Nontuberculosis Mycobacteria Species Research Articles

Genome sequences of Mycobacterium sp. Elmwood and accompanying phage, isolated from a public swimming pool in Nebraska.

Genome sequencing of a non-tuberculosis Mycobacterium species, isolated from a public pool, shows that the genome contains several genes for antibiotic resistance and anti-phage defense, which are absent from other related Mycobacteria. Metagenomic binning also provided the genome of the accompanying phage, which is distinct from other mycobacterial phages.

Treatment of non-tuberculosis mycobacteria skin infections.

Non-tuberculosis mycobacteria (NTM) skin infections have become increasingly prevalent in recent years, presenting a unique challenge in clinical management. This review explored the complexities of NTM infections localized to the superficial tissues and provided valuable insights into the optimal therapeutic strategies. The antibiotic selection should base on NTM species and their susceptibility profiles. It is recommended to adopt a comprehensive approach that considers the unique characteristics of superficial tissues to improve treatment effectiveness and reduce the incidence of adverse reactions, infection recurrence, and treatment failure. Infection control measures, patient education, and close monitoring should complement the treatment strategies to achieve favorable outcomes in managing NTM skin infections. Further efforts are warranted to elucidate factors and mechanisms contributing to treatment resistance and relapse. Future research should focus on exploring novel treatment options, innovative drug development/delivery platforms, and precise methodologies for determining therapeutic duration. Longitudinal studies are also needed to assess the long-term safety profiles of the integrated approaches.

Multiple mutations of Mycobacterium intracellulare subsp. chimaera causing false-negative reaction to the transcription-reverse transcription concerted method for pathogen detection

ObjectivesTo report an isolate of Mycobacterium intracellulare subsp. chimaera with multiple mutations in 16S ribosomal RNA (rRNA) gene, resulting in the false-negative reaction to the transcription-reverse transcription concerted (TRC) method for Mycobacterium avium-intracellulare complex. MethodsWe used TRC, polymerase chain reaction (PCR), and Matrix-assisted laser desorption/ionization Time-of-Flight/Mass Spectrometry (MALDI-TOF/MS) methods to identify a clinical isolate in 2021. Due to the discordant results between TRC and PCR or MALDI-TOF MS methods, 16S rRNA sequencing, whole-genome shotgun (WGS) sequencing, and average nucleotide identity (ANI) analysis were employed to identify the isolate. ResultsA mycobacterial isolate from a sputum sample gave negative results for the detection of Mycobacterium tuberculosis complex or M. avium-intracellulare complex by the TRC method. However, the isolate was identified as M. intracellulare by both PCR method and MALDI-TOF MS method. WGS sequencing of 16S rRNA genome revealed eight substitution mutations and one insertion mutation within the region, which could hamper the correct reaction to TRC method. Subsequent ANI analysis between the isolate and various species of nontuberculosis mycobacteria revealed that the isolate could be identified as M. intracellulare subsp. chimaera. ConclusionRare mutations within the 16S rRNA genome resulted in the false-negative identification of Mycobacterium chimaera by the TRC method. WGS sequencing and ANI analysis was necessary to identify the isolate.

2185. Pulmonary Non-Tuberculosis Mycobacteria (NTM) Infections in Adult Patients at a Tertiary Care Hospital in Saudi Arabia

