Tuberculous Mycobacteria Research Articles

Lobar distribution in non-cystic fibrosis bronchiectasis predicts bacteriologic pathogen treatment

Non-cystic fibrosis bronchiectasis (NCFBr) is a major cause of morbidity due to frequent infectious exacerbations. We analyzed the influence of patient age and bronchiectasis location on the bacterial profile of patients with NCFBr. This retrospective cohort study included 339 subjects diagnosed with an infectious exacerbation of NCFBr during the 9-year period between January 2006 and December 2014. Bronchoalveolar lavage (BAL) cultures and high-resolution computed tomography scans (HRCT) were utilized to characterize the location of the bronchiectasis and bacteriologic pathogenic profile. In univariate logistic regression, the frequency of Haemophilus influenzae was higher in patients aged ≤64 years (OR = 0.969, p < 0.0001, 95 % CI 0.954-0.983), whereas the frequency of Pseudomonas aeruginosa (OR = 1.027, p = 0.008, 95 % CI 1.007-1.048) and Enterobacteriaceae (OR = 1.039, p = 0.01, 95 % CI 1.009-1.069) were significantly higher in patients aged >64 years. The lobar distribution of bronchiectasis in the subjects was 25.9 % in the right middle lobe (RML), 20.7 % in the right lower lobe (RLL), 20.4 % in the left lower lobe (LLL), 13.8 % in the lingula, 13 % in the right upper lobe (RUL), and 6.2 % in the left upper lobe (LUL). In the lower lobes, H. influenzae was the dominant species isolated, whereas in the RUL it was P. aeruginosa and in the LUL it was non- tuberculous mycobacterium (NTM). H. influenzae was more prevalent in younger patients, whereas P. aeruginosa, Enterobacteriaceae and NTM predominated in older patients. Different pathogens were associated with different lobar distributions. The RML, RLL and LLL showed a greater tendency to develop bronchiectasis than other lobes.

Preliminary Study on the Prevalence of Bovine Tuberculosis and Risk Factors among Pastoralists in Gombe State, North Eastern Nigeria

A cross-sectional study was conducted in GombeState (North- eastern, Nigeria) from March, 2011 to April 2013 to estimate the prevalence of bovine tuberculosis (BTB) based on single caudal intradermal tuberculin test (SCITT), questionnaire and an abattoirs survey. The study was conducted among 250 households (100 household with a history or confirmed case of pulmonary tuberculosis and 150 households who had no history or confirmed case of pulmonary Tb), who raised 217 herds comprising of 2,245 herds of cattle. Questionnaire administration and Bioline® analysis of sputa collected from all pastoralists who were suspected to have TB and were smear positive were also conducted. Herd prevalence of SCITT was 13.87% and was higher than in herds of the negative households. At least one human Tb case was observed among 25% of the households interviewed, whereas 48% had reactor cattle. However, there was no statistically significant association (P>0.05) between the human Tb cases observed and the presence of reactor cattle. Similarly, fourty (40) isolates of Mycobacteria spp were obtained from the cultured sputa collected from the pastoralists, and were subjected to Ziehl-Nelson (ZN) and Bioline® analysis, where sixteen (16) of the (40%) were found to be M. tuberculosis complex (MTC) and the remaining 24 (60%) were members of Non- tuberculous Mycobacteria (NTM). All the isolates obtained (both sputum and tissues) which were identified as MBTC, were subjected to genotype MBTC ® Hain assay PCR analysis in order to differentiate them in to their various species of the MBTC isolates from the tissues, 8 (4.0%) were found to be M. bovis, 5(2.5%) wereM.tb and the remaining 5(2.5%) were unidentified using the standard banding patterns. The 40MBTC from sputum were analyzed as follows, 30 (75%) as M.tb, 6(15%) were M. bovis and 3(7.5%) were M. africanum. The remaining 1(0.4%) were unidentified using the standard banding patterns. All the isolates obtained (both sputum and tissues) which were identified as MBTC, were subjected to genotype MBTC ® Hain assay PCR analysis in order to differentiate them in to their various species of the MBTC isolates from the tissues, 8 (4.0%) were found to be M. bovis, 5(2.5%) wereM. tb and the remaining 5(2.5%) were unidentified using the standard banding patterns. The 40MBTC from sputum were analyzed as follows, 30 (75%) as M.tb, 6(15%) were M. bovis and 3(7.5%) were M. africanum. The remaining 1(0.4%) were unidentified using the standard banding patterns. However, a significant difference (p>0.05) was observed among the cattle age group, cattle over five (5) years were seen to have higher odds for tuberculin reactivity compared to those below the age of five (5). Out of the total cattle population (57,943) subjected to post mortem examination at the abattoir, 205 were found to be positive for gross Tb lesions, where a large proportion (50%) of the lesions were recorded in the respiratory pathway, digestive system (21%) and prescapular lymph nodes (18.6%). In spite of all these findings, it was observed that 70% (175 out of 250) of the respondents had knowledge of the existence of the disease but did not know the zoonotic implication. Also, all the potential risk factors of the disease transmission between cattle and human (milk consumption, livestock husbandry and presence of Tb positive cattle) were not statistically significantly (P< 0.05). In conclusion, it was observed that cattle belonging to the pastoralists who were positive for Mycobacterium species were more affected than those who were negative and lack of zoonotic awareness of the households. Therefore, further study to differentiate the MTC (Mycobacterium tuberculosis complex) using molecular analysis, collaboration between physicians and veterinarians and creation of awareness about the zoonotic nature of the disease were recommended.

