Mycobacterium genavense is arare cause of non-tuberculous mycobacterial disease, typically occurring in immunocompromised hosts. The case of a49-year-old immunocompetent man with respiratory symptoms is presented. Imaging revealed ahilar mass with mediastinal lymphadenopathy, initially suggesting malignancy. Molecular diagnostics identified M.genavense as the causative pathogen. A15-month regimen of rifampicin, azithromycin, and ethambutol led to complete clinical and radiological remission.

An engineered suicide vector-mediated genome editing of Mycobacterium sp. LY-1 for targeted 9α-hydroxyandrost-4-ene-3,17-dione biosynthesis

Microalgae-bacteria interactions represent a promising approach for improving microalgal growth and biomass productivity, with potential applications in biofuel production, wastewater remediation, and the synthesis of value-added bioproducts. In this study, enriched microalgae consortia from the Tallahassee Wastewater Treatment Facility were first characterized using shotgun metagenomic sequencing to assess their taxonomic composition and functional potential. The consortia were dominated by Chlorella species and associated with diverse bacterial communities. Subsequently, bacterial strains were isolated and characterized to evaluate their potential as natural growth enhancers for microalgae. Eight bacterial isolates, Mesorhizobium sp., Enterococcus avium, Stenotrophomonas sp., Agrobacterium tumefaciens, Citrobacter freundii, Cellulosimicrobium sp., Stenotrophomonas pavanii, and Mycobacterium sp. SMC-4 were identified through 16S rRNA sequencing and phylogenetic analysis. The influence of these isolates on microalgae was assessed using a membrane-separated coculture system that enabled metabolite exchange without direct cell-to-cell contact. Microalgal growth, monitored through optical density (OD) at 680nm over 18 days, showed significant enhancement across all bacterial treatments compared to the reference (microalgae without bacteria). The most pronounced effects were observed with Mesorhizobium sp., Enterococcus avium, Stenotrophomonas sp., and Agrobacterium tumefaciens, which exhibited the highest growth responses. These findings suggest that wastewater-derived bacteria can substantially enhance microalgal growth performance, likely through metabolite-mediated interactions. This study expands the repository of algal-supportive bacterial taxa and highlights the potential of targeted microalgae-bacteria consortia for scalable and sustainable bioprocessing.

Programmable mycolysins expand the antimicrobial toolkit against mycobacteria.

ObjectivesAzithromycin is a key drug in the treatment of most non-tuberculous mycobacterial (NTM) diseases. Its exposure may be decreased by rifampicin co-administration, but to what extent is largely unknown. We measured azithromycin exposure in an NTM disease patient population and quantified the effect of rifampicin co-administration.MethodsWe retrospectively collected plasma azithromycin area-under-the-curve from 0 to 6 hours after administration in mg/L*hours (AUC0-6h), peak (Cmax), and trough (Cmin) concentrations from the TDM service at Radboudumc, The Netherlands. Azithromycin exposure measures were compared between patients with and without concurrent rifampicin use, and within patients who had rifampicin stopped during treatment.ResultsWe analysed data of 130 patients, of whom 59% had NTM pulmonary disease. The azithromycin geometric mean of AUC0-6h in patients with (n = 48) and without (n = 82) rifampicin were 0.90 versus 1.83 mg/L*h, Cmax 0.22 versus 0.46 mg/L, and Cmin 0.043 versus 0.13 mg/L, respectively. A within-patient comparison in 14 subjects showed geometric means of AUC0-6h, Cmax, and Cmin (90%-CI) with rifampicin were 62% (45%–74%), 58% (38%–72%) and 66% (48%–77%) lower than without rifampicin. Interventions based on TDM enabled a strong increase in exposure to azithromycin. No association between azithromycin exposure and disease outcomes was shown, but the number of patients in these analyses was small.ConclusionsThis study provides new population exposure data for TDM of azithromycin in NTM disease. Rifampicin co-administration reduces azithromycin exposure by at least half, underscoring the need for upfront azithromycin dose adjustment, application of TDM, or considering alternative drugs for rifampicin, also considering controversy around its effectiveness and adverse effects.

