliation(s)
- Inma Aznar
- Centre for Veterinary Epidemiology and Risk Analysis, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
- Quantitative Veterinary Epidemiology group, Wageningen Institute of Animal Sciences, Wageningen University, Wageningen, The Netherlands
- * E-mail:
| | - Klaas Frankena
- Quantitative Veterinary Epidemiology group, Wageningen Institute of Animal Sciences, Wageningen University, Wageningen, The Netherlands
| | - Simon J. More
- Centre for Veterinary Epidemiology and Risk Analysis, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | | | - Wayne Martin
- Professor Emeritus, University of Guelph, Guelph, Ontario, Canada
| | - Eamonn Gormley
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Leigh A. L. Corner
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Denise Murphy
- Athlone Regional Veterinary Laboratory, Department of Agriculture, Food and the Marine, Athlone, Ireland
| | - Mart C. M. De Jong
- Quantitative Veterinary Epidemiology group, Wageningen Institute of Animal Sciences, Wageningen University, Wageningen, The Netherlands
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Ortega J, Noguera A, García-Quirós A, Viana D, Selva L, de Juan L, Romero B, García-Parraga D, Crespo JL, Corpa JM. Lesional patterns associated with mycobacteriosis in an Atlantic horse mackerel, Trachurus trachurus (L.), aquarium population. J Fish Dis 2014; 37:591-595. [PMID: 23802507 DOI: 10.1111/jfd.12145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/17/2013] [Accepted: 05/17/2013] [Indexed: 06/02/2023]
Affiliation(s)
- J Ortega
- Faculty of Veterinary Medicine, Biomedical Sciences Research Institute, PASACTA (Histología y AnatomíaPatológica), Universidad CEU Cardenal Herrera, Moncada, Valencia, Spain
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Aro L, Correa K, Martínez A, Ildefonso R, Yáñez JM. Characterization of Mycobacterium salmoniphilum as causal agent of mycobacteriosis in Atlantic salmon, Salmo salar L., from a freshwater recirculation system. J Fish Dis 2014; 37:341-348. [PMID: 23952471 DOI: 10.1111/jfd.12108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 02/22/2013] [Accepted: 02/27/2013] [Indexed: 06/02/2023]
Abstract
Thirty Atlantic salmon, Salmo salar L., with low corporal condition relative to other fish present in the culture system, were sampled from a freshwater recirculation pisciculture located in Chile. The most characteristic signs and lesions were cachexia and presence of multiple greyish-white granulomas within internal organs. The external and internal lesions, along with the microscopic, histologic and biochemical findings, were consistent with mycobacteriosis. The identification of Mycobacterium salmoniphilum as the causal agent of the lesions was possible through the use of molecular analyses. This study represents the first report of Mycobacterium salmoniphilum in a freshwater recirculation system and the first case of fish mycobacteriosis described in Chile.
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Affiliation(s)
- L Aro
- Aquainnovo S.A., Puerto Montt, Chile
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Gulín Dávila J, González-Gay MA. [Infectious events during the first year of treatment with an antagonist of the tumor necrosis factor]. Farm Hosp 2013; 37:351-357. [PMID: 24128096 DOI: 10.7399/fh.2013.37.5.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVE To assess the incidence of severe infections in patients treated with anti-TNF-??drugs, during the first year of treatment with these drugs. MATERIALS AND METHOD Retrospective observational study carried out at a general hospital from a sample of patients receiving their first anti-TNF-??drug, according to approved indications, to treat a rheumatic disease. Each patient follow-up lasted for 2 years: the year before receiving the drug and the year after starting on this therapy. We considered those severe infectious events requiring hospital admission. A cohort study was performed before-after. The incidence rates of number of events (infections) per 100,000 inhabitants/year for the first treatment year and the previous year (control period) were calculated. The relative risk was calculated. RESULTS We included 196 patients. Twelve severe infectious events were recorded during the first treatment year, with a relative risk of 2.4. The biological drug most frequently associated to infection was Adalimumab. All patients having an infection had been previously or concomitantly treated with Methotrexate, and 90.6% with glucocorticosteroids. The main location of the infection was the respiratory system (58.3%), and the gram-positive microorganisms were the most frequent (58.3%). CONCLUSIONS The use of anti-TNF-??drugs, and mainly Adalimumab, represents a risk factor for suffering severe infections, mainly at the respiratory tract, produced by gram-positive microorganisms. The use of immunosuppressive drugs such as Methotrexate and glucocorticosteroids seems to increase the risk for such events.