TUBERCULOSIS CONTROL SITUATION IN TERRITORIES OF THE RUSSIAN FEDERATION SUPERVISED BY CENTRAL TUBERCULOSIS RESEARCH INSTITUTE, 2014-2015

The article presents the results oftuberculosis epidemic situation analysis in 15 Russian regions supervised by the Institute in 2014-2015. Tuberculosis incidence decreased in 11 regions out of 15 in 2014-2015. 4 regions demonstrated minor increase. Tuberculosis incidence among children in the age from 0-17 years old went down in 10 regions and increased in 5. Tuberculosis mortality decreased butin 3 regions itis higher than the average Russian rate (9.2 per 100,000 pop.). Treatment efficiency among new tuberculosis cases registered for treatment in 2014 with positive sputum microscopy varied from 69.8% in Orel Region down to 32.6% in Ulyanovsk Region, treatment efficiency as persputum conversion by culture – from 70.6% in Orel Region down to 34.2% in Ulyanovsk Region, treatment efficiency as per cavity healing – from 72.3% in Orel Region down to 40.2% in Ulyanovsk Region. The main reasons of low chemotherapy effectiveness are defaults from treatment, multiple drug resistance and insufficient surgical activities. In order to enhance the treatment efficiency, rapid drug susceptibility testing techniques are to be introduced everywhere with susceptibility testing to all anti-tuberculosis drugs and adequate chemotherapy regimens are to be applied consisting only of those drugs to which tuberculous mycobacteria are susceptible, surgical treatment is to be used more often.

ОБМЕН ЖЕЛЕЗА У МИКОБАКТЕРИЙ

The review analyzes the major foreign publications on the iron exchange in mycobacteria for the recent years. The issues of iron absorption by tuberculous mycobacteria, its preservation and regulation of their metabolism have been reviewed. Deeper and more detail description of the above process will provide new opportunities for therapeutic interventions into it and assist in development of new tuberculosis treatment techniques.