Tuberculosis and nontuberculous mycobacterial pulmonary disease are major causes of chronic respiratory morbidity, yet detailed multicenter clinical data remain limited. We established a retrospective multicenter cohort using electronic medical records from 4 national university-affiliated tertiary hospitals in Korea. Eligible participants included patients with tuberculosis registered in the Korean National Tuberculosis Surveillance System and patients who met modified 2007 American Thoracic Society/Infectious Diseases Society of America microbiological criteria for nontuberculous mycobacterial pulmonary disease between 2015 and 2024. De-identified, standardized datasets were created using common data specifications and harmonized at a central coordinating center. The cohort included 11,790 patients with tuberculosis and 5,145 patients with nontuberculous mycobacterial pulmonary disease. Tuberculosis notifications declined steadily from 1,657 cases in 2015 to 580 cases in 2024, whereas nontuberculous mycobacterial pulmonary disease showed an overall upward trend despite a modest decrease in the final year. Mycobacterium avium complex accounted for 78.7% of nontuberculous mycobacterial pulmonary disease cases, with M. intracellulare and M. avium as the predominant species. Macrolide-based multidrug regimens were used consistently throughout the study period. This cohort profile describes the registry design, case definitions, data structure, and key baseline findings; the registry provides a platform for future clinical, epidemiological, and health-services research on mycobacterial disease in Korea.

Undifferentiated carcinoma (UC) is a rare and aggressive subtype of pancreatic cancer, typically diagnosed at an advanced stage. We report a case of UC detected as a small lesion (10mm on imaging) during follow-up for focal pancreatic parenchymal atrophy (FPPA). A 75-year-old woman with a history of nontuberculous mycobacterial disease underwent routine computed tomography, revealing focal parenchymal atrophy in the pancreatic body without any abnormality in the main pancreatic duct (MPD). During follow-up, CA19-9 levels increased, and diffusion-weighted magnetic resonance imaging identified a small lesion. Endoscopic ultrasonography-guided fine-needle aspiration yielded a pathological diagnosis suggestive of UC. Surgical resection was performed, and pathology confirmed anaplastic-type UC arising within the FPPA region with fatty replacement, along with adenocarcinoma in situ in the same area. The tumor measured 14mm in size. Despite curative resection, the patient developed liver metastases and died 7months postoperatively. This case illustrates that early malignant lesions, including UC, may develop in areas of FPPA even without MPD abnormalities. Careful surveillance using imaging and tumor markers may facilitate early detection of such aggressive tumors. To our knowledge, this is the first reported case of resectable UC arising from an area of FPPA with fatty replacement.

Nontuberculous mycobacterial pulmonary disease (NTM-PD) requires prolonged, complex antimicrobial therapy. Identifying predictors of treatment initiation in routine practice is crucial. We conducted a retrospective observational study of consecutive adults with NTM-PD evaluated at a tertiary referral center between 2021 and 2025. Demographic, clinical, radiological, and microbiological characteristics were compared between patients managed with observation and those who initiated treatment. Multivariate logistic regression identified independent predictors of treatment initiation. Among 317 patients, 176 initiated therapy and 141 were observed. Treatment initiation was independently associated with smear positivity, mixed or cavitary radiological patterns, systemic symptoms, particularly fever and weight loss, and immunosuppression. Airway clearance techniques and isolation of Mycobacterium abscessus were associated with a lower likelihood of treatment initiation. Respiratory symptoms did not influence treatment decision. These findings support current guideline recommendations and provide additional insight into the clinical aspects of the disease.

Investigation of a disease outbreak in a hobbyist's medaka (Oryzias latipes) collection led to the detection of Trichodina sp. in the kidney tubuli of individual fish. Based on this observation, a thorough clinical workup, including native microscopy, histopathology and molecular genetics, was conducted. Besides the trichodinids, Ichtyobodo necator and microsporidian gill infection were found in one out of the eight fish, and all of them were infected with Mycobacterium sp. Morphological description of the renal Trichodina sp. was based on the parasites found in renal tubules. For molecular genetic characterization and phylogenetic analysis, primers targeting the 18S rRNA gene of all members of the order Mobilida were designed. The phylogenetic analysis of the 18S rRNA sequences showed a close relationship to Trichodina ruditapicis (FJ499385), Trichodina glossogobae (ON042773) and Trichodina sinonovaculae (FJ499386) sampled from fish and mussels in China, differing by 2.2%-2.5%. Here we report for the first time renal trichodinosis of O. latipes and molecular data of a fish-endozoic Trichodina sp.