Abstract Background Burden of Non-tuberculous Mycobacteria (NTM) disease is increasing in both developed and developing countries. Local data is needed to guide our understanding of the epidemiology and outcome of NTM management in our population. The main objectives of the study are to describe management of patients with NTM infection and determine treatment outcomes in adult patients. Also, to explore the epidemiology of mycobacterial species associated with pulmonary NTM. Methods A 10-year (2010-2020), retrospective cohort study was conducted at a tertiary care hospital in Saudi Arabia. All patients with positive NTM culture were screened. Adult patients (≥ 18 years old) diagnosed with pulmonary NTM disease and received treatment for ≥ two months were included. Clinical data was collected from the patient’s chart using standardised form. The primary end points were overall cure rate (clinical, microbiological, and radiological cure), recurrence, relapse, and re-infection rate. The secondary end points were mortality and hospital admission rate for NTM infection. The Chi-square test was used to compare parameters. Univariate then multivariable logistic regression were used to model the effect of the outcome. Screening of patients with positive Non-tuberculous Mycobacteria culture for eligibility Results Forty-five patients met the study inclusion criteria. 60% were male with a median age of 53. The most common comorbidities were malignancy and bronchiectasis. NTM species were Mycobacterium simiae (35%), Mycobacterium avium Complex (27%), and Mycobacterium abscessus (18%). Overall cure rate was 95%, with 85%, 85% and 74% of microbiological, clinical, and radiological rate achieved, respectively. Greater number of patients were treated before the recent pulmonary NTM guideline. Regimens were based on general treatment for NTM infection with clarithromycin, ethambutol, and rifampicin utilized the most. 69% of regimens were adjusted after speciation. The median duration of treatment was 36 weeks. Relapse, recurrence and reinfection rate was 20%, 9%, and 2%, respectively. NTM related hospital admission rate was 34%. Baseline characteristics of Patients with Pulmonary Non-tuberculous Mycobacteria (n=45) Primary and secondary outcomes Clinical Presentation, diagnosis and treatment of Patients with pulmonary Non-tuberculous Mycobacteria (n=45) This table is showing the clinical course of all patients included in the study with subgroup analysis per each specie of Non-tuberculous Mycobacteria Conclusion Pulmonary NTM disease in our patients was mainly due to three species in 80%. High overall cure rate and low recurrence rate were achieved. The findings of this study will serve as a guide for the management of pulmonary NTM disease in Saudi population. Disclosures All Authors: No reported disclosures.

Novel and rare species of nontuberculous mycobacteria by Hsp-65 gene sequencing.

Nontuberculosis mycobacterium (NTM) is the emerging group of organisms being recognized as etiological agents for diverse clinical conditions such as lymphadenitis, cutaneous, and pulmonary or disseminated lesions. Diverse background patients can acquire these infections such as immunocompetent, immunocompromised patients, or postoperative settings. Rapid addition of newer strains to this group necessitates heightened suspicion in the clinical settings. Specific requirements for cultures, biochemical testing, and molecular methods are needed to diagnose these organisms. The prospective study conducted at Nizam's Institute of Medical Sciences from January 2019 to December 2021 using various clinical samples using molecular techniques such as line probe assay and hsp-65 gene sequencing to discover new NTM species. The management is challenging since it requires prolonged treatment, multiple drugs, drug resistance, and individualization of treatment in the combination of surgery if needed. In this article, we describe three different NTM species which were not reported in India and highlight to consider these organisms in adequate clinical situation. Mycobacterium iranicum is a rare strain with quick growth and scotochromogenic colonies that are orange-colored. Eight distinct strains were discovered in clinical samples from six different countries: Two each from Iran, Italy, Greece, the Netherlands, Sweden, and the United States. Two of the strains were recovered from cerebrospinal fluid, which is unusual. Mycobacterium species AW6 is an unidentified and unclassified Mycobacterium according to NCBI taxonomy. Mycobacteria malmoense has been linked to lymphadenitis, notably cervical adenitis in children, and pulmonary infection in the majority of cases. Using Line Probe Assay and hsp-65 gene sequencing, novel and uncommon species of NTM were detected from a clinical samples, including sputum and tissue. We report three unusual species of NTMs: M. iranicum, M. species-AW6, and M. malmoense for the first time in India. Novel and rare emerging species of NTMs need to be considered in diverse clinical situations for appropriate therapy and good clinical outcomes.