Mycobacterium abscessus Urinary Infection in Hypertensive Patient: A Case Report

Mycobacterium abscessus is a common non tuberculous mycobacterium associated with diseases in patients with underlying conditions. The diagnosis is often missed in resource limited settings. We reported a case of M. abscessus in a patient with renal failure. A young female patient admitted at the hospital for kidney failure was diagnosed with malignant hypertension based on clinical and laboratory findings. Over the course of hospitalization, the patient presented hematuria and leukocyturia and the urine culture was positive for acid-fast bacilli. Empirically antituberculous treatment given to the patient was changed to clarithromycin after confirmation of M. abscessus by probe line hybridization assay. Favorable outcome was achieved with regression of symptoms and the decrease of the serum creatinine level. In patients with underlying conditions, differential diagnosis should be considered particularly in resource limited settings.

Genomics and Proteomics of Virulent, Avirulent and Drug Resistant Strains of Tuberculous Mycobacteria

Mycobacterium tuberculosis (MTB), the causal organism of the oldest infectious disease tuberculosis is the leading cause of morbidity and mortality worldwide. This pathogenic organism has been evolved into variety of strains with diverse genotype, phenotype and pathogenic properties such as MTB H37Rv and CDC1551 strains which are virulent, while MTB H37Ra is an a virulent strain and MTB KZN strain is resistant to different antituberculosis drugs. Due to the advancement in genome sequencing and molecular biology, whole genomes of different MTB strains have been completely sequenced. Genomic as well as proteomic comparison among the sequenced strains will help in understanding the differences between virulent, a virulent and resistant organisms. This article reviews the information available on completely sequenced MTB strains and presents the studies reported by researchers on genomic and proteomic comparison of various MTB strains.

EVALUATION OF DIAGNOSTIC ACCURACY OF THE COMPARATIVE TUBERCULIN SKIN TEST IN REHABILITANT BORNEAN ORANGUTANS (PONGO PYGMAEUS)

The tuberculin skin test (TST) has been the mainstay of tuberculosis (TB) testing in primates for decades, but its interpretation in orangutans (Pongo spp.) is challenging, because many animals react strongly, without evidence of infection with Mycobacterium tuberculosis complex. One explanation is cross-reactivity with environmental nontuberculous mycobacteria (NTM). The use of a comparative TST (CTST), comparing reactivity to avian (representing NTM) and bovine (representing tuberculous mycobacteria) tuberculins aids in distinguishing cross-reactivity due to sensitization by NTM from shared antigens. The specificity of the TST can be increased with the use of CTST. We considered three interpretations of the TST in rehabilitant Bornean orangutans ( Pongo pygmaeus ) using avian purified protein derivative (APPD; 25,000 IU/ml) and two concentrations of bovine purified protein derivative (BPPD; 100,000 and 32,500 IU/ml). The tests were evaluated for their ability to identify accurately seven orangutans previously diagnosed with and treated for TB from a group of presumed negative individuals (n = 288 and n = 161 for the two respective BPPD concentrations). BPPD at 32,500 IU/ml had poor diagnostic capacity, whereas BPPD at 100,000 IU/ml performed better. The BPPD-only interpretation had moderate sensitivity (57%) and poor specificity (40%) and accuracy (41%). The comparative interpretation at 72 hr had similar sensitivity (57%) but improved specificity (95%) and accuracy (94%). However, best results were obtained by a comparative interpretation incorporating the 48- and 72-hr scores, which had good sensitivity (86%), specificity (95%) and accuracy (95%). These data reinforce recommendations that a CTST be used in orangutans and support the use of APPD at 25,000 IU/ml and BPPD at 100,000 IU/ml. The highest score at each site from the 48- and 72-hr checks should be considered the result for that tuberculin. If the bovine result is greater than the avian result, the animal should be considered a TB suspect.