Predicting progression of Mycobacterium avium complex pulmonary disease with treatment using explainable artificial intelligence techniques.

Genome-and structure-guided mechanism of carboxymethyl cellulose and straw degradation by a marine sediment bacterium Mycobacterium sp. CBM1

Rationale:The co-occurrence of adult-onset immunodeficiency syndrome mediated by anti-interferon-γ autoantibodies (AIGA-AOID), disseminated non-tuberculous mycobacterial (NTM) infection, and Sweet syndrome is a recognized but underreported triad, particularly in East Asian populations. Detailed case reports emphasizing diagnostic approach and integrated management remain valuable for improving clinical recognition.Patient concerns:A 70-year-old Asian female presented with a 1-year history of a progressive neck mass, a 6-month history of recurrent fever, and a painful cutaneous eruption on the face, trunk, and limbs.Diagnoses:Evaluations revealed disseminated Mycobacterium massiliense infection involving lymph nodes, lung, and skin. Skin biopsy was consistent with Sweet syndrome. High-titer anti-interferon-γ autoantibodies (1:2500) were detected, confirming AIGA-AOID in the absence of HIV or other immunosuppression.Interventions:Combined therapy was initiated: rituximab (two weekly doses) with corticosteroids, and a 12-month oral antimycobacterial regimen (clarithromycin, moxifloxacin, linezolid).Outcomes:The patient showed marked clinical improvement within 2 weeks, with resolution of fever and skin healing. Follow-up imaging at 3 months demonstrated significant regression of lymphadenopathy and lung consolidation.Lessons:Sweet syndrome can be a presenting sign of disseminated NTM disease. In immunocompetent-appearing adults, especially in endemic regions, this should prompt investigation for AIGA-mediated immunodeficiency. Early diagnosis and combined immunomodulatory-antimicrobial therapy are crucial for successful outcomes.

ABSTRACT Background Sex-related differences in nontuberculous mycobacterial pulmonary disease (NTM-PD) may influence both clinical presentation and radiographic phenotypes; however, evidence from Chinese populations remains limited. Research design and methods This retrospective study included 218 patients with NTM-PD in China. Patients were stratified by sex. Clinical characteristics, comorbidities, laboratory parameters, and high-resolution computed tomography findings were compared. Logistic regression analyses were performed to evaluate the association between sex and specific radiographic manifestations. Results Females had lower body mass index and higher rates of bronchiectasis and gastroesophageal reflux disease. The nodular bronchiectatic phenotype predominated in females (85.85%), with middle lobe/lingula involvement (71.70%). Female sex was independently associated with tree‑in‑bud opacities (p = 0.031). Males had higher rates of smoking, previous tuberculosis, and chronic obstructive pulmonary disease (COPD), and more fibrocavitary disease (25.00%), but cavitation was linked to smoking, tuberculosis, and COPD rather than sex (p = 0.118). Conclusions Significant sex differences exist in the clinical and radiographic phenotypes of Chinese patients with NTM-PD. Limitations include the single-center retrospective design, relatively small sample size, lack of long-term follow-up data, and absence of sex hormone and environmental exposure assessments.

Association of body morphotypes with disease severity and its dynamic changes following treatment in patients with nontuberculous mycobacterial lung disease: a sex-stratified analysis.