Evaluation of the diagnostic value of loop-mediated isothermal amplification assays targeting three different Mycobacterium tuberculosis genes

The aim of the study was to evaluate a loop-mediated isothermal amplification (LAMP) assay for the ability to diagnose tuberculosis directly from clinical samples rapidly. LAMP assays were performed using previously reported primer sets to amplify three specific Mycobacterium tuberculosis (MTB) gene targets, hspX, gyrB, and IS6110. Quantitated DNA from strain H37Rv were detected for assessment of analytical sensitivity; specificity was evaluated by testing eight species of non-tuberculosis Mycobacterium (NTM) and four unrelated bacterial species. Sputum samples from 68 pulmonary tuberculosis patients and a control group consisting of 45 lung cancer patients and 20 healthy controls were analyzed using LAMP assays, and then compared with smear, culture and quantitative real-time PCR (qRT-PCR) methods. All three LAMP assays showed 100% specificity for MTB when tested against NTM and other bacterial species. The gyrB-LAMP assay was able to detect 60 cfu/ml of H37Rv suspension within 1 h, similar to qRT-PCR, but 10 times more sensitive than the hspX-LAMP and IS6110-LAMP assays. In clinical samples, when qRT-PCR was used as the reference method, the sensitivity of the three LAMP assays targeting hspX, gyrB, and IS6110 genes was 94.6, 98.2 and 92.9%, respectively. LAMP is more sensitive than smear microscopy and close to qRT-PCR in sensitivity for the detection of MTB. LAMP has comparable specificity to qRT-PCR but was more rapid and convenient.

Resistance Profile of Mycobacterial Strains Causing Cluster Pulmonary Infection in Bayelsa State, Nigeria

Aim: The aim of this study was to profile the anti-microbial resistant of Mycobacterial strains causing cluster pulmonary infections in Bayelsa State, Nigeria.
 Study Design: Cross sectional facility based.
 Place and Duration: This study was carried out in all the in tuberculosis centers in all the eight local government area in Bayelsa State, Nigeria between January 2019 to February 2021.
 Materials and Methods: A total of 102 tuberculosis patients who had been previously diagnosed of Tuberculosis (both new and old cases) participated in the study. Two sputum samples were collected from each subject in a wide mouth screw cape container and falcon tube container respectively. The first was used for GenXpert technique while the second was used for culture on Lowenstein Jensen solid Media. The visible and confirmed Mycobacterium growth was subjected to Line Probe Assay (MTBDRplus assay) and genetic sequencing. The DNA of the isolates where extracted using Genolyse method. The extracted DNA was used to perform a gene mutation profiling using MTBRplus Assay. The 16Sr RNA sequencing was done on the amplified genes using the BigDye terminator kit on a 3510 AB1 sequencer.
 Results: Out of the 102 sputum samples analyzed a total of 91(89.2%) were GeneXpert positive. Drug resistant profiling by GeneXpert shows 8(7.8) strain mutation at the rpoB gene only while the resistant profiling of the isolated on Lowenstein Jensen solid media had 14(13.7) strain with mutation on genes responsible for first and second line drug resistant. Two non-tuberculosis Mycobacterium species which are Mycobacteriode abscessus subsp. abscessus st and Mycobacterium Kansasii strain FDAARGOS_1534 where isolated among Tuberculosis patients, both are multidrug-resistant strains. The Mycobacterium tuberculosis strains in circulation causing cluster TB infection in Yenagoa especially and other parts of Bayelsa State, Nigeria are MG003 and R2092 strains, but the most predominant strain that is traced to cluster TB infection is MG003. The extraction of MTB gene from a pure culture of a Lowenstein Jensen selected media reduced the possibility of contamination and enhanced the reliability of gene sequencing and Bioinformatics analysis which includes comparing strains of MTB with the once in the National center for Biotechnology information (BLAST) data base.
 Conclusion: The resistance profiling of MTB reveals that most strains were resistant to rifampicin. This means that there were more mutation on the rifampicin activation gene (rpoB) than any other gene. Most cases of multi drug resistance is associated with rifampicin resistance while cases of extensive drug resistance is not common.