53 Non-tuberculous mycobacteria in cystic fibrosis: A single centre study of prevalence, sampling and microbiological outcomes

Background The rise in non tuberculous mycobacteria (NTM) from cystic fibrosis patients is of concern. Discerning pathogenicity from colonisation increases difficulty in treatment. Objective The aims of the study were to evaluate the impact of NTM's by calculating prevalence and species distribution. Macrolide use in the context of NTM sampling was analyzed as were microbiological outcomes of patients who received treatment with those not considered for therapy. Methods This was a single centre study of cystic fibrosis patients in Glasgow. Electronic databases and written case notes were used to gain microbiological and clinical information. Data was collected from patients who had at least one NTM screen processed. Results The prevalence of NTMs was 14.9%, the majority species was the Mycobacterium abscessus group (MABSC) followed by Mycobacterium avium complex (MAC). The majority received macrolides prior (58%) and equal figures after first positive culture (50%), predominantly within the MAC group. Despite treatment, microbiological eradication rates (57%) were similar to untreated transient colonisation (61%). Data showed MABSC equally likely to be eradicated or persistent post treatment (50% vs 50%). Conclusion The data showed an increasing prevalence of NTMs with predominance of MABSC. A potential link between macrolide monotherapy and increasing, persisting NTMs is a concern. This requires more research and judicial use of macrolides. The emergence of MABSC highlights that further studies are required regarding subspecies and transmission. These increasing numbers mandate a multidisciplinary approach for management.

The Psp system of Mycobacterium tuberculosis integrates envelope stress-sensing and envelope-preserving functions.

The bacterial envelope integrates essential stress-sensing and adaptive functions; thus, envelope-preserving functions are important for survival. In Gram-negative bacteria, envelope integrity during stress is maintained by the multi-gene Psp response. Mycobacterium tuberculosis was thought to lack the Psp system since it encodes only pspA and no other psp ortholog. Intriguingly, pspA maps downstream from clgR, which encodes a transcription factor regulated by the MprAB-σ(E) envelope-stress-signaling system. clgR inactivation lowered ATP concentration during stress and protonophore treatment-induced clgR-pspA expression, suggesting that these genes express Psp-like functions. We identified a four-gene set - clgR, pspA (rv2744c), rv2743c, rv2742c - that is regulated by clgR and in turn regulates ClgR activity. Regulatory and protein-protein interactions within the set and a requirement of the four genes for functions associated with envelope integrity and surface-stress tolerance indicate that a Psp-like system has evolved in mycobacteria. Among Actinobacteria, the four-gene module occurred only in tuberculous mycobacteria and was required for intramacrophage growth, suggesting links between its function and mycobacterial virulence. Additionally, the four-gene module was required for MprAB-σ(E) stress-signaling activity. The positive feedback between envelope-stress-sensing and envelope-preserving functions allows sustained responses to multiple, envelope-perturbing signals during chronic infection, making the system uniquely suited to tuberculosis pathogenesis.

First approach to the identification of clinically relevant non tuberculous mycobacteria (NTM) from solid media by matrix-assisted laser desorption/ionization spectrometry (MALDI-TOF MS) protein analysis

First approach to the identification of clinically relevant non tuberculous mycobacteria (NTM) from solid media by matrix-assisted laser desorption/ionization spectrometry (MALDI-TOF MS) protein analysis

Utility of a lateral flow assay for culture confirmation of Mycobacterium tuberculosis complex

BackgroundTherapy for the clinical management of patients with Mycobacterium tuberculosis complex (MTBC) and non tuberculous mycobacteria (NTM) is different. Prompt detection and discrimination is necessary for administration of suitable therapy. MethodsThe aim of the study was to evaluate the performance of a Immunochromatographic Test (ICT) in rapid differentiation of MTBC from NTM grown in Lowenstein-Jensen medium and MGIT broth in comparison to molecular methods. ResultsOf the 106 isolates in this study, 96 and 95 were identified as MTBC by 16S rRNA PCR and MPT64 respectively. The sensitivity and specificity of MPT64 was found to be 99% and 100% respectively. ConclusionThe Lateral Flow Assay Test is a useful and specific tool in rapid differentiation of M. tuberculosis complex from culture. Therefore proper identification avoids unnecessary ATT to patients infected with NTM.