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Abstract
Given the increasing prevalence of mycobacterial resistance to aminoglycoside antibiotics, we examined the susceptibility of 76 clinical isolates of mycobacteria to arbekacin, amikacin, gentamicin, kanamycin, tobramycin and streptomycin using an agar dilution method. Only arbekacin and amikacin showed excellent therapeutic potential (minimum inhibitory concentrationis (MICs) < or =0.25-4 microg/ml) against 30 isolates of rapidly growing mycobacteria, including Mycobacterium fortuitum, M. chelonae and a related organism, Nocardia asteroides. The MIC(90)of tobramycin against 23 isolates of M. avium complex was 8 microg/ml, while that of the other 5 aminoglycosides ranged from 64-256 microg/ml. Of the 23 M. tuberculosis isolates tested, 5 showed aminoglycoside resistance (MICs 128 to > or =1,024 microg/ml), while the others were variably susceptible (MICs < or =0.25-32 microg/ml) to all 6 aminoglycosides. The chemotherapeutic potential of arbekacin, amikacin and streptomycin as treatment of tuberculosis was apparent; however, proper patient management would be required to control against the emergence of the drug-resistant strains during prolonged treatment.
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Affiliation(s)
- T Udou
- Department of Clinical Microbiology, University of Occupational and Environmental Health, Kitakyushu, Japan.
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Łucejko M, Grzeszczuk A, Rogalska M, Flisiak R. Incidence of tuberculosis and mycobacteriosis among HIV-infected patients--clinical and epidemiological analysis of patients from north-eastern Poland. Pneumonol Alergol Pol 2013; 81:502-510. [PMID: 24142779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION According to WHO data, among patients infected with HIV, tuberculosis occurs in about 30% of patients and causes approximately 25% of deaths due to AIDS worldwide. The incidence rate of tuberculosis in the Polish population was 22.2/100,000 in 2011, while the average in European Union countries in 2011 was 14/100,000. Since 1985 to 30 April 2013 HIV infection in Poland was confirmed in 16,588 patients, while the number of reported tuberculosis cases in HIV-infected individuals in 2011 was 26. The aim of this study was to assess the prevalence and clinical course of tuberculosis and mycobacterial disease in HIV-infected patients treated in the Department of Infectious Diseases and Hepatology in Białystok. MATERIAL AND METHODS We analysed documentation of 577 HIV-infected patients, their demographic data, epidemiological status, degree of immunosuppression (T CD4 and CD8 numbers) and stage of HIV infection. RESULTS Complete follow-up was possible in 389 patients, of whom 265 (68%) were male. Tuberculosis (TB) was diagnosed in 41 patients (10.5%) and mycobacteriosis in 4 patients (1.03%). In 19 patients (42%) HIV and TB or mycobacteriosis were diagnosed simultaneously. The median CD4 T lymphocyte count was lower in patients with a simultaneous diagnosis of HIV and tuberculosis or mycobacteriosis compared to the group in whom TB/mycobacteriosis was diagnosed later. The number of CD4 T-cells less than 50 cells/μL was found in 63.2% (12/19) of patients when HIV and TB or mycobacteriosis were diagnosed simultaneously and in 38.5% (10/26) of patients who were diagnosed with TB or mycobacteriosis later than the HIV infection (p = 0.14). The median HIV viral load in patients in whom HIV infection and tuberculosis or mycobacteriosis were diagnosed at the same time was higher than in other patients and this difference was statistically significant. Pulmonary tuberculosis was the most common form of clinical disease and accounted for 60% of all cases. Among the analysed cases with HIV and tuberculosis or mycobacteriosis coinfection, tuberculosis or mycobacteriosis was the cause of death in 8 patients, and 9 died of other causes. CONCLUSION In our material of 389 HIV-infected patients, tuberculosis was diagnosed in 41 (10.5%) and mycobacterial diseases in 4 (1.03%). In 42% of co-infected patients (HIV+TB or mycobacteriosis) the diagnosis of both diseases was made at the same time. In these patients, a deep deficit of cellular immunity (CD4 < 50 cells/μL) was observed more frequently than in patients diagnosed with TB or mycobacteriosis in the later course of HIV. HIV RNA viral load was significantly higher in the group diagnosed simultaneously than in the remaining patients with HIV and TB or mycobacteriosis coinfection.
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Affiliation(s)
- Mariusz Łucejko
- Department of Infectious Diseases and Hepatology of the Medical University of Białystok, The Medical University of Bialystok Clinical Hospital.
