Abstract
BackgroundThe emergence of Acquired Immunodeficiency Syndrome has highlighted the increased incidence and importance of the disease caused by Non-tuberculous Mycobacteria (NTM). While disease due to M. avium-intracellulare complex is apparently common throughout the world, other Non-tuberculous mycobacterial species have been isolated from both immunocompromised and immunocompetent individuals. The increasing number of infections caused by these organisms has made it clinically important to quickly identify mycobacterial species. The diagnosis of a pathogenic versus a non-pathogenic species not only has epidemiological implications but is also relevant to the demands of patient management. Since antibiotic treatment varies according to the species encountered, species identification would reduce the burden of some of these emerging opportunistic pathogens especially in immunocompromised patients and improve their quality of life.FindingsA total of 91 NTM suspected isolates from four regions of Zambia were included in the study. These isolates were identified using the sequence analysis of the 16S-23S rRNA intergenic transcribed spacer (ITS) region of Mycobacteria.Fifty-four of the 91 (59%) isolates were identified as NTM and these included M. intracellulare (27.8%), M. lentiflavum (16.7%), M. avium (14.8%), M. fortuitum (7.4%), M. gordonae (7.4%), M. kumamotonense (3.7%), M. indicus pranii (3.7%), M. peregrinum (3.7%), M. elephantis (1.85%), M. flavescens (1.85%), M. asiaticum (1.85%), M. bouchedurhonense (1.85%), M. chimaera (1.85%), M. europaeum (1.85%), M. neourum (1.85%), M. nonchromogenicum (1.5%).ConclusionThe study has shown that DNA sequencing of the ITS region may be useful in the preliminary identification of NTM species. All species identified in this study were potentially pathogenic.Electronic supplementary materialThe online version of this article (doi:10.1186/s12941-014-0059-8) contains supplementary material, which is available to authorized users.
Highlights
The emergence of Acquired Immunodeficiency Syndrome has highlighted the increased incidence and importance of the disease caused by Non-tuberculous Mycobacteria (NTM)
The study has shown that DNA sequencing of the intergenic transcribed spacer (ITS) region may be useful in the preliminary identification of NTM species
Non-tuberculous Mycobacteria have gained a lot of clinical significance in the last couple of decades in immunocompromised and immunocompetent individuals or patients [2]
Summary
The study has shown that DNA sequencing of the ITS region may be useful in the preliminary identification of NTM species. NTM pulmonary infections are encountered with increasing frequency in the immune-competent patients Another major factor contributing to the increased awareness of the importance of NTM as human pathogens is the improvement in the mycobacteriology laboratory techniques, resulting in enhanced isolation and more rapid and accurate identification of NTM from clinical specimens [3]. The presence of NTM in water, coupled with their disinfectant resistance, leads to their presence in hot tubs, solutions used in medical treatments and water–oil emulsions used to cool metal working tools [10] It is generally believed that the majority of human-mycobacterial interactions are transient, self-curing colonisations [11,12]. The significance of isolation of these organisms in clinical samples remains unclear since the number of diseases they cause is difficult to assess and no system for notification exists as in the case of M. tuberculosis. This study was initiated to identify NTM to species level for ease of managing such suspect conditions
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