Molecular Identification of Clinical Isolates of Mycobacterium fortuitum by Random Amplified Polymorphic DNA (RAPD) Polymerase Chain Reaction and ERIC PCR.

Non tuberculous mycobacteria (NTM) are of importance now-a-days due to their increasing virulence outbreaks and emerging antibiotic resistance. Since the most common NTM in Iran is reportedly Mycobacterium fortuitum, the present study was designed with the aim of molecular identification of clinical isolates of M. foruitum to analyse their heterogeneity. A total of 81 isolates of NTM isolated from various samples were collected. The clinical isolates were assigned to species M. fortuitum by using conventional and molecular methods. The DNA banding patterns of ERIC- PCR and RAPD- PCR were analysed by using Bionumeric 7.5 software. Out of 81 tested NTM, 36 strains of M. fortuitum were identified. 33 isolates were selected for molecular typing in this study. Based on RAPD and ERIC analysis, M. fortuitum isolates were divided into 3 and 6 clusters, respectively. Most of the isolates were distributed into types of II RAPD (20 members/ 60.6 %) and V (14 members/ 42.4% with sub cluster I & II) of ERIC. In RAPD analysis, the major fragments were 300 bp, followed by fragment 1000. In ERIC analysis, the major fragments were 280 bp followed by fragment 1200 bp. In conclusion, though the results from this study represented higher discriminatory power of ERIC, however the combination of RAPD and ERIC analysis were able to sufficiently discriminate the genotypic diversity, infection control, and gain useful epidemiological information regarding M. fortuitum isolates.

Molecular Characterization of Mycobacterial Ribonucleotide Reductase (RNR) and its Implication as a Novel Drug Target

The genus Mycobacterium consists of both pathogenic and non-pathogenic species. The emergence of MDR and XDR tuberculosis and opportunistic infections by non tuberculous mycobacterium in immunosuppressive persons are major concern now a days. The aim of the study was to characterize ribonucleotide reductase (RNR) of Mycobacterium species to produce information about the evolution of the gene which could further be used in targeting RNR as a novel drug target. Here we were analyzed RNR of 23 mycobacterial species. The sequence length of RNR region is about 975 bp. Out of 975 characters 625 (64.10%) are conserved sites (monomorphic) and 350 (35.89%) are variable sites (polymorphic). The total nucleotide diversity (π) is=0.120114 (12.011%). The RNR phylogeny approach in Mycobacterium species provides evidence of several evolutionary lineages evolving from the ancestral polymorphism and fixed in the descendant population. Species of mycobacteria causing tuberculosis or respiratory infection in humans have specific patterns of allele distribution in different motifs, which differentiate them from other opportunistic mycobacterial species. Molecular analysis and structural motif analysis of RNR suggests the occurrence of host-mediated genetic differentiation in mycobacterial species, which requires further wet lab investigations.

Cost-effectiveness of point-of-care digital chest-x-ray in HIV patients with pulmonary mycobacterial infections in Nigeria.

BackgroundChest-x-ray is routinely used in the diagnosis of smear negative tuberculosis (TB). This study assesses the incremental cost per true positive test of a point-of-care digital chest-x-ray, in the diagnosis of pulmonary mycobacterial infections among HIV patients with presumed tuberculosis undetected by smear microscopy.MethodsConsecutive patients with clinical suspicion of pulmonary tuberculosis were serially tested for Human immunodeficiency virus (HIV), their sputum examined for Acid Fast Bacilli then cultured in broth and solid media. Cultures characterized as tuberculous (M.tb) and non-tuberculous (NTM) mycobacteria by Hain assays were used as gold standards. A chest-x-ray was classified as: (1) consistent for TB, (2) not consistent for TB and (3) no pathology.ResultsOf the 1391 suspected cases enrolled, complete data were available for 952 (68%): 753/952 (79%) had negative smear tests while 150/753 (20%) had cultures positive for TB. Of those, 82/150 (55%) had chest-x-ray signs consistent with TB and 29/82 (35%) were positive for HIV. Within the co-infected, 9/29 (31%) had NTM infections. Among all suspects, the cost per positive case detected using smear microscopy test was $52.84; the overall incremental cost per positive case using chest-x-ray in smear negatives was $23.42, and in smear negative, HIV positive patients the cost was $15.77.ConclusionPoint-of-care chest-x-ray is a cost-effective diagnostic tool for smear negative HIV positive patients with pulmonary mycobacterial infection.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0675-0) contains supplementary material, which is available to authorized users.