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Mrlik V, Slany M, Kubecka J, Seda J, Necas A, Babak V, Slana I, Kriz P, Pavlik I. A low prevalence of mycobacteria in freshwater fish from water reservoirs, ponds and farms. J Fish Dis 2012; 35:497-504. [PMID: 22537026 DOI: 10.1111/j.1365-2761.2012.01369.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A survey of the occurrence of mycobacteria was conducted from 717 freshwater fish (25 species) in two water reservoirs, five ponds and two farms in the Czech Republic. A total of 2182 tissue samples from these fish were examined using the conventional culture method. Thirteen mycobacterial isolates were obtained from 12 (1.7%) fish belonging to nine species. Isolates were identified using sequence analysis of the 16SrRNA gene as: Mycobacterium algericum, M. fortuitum, M. gordonae, M. insubricum, M. kumamotonense, M. nonchromogenicum, two isolates of M. peregrinum, M. terrae and M. triplex. Mycobacteria were isolated more frequently from fish skin and gills than from internal organs or muscles.
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Affiliation(s)
- V Mrlik
- Veterinary Research Institute, Brno, v.v.i., Czech Republic
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Godreuil S, Marchandin H, Michon AL, Ponsada M, Chyderiotis G, Brisou P, Bhat A, Panteix G. Mycobacterium riyadhense pulmonary infection, France and Bahrain. Emerg Infect Dis 2012; 18:176-8. [PMID: 22261434 PMCID: PMC3310108 DOI: 10.3201/eid1801.110751] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kim SY, Kim MS, Chang HE, Yim JJ, Lee JH, Song SH, Park KU, Song J, Kim EC. Pulmonary infection caused by Mycobacterium conceptionense. Emerg Infect Dis 2012; 18:174-6. [PMID: 22257692 PMCID: PMC3310090 DOI: 10.3201/eid1801.110251] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Muwonge A, Kankya C, Johansen TB, Djønne B, Godfroid J, Biffa D, Edvardsen V, Skjerve E. Non-tuberculous mycobacteria isolated from slaughter pigs in Mubende district, Uganda. BMC Vet Res 2012; 8:52. [PMID: 22564290 PMCID: PMC3490772 DOI: 10.1186/1746-6148-8-52] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 05/07/2012] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The importance of infections caused by non-tuberculous mycobacteria (NTM) in animals and humans has gained considerable recognition during the past few years. In the developed world, where pig production is extensively practiced, studies on mycobacterial infections and related control strategies have received increasing attention. The infections are reported to be caused by a wide spectrum of NTM. Unfortunately, these infections have been less recognized in sub-Saharan Africa owing to lack of awareness and systematic studies. In this study we aimed at isolating and identifying species of mycobacteria involved in causing infections in slaughter pigs in Mubende district of Uganda. Furthermore we wanted to identify factors associated with infection prevalence in the study area. METHODS A total of 363 lymph nodes were collected and cultured for the presence of mycobacteria. Isolates were identified by 16S rDNA gene sequencing. A questionnaire survey was administered to identify production related factors associated with infection prevalence. Data were assembled and analysed using descriptive statistics and mixed effects logistic regression analysis. RESULTS Mycobacteria were detected in 39 % (143/363) of the examined lymph nodes, 63 % (59/93) of lymph nodes with gross lesions typical of mycobacteriosis and 31% (84/270) of lymph nodes with no visible lesions. Nineteen per cent of the isolated mycobacteria were identified as Mycobacterium (M) avium, of these 78% and 22% were M. avium sub sp. Hominissuis and avium respectively. Other mycobacterial species included M. senuense (16%), M. terrae (7%) and M. asiaticum (6%). This study found free range systems (OR = 3.0; P = 0.034) and use of water from valley dams (OR = 2.0; P = 0.049) as factors associated with high prevalence of mycobacteria in slaughter pigs. CONCLUSIONS This study demonstrated a high prevalence of NTM infections among slaughter pigs in Mubende district of Uganda. M. avium was the most prevalent of all NTM isolated and identified. Free range system of pig management and valley dam water were the most significant factors associated with NTM prevalence in Mubende district. These findings could be of a major public health concern given that it is in a predominantly pork consuming population with 18% HIV/AIDS prevalence. Therefore, stringent post-mortem inspection at the slaughter houses is of paramount importance to reduce human exposure.