Is a Time to Established Medical Mycobacteriology as an Academic Degree (Master of Science)? Strategical Plan for Next Future

The genus Mycobacterium contains more than 190 species, including several major human pathogens as well as numerous environmental species. With so much advances in molecular methods, the transmission of huge number of mycobacteria called nontuberculosis mycobacterium (NTM) is still under a question. Till date, the majority of work have been focused on tuberculosis (TB) complex mycobacteria, the knowledge of human-to-human, environmental, animal-to-human transmission, and vice versa susceptibility, and most of their NTM genomic structures have been ignored, especially in limited-resource countries. For example, in Iran, there are currently 423 public laboratories for direct smear microscopy (DSM) and 42 laboratories for mycobacterial cultures, and 9 diagnostic centers for susceptibility and identification of TB complex from NTM species. Only National TB Reference Laboratory in Iran is capable of identifying subspecies of NTMs and preforms second-line drug resistant. Furthermore, there are some governmental centers such as Pasteur and Razi Institutes that are capable to detect TB and NTM species within the country. Due to the importance of these opportunistic microorganisms that caused pulmonary and extrapulmonary infections, the need for specialized personnel in this field seems to be necessary. Due to the weakness of governing bodies to educate personals in the TB laboratories, it is essential to have an academic degree as a “Master of Science (MSc)” in medical universities to educate skilled academic individuals in this particular field. As a consequence, we can expect to use the updated identification methods and perform research in various fields of NTMs. With no doubt, this course will help to recognize the related diseases and improve the overall public health problems because Mycobacterium species are no longer considered to be a narrow group of microorganisms.

Epidemiology of Nontuberculous Mycobacterial Infection in Tuberculosis Suspects.

Nontuberculosis mycobacteria (NTM) are opportunistic pathogens that cause a wide range of illnesses. Here, the species distribution and prevalence of NTM infections in tuberculosis suspects was analyzed. A total of 7,073 specimens from pulmonary and extrapulmonary sites were analyzed, and 709 (10%) were found to be culture positive for mycobacteria. Of these, 85.2% were identified as Mycobacterium tuberculosis complex and 14.8% as NTM (65.7% rapid growers and 34.3% slow growers). Speciation of the NTM isolates (n = 69) identified 19 NTM species. M. abscessus (33.3%) and M. fortuitum (24.6%) were the most dominant NTM species isolated from the patients, followed by M. porcinum (5.8%) and M. parascrofulaceum (4.3%). We also report peritonitis caused by rapidly growing NTM among the patients undergoing continuous ambulatory peritoneal dialysis and a case of M. senegalense peritonitis. A low prevalence but high species diversity of NTM was detected in our study. The high species diversity of NTM necessitates the need to unequivocally identify mycobacterial isolates for appropriate treatment.

Direct Molecular Characterization of Acid-Fast Bacilli Smear of Nontuberculosis Mycobacterium Species Causing Pulmonary Tuberculosis in Guna Yala Region, Panama.

Mycobacterium tuberculosis (MTB) stands out as the main causative agent of pulmonary tuberculosis (TB). However, nontuberculous mycobacteria (NTM) species also have the potential to infect and cause TB in susceptible individuals. The objective of this study was to identify NTM species that cause public health problems in remote areas. The study was carried out using 105 sputum smears obtained from patients from the Guna Yala Region of Panama with clinical signs suggestive of TB. DNA was extracted from sputum smears. Nontuberculous mycobacteria and MTB were characterized using polymerase chain reaction restriction analysis (hsp65, rpob) and an evaluation of 24-mycobacterial interspersed repetitive units-variable number of tandem repeats loci. Twenty-six Mycobacterium species were characterized; 19 (18%) were identified as MTB, and 7 (6.7%) were identified as NTM (four M. avium complex, two M. haemophilum, one M. tusciae). These results suggest that at least one in five cases of pulmonary TB among this population is caused by an NTM. Thus, identifying the bacteria causing pulmonary disease is key even in remote regions of the world where standard diagnosis and culture are not available. Strengthening the laboratory capacity within the Guna Yala Region is needed to identify NTM infections promptly.