Incidence and aetiologies of pulmonary granulomatous inflammation: a decade of experience.

Granulomatous lung disease (GLD) is caused by a wide range of conditions. Often there is a need to correlate pathological findings with clinical, microbiological or radiological data to determine an aetiology. The aim of this study was to determine the different aetiologies of GLD over the past decade. Among 2228 consecutive lung specimens from 1999 to 2011, 226 cases (10.1%) were positive for GLD. One hundred ninety patients were retrospectively reviewed and diagnoses were assigned based on availability of histological/clinical/microbiological correlation. A confident, probable and uncertain diagnosis was made in 68.4%, 13.2% and 18.4% patients. The aetiologies comprised infectious, non-infectious and uncertain in 54.7%, 26.8% and 18.4% patients. Mycobacterial infections constituted 27% of all patients, and included atypical, tuberculous and unclassified mycobacteria in order of frequency. Acid-fast bacilli (AFB) were visualized in tissue sections in 29% cases and cultured in 73% cases. Fungal infections comprised 27% of all cases, which included Coccidioides, Cryptococcus, Aspergillus and Histoplasma in order of frequency. Fungi were visualized in tissue sections with Gomori methenamine silver (GMS) stain in 83% patients and cultured in 52% cases. Sarcoidosis was the major non-infectious aetiology, constituting 21% of all patients. Necrosis in granulomas was associated with the presence of infection (P < 0.001). The aetiology in necrotizing GLD with negative AFB and GMS stains is most likely infectious due to atypical mycobacteria. Coccidioidomycosis was the most common fungal infection. The aetiology in non-necrotizing GLD is most likely non-infectious, probably sarcoidosis.

Mendelian Susceptibility to Mycobacterial Disease Presenting With Cholecystitis

Introduction: Mendelian susceptibility to mycobacterial disease (MSMD) is a rare and recently discovered primary immunodeficiency syndrome characterized by a predisposition to intracellular pathogens, non-tuberculous, and tuberculous mycobacteria. Recognition of this disease spectrum is important in guiding appropriate investigations and management. A 47-year-old Hmong female with a past history of remote pulmonary tuberculosis presented with fever, abdominal pain, and diarrhea for 3 days. Four months prior to this, she developed a bulky right cervical lymphadenopathy extending to the upper mediastinum. At that time, biopsy of the lymph node revealed necrotizing granulomatous inflammation and blood tests were pertinent for intermediate results of QuantiFERON-TB Gold and Salmonella O group B bacteremia, for which she completed a 14-day course of oral ciprofloxacin. Cultures of the lymph node yielded Histoplasma capsulatum, which was treated with intravenous amphotericin, followed by oral itraconazole. On initial exam, she was febrile and suffered from septic shock, and had a positive Murphy’s sign. Labs were pertinent for acute kidney injury, lactic acidosis, and no obstructive pattern on liver enzymes. Ultrasonography revealed acute cholecystitis, gallstones, sludge, and dilated common bile duct of 10 millimeters. The patient received antibiotics, biliary stenting, intraoperative cholangiogram, and subsequent cholecystectomy. Her blood cultures on this admission again grew Salmonella O group B. Her HIV status was unremarkable, normal CD4 counts, and T4/T8 ratio of 0.4 (0.8-3.7). Four months after this admission, she developed left-sided chest pain for 2 days with a new left supraclavicular lymphadenopathy causing isolated left internal jugular venous dilation. Biopsy of the lymph node was unremarkable, but both of blood cultures and the lymph node culture grew Mycobacterium avium intracellulare. She was treated with oral azithromycin, ethambutol, and intravenous amikacin. Molecular analysis of the interferon-gamma/interleukin-12 cascade revealed autoantibodies to interferon gamma. A defect in the interferon-gamma/interleukin-12 cascade should be suspected in patients who are vulnerable to recurrent systemic salmonellosis, extensive infections with mycobacterium, and intracellular pathogen, e.g. Histoplasma capsulatum. The spectrum is phenotypically described as MSMD, which is derived from Mendelian inheritance of defects in the cascade. This case also highlights an unusual presentation of MSMD as cholecystitis. Molecular and genetic analysis are required to define specific defect and possible treatment, e.g. interferon-gamma therapy and vaccinations, in addition to standard antibiotic regimens.