To analyze the microbiological characteristics of extrapulmonary nontuberculous mycobacterial (ENTM) infections in a tertiary hospital and to provide data to support clinical diagnosis and treatment of ENTM infections. A retrospective analysis was conducted on mycobacterial culture results from West China Hospital, Sichuan University from 2020 to 2023. A total of 68 confirmed cases of ENTM infection were enrolled, with all of which meeting the diagnostic criteria for extrapulmonary infection outlined in the Guidelines for the Diagnosis and Treatment of Nontuberculous Mycobacterial Disease (2020). Demographic data, strain distribution, and drug susceptibility test results were analyzed. Microbial species identification was performed using mass spectrometry, and drug susceptibility was assessed using the microbroth microdilution method. Among the 68 ENTM cases, the male-to-female ratio was 1 to 1.2, with individuals aged 40-59 years being the main affected group population. The most common sites of infection were the skin and soft tissues. The primary specimen source was pus (33.8%, 23 cases), followed by pathological tissues (26.5%, 18 cases). The Department of Infectious Diseases was the main source of confirmed cases (29.4%, 20 cases). Among the 68 EMTM cases, rapid-growing mycobacteria (RGM) accounted for 32.4% (22 cases), with Mycobacterium abscessus being the predominant species, while slowly-growing mycobacteria (SGM) accounted for 67.6% (46 cases), with Mycobacterium intracellulare and Mycobacterium marinum being the predominant species. RRGM exhibited higher minimum inhibitory concentration (MICs) for rifampicin and rifabutin but lower MICs for clarithromycin and amikacin. In contrast, SGM demonstrated low MICs for most antibiotics tested. In this study, ENTM infections most commonly involve the skin and soft tissues, with SGM being the predominant pathogens and Mycobacterium intracellulare being the dominant species. RGM shows susceptibility to clarithromycin and amikacin, which provides a basis for empirical anti-infective therapy. Although SGM exhibits low MICs to most tested antimicrobial agents, combination regimens remain necessary in clinical practice, and the risk of treatment failure should be thoroughly evaluated.

Analysis of the differential clinical characteristics of tuberculosis and nontuberculous mycobacterial diseases among AIDS patients

We report the complete genome sequence of Mycobacterium sp. strain Panama NTM2, isolated from a sputum sample of a patient with pulmonary tuberculosis in Panama. The 5,922,402-bp genome (68% GC) was assembled into five contigs containing 5,703 protein-coding genes. FastANI identified Mycobacterium kyogaense NCTC 11659 as the closest relative (88.13% ANI), suggesting Panama NTM2 represents a novel species within the genus.

IntroductionThe global prevalence of non-tuberculous mycobacterial pulmonary disease (NTM-PD) is increasing. Individuals with NTM-PD frequently develop chronic pulmonary aspergillosis, which is associated with poor clinical outcomes. However, the biological mechanisms underlying the interaction between Aspergillus species and non-tuberculous mycobacteria (NTM) remain poorly understood. This study aimed to investigate the interaction between Aspergillus fumigatus and NTM and to identify mechanisms that may inform novel therapeutic strategies.MethodsA. fumigatus was incubated with NTM culture supernatants, and biofilm formation was quantified using the crystal violet assay. Phagocytic activity against A. fumigatus conidia were assessed in THP-1-derived macrophages infected with Mycobacterium avium. Conversely, phagocytosis of M. avium was evaluated in macrophages exposed to A. fumigatus culture supernatants. Finally, fungal clearance in vivo was assessed in mice pre-infected with M. avium.ResultsNTM supernatants significantly enhanced A. fumigatus growth. M. avium infection decreased the macrophages-phagocytosis rate of A. fumigatus by approximately 40% compared to uninfected control. Additionally, M. avium infection reduced Dectin-1 gene expression in macrophages by half. Secondary metabolites produced by A. fumigatus impaired macrophage phagocytosis of M. avium. In vivo, prior M. avium infection delayed fungal clearance from the lungs.DiscussionNTM promote not only A. fumigatus growth but also its colonization by impairing macrophage immune function. Conversely, A. fumigatus suppresses host defense against NTM via secondary metabolites. These findings suggest that microbial cross-modulation creates a permissive niche that facilitates co-colonization and may contribute to disease progression.

Development of the novel nontuberculous mycobacterial pulmonary disease symptoms scale (NTM-SS)

Impact of timing of nontuberculous mycobacterial pulmonary disease antibiotic initiation on hospitalizations in Japan.