Mycobacteria Tales Post Lung Transplantation: An Indian Experience

Purpose Post-lung transplant infection is one of the leading causes of morbidity and mortality. The diagnosis of pulmonary tuberculosis can be even more challenging in the setting of lung transplantation where other pulmonary complications can make diagnosis difficult. Infection may be caused by reactivation of a primary infection in the recipient, reactivation of a lesion from the donor lung, or primary infection. We present a retrospective study from India to define the incidence, clinical presentation, and course of Mycobacterial infections in a cohort of lung transplant recipients. Methods Between 1 April 2017 and 1 September 2020, 140 lung transplants were performed. Serial bronchoscopies with transbronchial biopsies and bronchioalveolar lavages were performed during follow-up. Explant Histopathological findings were taken into consideration. Pleural based interventions in the form of Tapping or CT guided Pleural biopsy were noted. Similarly, NTM infections were documented with species identification on cultures. Results 12 (8.57%) Recipients had Mycobacterial Infections post lung transplant. Mycobacterium Tuberculosis species was diagnosed in 9 patients (75%). Rest 3 recipients (25%) had Non-Tuberculosis Mycobacterium species (2 Mycobacterium abscessus and 1 Mycobacterium fortuitum). In 4 MTB patients, diagnosis was determined from the explanted lungs histopathology. The remainder were diagnosed during postoperative period. Median time to diagnosis was 40.5 days . Radiographic findings (HRCT scan) were Consolidations (n=3), Pleural Effusion (n=3), Tree in Bud (n=1), Cavity (n=1), no typical radiographical presentations (n=4) All patients responded well to anti-mycobacterial therapy. 3 recipients with NTM received individualised treatment for the same. Among these 12 recipients, 3 recipients expired with death attributable to Mycobacterial disease in only 1 recipient. Conclusion Mycobacterial Infection is not rare in lung transplant recipients and can be managed successfully with individualised antimycobacterial therapy. Non-Rifampicin based AntiMycobacterial treatment strategy is preferred to avoid drug interactions with immunosuppressants. Explant Lung Histopathology is an important tool to diagnose Tuberculosis specifically in Indian settings. NTM infection is not uncommon post lung transplantation & should have low threshold for diagnosis.

PCR-reverse blot hybridization assay in respiratory specimens for rapid detection and differentiation of mycobacteria in HIV-negative population

BackgroundRapid identification of pathogenic Mycobacterium species is critical for a successful treatment. However, traditional method is time-consuming and cannot discriminate isolated non-tuberculosis mycobacteria (NTM) at species level. In the retrospective study, we evaluated the clinical applicability of PCR-reverse blot hybridization assay (PCR-REBA Myco-ID) with clinical specimens for rapid detection and differentiation of mycobacterial species.MethodsA total of 334 sputum and 362 bronchial alveolar lavage fluids (BALF) from 696 patients with mycobacterium pulmonary disease (MPD) and 210 patients with non-mycobacterium pulmonary disease used as controls were analyzed. Sputum or BALF were obtained for MGIT 960-TBc ID test and PCR-REBA Myco-ID assay. High resolution melt analysis (HRM) was used to resolve inconsistent results of MGIT 960-TBc ID test and PCR-REBA Myco-ID assay.ResultsA total of 334 sputum and 362 BALF specimens from 696 MPD patients (292 MTB and 404 NTM) were eventually analyzed. In total, 292 MTBC and 436 NTM isolates (mixed infection of two species in 32 specimens) across 10 Mycobacterium species were identified. The most frequently isolated NTM species were M. intracellulare (n = 236, 54.1%), followed by M. abscessus (n = 106, 24.3%), M. kansasii (n = 46, 10.6%), M. avium (n = 36, 8.3%). Twenty-two cases had M. intracellulare and M. abscessus mixed infection and ten cases had M. avium and M. abscessus mixed infection. A high level of agreement (n = 696; 94.5%) was found between MGIT 960-TBc ID and PCR-REBA Myco-ID (k = 0.845, P = 0.000). PCR-REBA Myco-ID assay had higher AUC for both MTBC and NTM than MGIT 960-TBc ID test.ConclusionPCR-REBA Myco-ID has the advantages of rapid, comparatively easy to perform, relatively low cost and superior accuracy in mycobacterial species identification compared with MGIT 960-TBc ID. We recommend it into workflow of mycobacterial laboratories especially in source-limited countries.