Isolation and characterization of non tuberculous mycobacteria from humans and animals in Namwala District of Zambia.

BackgroundThe genus Mycobacterium contains more than 100 species, most of which are classified as non-tuberculous mycobacteria (NTM). In Zambia, the NTM are slowly becoming recognized as pathogens of major public health significance with the advent of Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS). This study aimed at reporting the isolated NTM and ascertains their zoonotic potential and diagnostic significance in Zambia.MethodA total of 100 sputum samples were collected from three health facilities from suspected pulmonary tuberculosis human patients. In addition, 67 lymph node tissue samples from cattle and 14 from Kafue lechwe (Kobus leche kafuensis) showing tuberculosis-like lesions were collected. The samples were appropriately decontaminated and cultured on Middlebrook 7H10 and Stone brink. The isolates were then identified accordingly using the 16S ribosomal RNA analysis method.ResultsA total of 8 NTM were isolated from human sputum, 12 from cattle and 1 from the Kafue lechwe. The identified NTM included M. intracellulae, M. abscess, M. chimaera, M. bolleti, M. fortuitum and M. stomatopae sp. Nov.ConclusionThe isolation of NTM from humans and animals at the interface in Namwala district has highlighted the clinical significance and diagnostic challenge. The epidemiological investigation of NTM in the study area is therefore recommended. This should include sampling from environmental sources such as water and soil.

Non-tuberculous mycobacterial infections of veterinary relevance

Mycobacteria play an important role in human and animal health fields. We here examine the place of non tuberculous mycobacteria (NTM) infections in the veterinary context. Relevant aspects of a reference laboratory experience and a literature review are presented in this article. Importance is given both to productivity and to economic losses due to misdiagnosis with bovine tuberculosis and paratuberculosis. The impact NTM may have is relative to geographical location, ecology, husbandry, extent of surveillance programs and bovine tuberculosis and paratuberculosis prevalence. The role of the most relevant NTM in animal disease is summarized with a special focus on Mycobacterium avium subsp. paratuberculosis, given its role as causative agent of paratuberculosis, a disease with huge economic consequences for ruminant livestock.

Usefulness of PCR to Mycobacterium Tuberculous and Nontuberculous Mycobacteria from Paraffin-embedded Tissues

Usefulness of PCR to Mycobacterium Tuberculous and Nontuberculous Mycobacteria from Paraffin-embedded Tissues

High diagnostic yield of line probe assay as a point-of care test in a TB rural setting

Background Tuberculosis is the second leading cause of death due to infectious disease worldwide. Delay in bacilli isolation in culture, cumbersome susceptibility testing methods, lack of methods for differentiation of Mycobacterium tuberculosis (MTB) from non tuberculous mycobacteria, are important issues which impinge on the WHO’s millennium goal of disease reduction by 2015. Traditional methods of TB detection and anti tB drug susceptibility assays are time consuming and with a steep rise in number of MDR tB cases the need of the hour is rapid diagnostic methods like direct drug susceptibility testing in liquid medium, molecular hybridization methods and RealTime PCR.