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Affiliation(s)
- Adrian Muwonge
- Centre for Epidemiology and Biostatistics, Norwegian School of Veterinary Science, P.O. Box 8146 Dep, 0033, Oslo, Norway
| | - Clovice Kankya
- Centre for Epidemiology and Biostatistics, Norwegian School of Veterinary Science, P.O. Box 8146 Dep, 0033, Oslo, Norway
- Department of Biosecurity, Ecosystems and Public Health (BEP), College Of Veterinary Medicine, Animal Resources & Biosecurity Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Tone B Johansen
- Norwegian Veterinary Institute, P.O. Box 750, N-0106, Oslo, Norway
| | - Berit Djønne
- Norwegian Veterinary Institute, P.O. Box 750, N-0106, Oslo, Norway
| | - Jacques Godfroid
- Section for Arctic Veterinary Medicine, Norwegian School of Veterinary Science, Stakkevollveien 9010, Tromsø, Norway
| | - Demelash Biffa
- College of Medicine, University of Arizona, 1656 E. Mabel St, P.O. Box 245221, Tucson, AZ, 85724, USA
| | - Vigdis Edvardsen
- Norwegian Veterinary Institute, P.O. Box 750, N-0106, Oslo, Norway
| | - Eystein Skjerve
- Centre for Epidemiology and Biostatistics, Norwegian School of Veterinary Science, P.O. Box 8146 Dep, 0033, Oslo, Norway
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Ying WJ, Wang XC, Sun JQ, Liu DR, Yu YH, Wang JY. [Clinical features of chronic granulomatous disease]. Zhonghua Er Ke Za Zhi 2012; 50:380-385. [PMID: 22883043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Chronic granulomatous disease (CGD) is a rare primary immunodeficiency of phagocytic oxidative bursts leading to recurrent severe bacterial and fungal infections as well as granuloma formation. There were few reports on the clinical characteristics of this disease in China. The purpose of this study was to evaluate the clinical features of 48 Chinese cases with CGD which were confirmed by clinical features, dihydrorhodamine (DHR) assay and gene mutation analysis. METHOD The study cohort was the population of CGD patients diagnosed in Children's Hospital of Fudan University from January, 2004, to June, 2011. Cases included in our analysis were restricted to those who had complete data of the clinical symptoms and laboratory tests. The patients were followed up by outpatient visiting and telephone call regularly for 0.5 to 6 years. The history and data of physical examination and treatment of 48 cases were collected and reviewed. RESULT All the patients were diagnosed by DHR analysis. The age of onset of all the 48 patients were less than 6 months, including 43 male and 5 female. The mean age at diagnosis was 2.42 years; 12 patients were infants under six months, 10 were between 6 and 12 months, 9 were between 1 and 2 years, 5 patients were between 2 and 3 years, 4 were between 4 and 5 years, and 8 were between 6 and 10 years. Recurrent respiratory infection (44/48) and chronic diarrhea (31/48) were the common symptoms in all the patients, and then skin lesion (22/48), including marked reaction at BCG infected site, pustular eruption and infected skin ulcer and urinary tract infection (3/48) were also general symptoms in our study. In addition, lymphadenectasis occurred in 31 cases and 23 of them were considered to be associated with BCG vaccination. The pathogens caused the infection were mycobacteria (52.08%), fungi (43.75%) and pyogenic bacteria. Thirty-seven patients had mutations in CYBB/CYBA/NCF1/NCF2 genes. Recombinant human interferon-gamma (rhIFN-γ) plus sulfamethoxazole were used for the prevention and treatment of infection, the frequency and severity of the disease could be reduced. CONCLUSION The age at onset and diagnosis of the present group of CGD was younger. Clinical symptoms were associated with recurrent mycobacterial, fungal and pyogenic bacterial infection, which involved respiratory tract, alimentary tract, skin and lymph node. rhIFN-γ partially improved the prognosis of CGD.
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Affiliation(s)
- Wen-jing Ying
- Department of Clinical Immunology, Institute of Pediatrics, Children's Hospital of Fudan University, Shanghai 201102, China
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Abstract
Mycobacteriosis is an important disease in the feral ferret (Mustela putorius furo) of New Zealand; elsewhere, reports of tuberculosis in the ferret are sporadic. Genus Mycobacterium consists of aerobic, non-spore-forming, gram-positive, nonmotile bacteria that characteristically feature a cell wall rich in mycolic acids and esters. The epidemiology of mycobacteriosis in the ferrets of New Zealand involves complex interactions between ferrets, possums, and livestock. Investigators have shown that the ferret is highly susceptible only to Mycobacterium bovis infection and is more resistant to infection by other Mycobacterium spp. The principal site of all mycobacterial infection in the ferret is the gastrointestinal tract.
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Affiliation(s)
- Christal Pollock
- Lafeber Company, 24981 North 1400 East Road, Cornell, IL 61319, USA.
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