The double-edged sword of Tregs in M tuberculosis, M avium, and M absessus infection.

Immunity against different Mycobacteria species targeting the lung requires distinctly different pulmonary immune responses for bacterial clearance. Many parameters of acquired and regulatory immune responses differ quantitatively and qualitatively from immunity during infection with Mycobacteria species. Nontuberculosis Mycobacteria species (NTM) Mycobacterium avium- (M avium), Mycobacterium abscessus-(M abscessus), and the Mycobacteria species Mycobacterium tuberculosis-(Mtb). Herein, we discuss the potential implications of acquired and regulatory immune responses in the context of animal and human studies, as well as future directions for efforts to treat Mycobacteria diseases.

Non-tuberculosis Mycobacteria (NTM) and the issue of false-reactors in tuberculination of cattle, an iranian observation

The genus Mycobacterium comprises a broad spectrum of obligate microorganisms most notably the M. tuberculosis complex bacteria; potentially-pathogenic or opportunistic species gathered under the common name of M. avium-intracellulare complex, and finally saprophytic mycobacteria. In cattle farming, Mycobacterium bovis (M. bovis) is considered as the principle cause for bovine tuberculosis (bTB). Nevertheless, non-tuberculosis mycobacteria (NTM) are potential pathogens that are increasingly reported to interfere with contemporary intradermal tuberculin tests in veterinary medicine. Therefore, these neglected mycobacteria are capable to make hurdles for bTB diagnosis. In the Iranian environment, the extent and importance of this phenomenon in regard with the public health and economical aspects is just underestimated. This work was therefore intended to isolate and characterize the mycobacterial organisms potentially involved in causing positive reactions in tuberculination of Iranian cattle. Abattoir meat inspection and laboratory microbiological investigation of slaughtered heifers from a 2,000-head Simental cattle farm with 10% of the herd positive tuberculin reactors, failed to provide any evidence of M. bovis infection. No mycobacteria was detected in bacterial culture of specimens from feedstuff, water or even the visiting feral rodents of the farm. When the farm workers were included in assessments, 22 individuals were found tuberculin-positive with 5 of them also smear-positive in their sputa assessment. Molecular identification of the five isolates from workers through sequencing of the 16SrRNA proved their identity as Mycobacterium thermoresistibile (Mth). Removing of the carrier workers from the farm vicinity, successfully ended the issue of the constantly-positive tuberculin test in the herd with no return of the problem until now. We are convinced further investigations are essential in search for interference extent and importance of NTM species in cattle tuberculination scheme in Iran.

No ntuberculous Mycobacteria

There has been a sharp increase in the number of diseases associated with potentially pathogenic microorganisms of the genus Mycobacterium, which differ from Mycobacterium tuberculosis. These bacteria are known as atypical mycobacteria or nontuberculosis mycobacteria (NTM), and the diseases they cause are called mycobacteriosis. NTMs include more than 20 species of acid-resistant microorganisms that are widespread in the environment and that are not members of the M. tuberculosis complex. However, the role of certain types of NTMs in the pathogenesis of human diseases is rather ambiguous. The aim of the paper was to analyse the current rise in the incidence of NTM diseases, as well as the main areas of research on early diagnosis of mycobacteriosis and the detection and testing of drug susceptibility of these microorganisms. The paper summarises current views on NTM species differences, their prevalence and pathogenicity for humans and animals. The authors analysed the main efforts aimed at diagnosis and treatment of NTM diseases. The paper cites the results of the study of NTM susceptibility/resistance to anti-tuberculosis drugs. The diagnosis of mycobacteriosis remains extremely difficult, mainly because of the similarity of the clinico-radiological evidence with that of tuberculosis. Detection of NTM multiple and extensive drug resistance to the majority of anti-tuberculosis drugs complicates the treatment of the NTM disease. Further study of various aspects of NTM diseases is especially important given the increase in the incidence and prevalence of mycobacteriosis all over the world, challenging differential diagnosis, and detection of NTM extensive drug resistance.

Marine Microbial Bioactive Compounds: New Way to Treat Resistance of Neglected Tropical Diseases

The neglected tropical diseases (NTDs) are most prevalent in cause severe and lifelong impairment in the world. Causing of these infectious diseases belongs to several pathogenesis groups, including vector-borne protozoa, bacteria and two species of non-tuberculosis mycobacteria. Despite causing serious complications, NTDs has been rarely concerned because the majority of cases occur in underdeveloped countries, whose health care standards are only acceptable to poor [1]. Nevertheless, recent studies have highlighted major technology hubs even markedly increased susceptibility to NTDs because natural population growth and over longstanding rural-urban migration.

2124. The Epidemiology, Demographics, and Geographical Distribution of Human Non-Tuberculosis Mycobacteria (NTM) Disease in the Endemic Central Florida Region

BackgroundOf the >100,000 people in the United States infected yearly with non-tuberculosis mycobacteria (NTM), Florida has the highest yearly incidence and prevalence of NTM disease. However, little has been documented on the epidemiology and distribution of NTM disease within Central Florida.MethodsA retrospective case review study was conducted from January, 2011 to December, 2017 at a large tertiary acute care medical center in Tampa, Florida to identify all NTM infection cases. Demographics (age, sex at birth, ethnicity), comorbidities, HIV testing status, residential zip code, NTM species, and specimen sources were collected.ResultsOf the 507 isolates, Mycobacterium abscessus group was the most common (45.4%; n = 230), and contained M. abscessus spp. abscessus (34.5%; n = 175), M. abscessus spp. massilense (8.7%; n = 44), and M. abscessus spp. bolletii (1.18%; n = 6). Other rapid growers were M. fortuitum species (6.9%; n = 35) and M. chelonae (2.56%; n = 13). Of the slower growers, M. gordonae (19.9%; n = 101) and M. avium complex (8.28%; n = 42) were the most common. Of the M. avium complex, M. chimera was most common (4.9%; n = 25). Samples were mostly isolated from sputum (51.7%; n = 262), bronchial lavage (26%; n = 132), skin and soft tissue (11%; n = 58), and blood (7.1%; n = 36). Of the 361 unique patients, average age was 59.2 years (12 to 95 years), with 47.6% (n = 172) greater than 65 years of age, and mostly male 57.9% (n = 208). Caucasians represented 73.4% (n = 265) of our cohort, and African Americans and Hispanics represented 16.3% (n = 59) and 6.8% (n = 24), respectively. Most cases were in those residing outside the Tampa Bay metro area 81.2% (n = 293/361). Notable comorbidities included COPD (n = 83), cystic fibrosis (n = 41), lung transplant (n = 40), heart transplant (n = 12), pulmonary fibrosis (n = 12), and renal transplant (n = 7). A total of 145 individuals received HIV testing at the hospital facility, and of these 44 individuals were living with HIV.ConclusionThis study identified a diversity of NTM species across a wide geographical and demographic distribution in the endemic Central Florida region. M. abscessus group had the highest prevalence. This is valuable in understanding which populations are at risk for developing NTM infection in this area of Florida. Disclosures All authors: No reported disclosures.

Non-tuberculous mycobacteria profiles and their anti-mycobacterial resistance at a major medical center in Lebanon

Infection with non-tuberculosis mycobacteria (NTM) has been on the rise globally causing a wide spectrum of respiratory and extrapulmonary infections in humans. Studies on these pathogens from the Middle-East including Lebanon are scarce. This retrospective study addresses the approach used for investigation, speciation and antimicrobial resistance (AMR) profiles of recovered NTM isolates from respiratory sources at a major tertiary care center in Lebanon during two periods (2003-2007 and 2013-2017). Processing of specimens, culture and differentiation of recovered NTM isolates from Mycobacterium tuberculosis were done in-house according to standard procedures. Upon request, speciation and AMR testing were performed using molecular and broth dilution methods, respectively, at Mayo Medical Laboratories (Rochester, Minnesota, USA). Among 108 NTM analyzed isolates, 8 species were revealed during the two periods: M. simiae (51% vs 61%), M. avium complex (MAC) (6 % vs 12%) M. fortuitum (12% vs 5%), M. gordonae (6% vs 5%), M. abscessus (6% vs 7%), M. immunogenum (12% vs 0%), M. szulgai (4% vs 0%) and M. peregrinum (0% vs 2%). M. simiae isolates showed high susceptibility (93%-96%) to amikacin and clarithromycin, but high resistance to rifampin, ethambutol, ciprofloxacin, rifabutin, linezolid, trimethoprim/sulfamethoxazole and moxifloxacin. MAC isolates were only susceptible to clarithromycin (86%). M. abscessus isolates were uniformly susceptible to amikacin (100%). The revelaed different NTM species, with predominance of M.simiae and various AMR profiles provide a current epidemiologic database and help guiding the selection of appropriate empirical therapy once the clinical relevance is established.

Prevalence and Risk Factors for Pulmonary Mycobacteriosis in Lagos, Nigeria

Background: Pulmonary mycobacteriosis has been documented in HIV-infected, diabetics, asthmatics, smokers and alcoholics and its progression and severity are affected by these risk factors. Inappropriate diagnosis of mycobacteriosis could lead to inappropriate treatment with anti- tuberculosis drugs.
 Methods: This cross-sectional, prospective study was conducted in patients with TB-like diseases attending six DOTs centres in Lagos, Nigeria, from May 2012 to October 2016. Participants’ informed consent was obtained, structured questionnaires administered to obtain socio-demographic and co-morbid data. Sputum samples collected and processed for microscopy and culture using Lowenstein-Jensen medium with or without pyruvate and MGIT 960 liquid medium. Mycobacteria were identified using MPT64 immunochromatographic, biochemical and molecular methods. This study investigated the presence and prevalence of mycobacteriosis in the participants and assessed the risk factors for the mycobacterial infections.
 Results: Of the 1,020 participants, 339 (33.2%) had mycobacteriosis of which 33 (9.7%) were caused by Non-Tuberculosis Mycobacteria (NTM) and 306 (90.3%) caused by Mycobacterium tuberculosis complex (MTBC). Of the isolated 306 MTBC, 247 (80.7%) were M. tuberculosis, 28 (9.2%) were M. africanum, 23 (7.5%) were M. bovis while 8(2.6%) were M. ulcerans [P < 0.0005]. The 33 NTM showed 11 (33.3%), 20 (60.6%) had HIV, 8(24.2%) M. fortuitum, 2 (6.1%) M. abscessus, 2 (6.1%) M. scrofulacium, 6 (18.2%) M. kansasii, 4 (12.1%) M. megateriense and 11 (33.3%) Mycobacterium avium complex (MAC). Sequence analysis of the 16s rRNA of the 11 MAC showed 3 (27.3%) M. avium, 5(45.5%) M. intracellulare, 2(18.2%) M. colombiense and 1(9.1%) M. velneri. M. fortuitum and MAC were significantly (P<0.05) associated with HIV infection, while only M. fortuitum relate strongly with diabetes (P <0.05).
 Conclusion: The study showed that mycobacteriosis is caused by different species of MTBC and NTM. Relatively high mycobacteriosis were detected during dry season and were significantly associated with gender, age, HIV and diabetes.

Case report of isolation of Mycobacterium setense from a hospital water supply

Objective: The current study is a report of isolation and identification of Mycobacterium setense from a tap running water in a general surgery ward in a hospital in Isfahan, Iran. Materials and Methods: This bacterium was obtained from a hospital water sample according to the cetylpyridinium chloride 0.005% method on Lowenstein–Jensen slant and characterized to the species level as M. setense using results of phenotypic test and 16S rRNA sequencing. Results: This isolate identified to the species level using the conventional and molecular method as M. setense, this bacterium has highest similarity (100%) with those of M. setense CIP109395 16S rRNA gene sequences. Conclusion: This study can be useful and provide important information for learning about the natural habitats of pathogenic species of nontuberculosis mycobacteria. Furthermore, the molecular tests such as 16S rRNA gene sequencing can be applied for reliable and appropriate identification of mycobacterial species.