Unclassified Mycobacteria Research Articles

Utility of urine lipoarabinomannan (LAM) in diagnosing mycobacteria infection among hospitalized HIV-positive patients

ObjectivesCross-reactivity with nontuberculous mycobacteria (NTM) species might limit the use of urine lipoarabinomannan (LAM) test to diagnose tuberculosis (TB) in people living with HIV (PLWH). This study aimed to investigate the utility of the LAM test among hospitalized HIV-positive patients. MethodsThis prospective study enrolled HIV-positive inpatients with any TB symptom or seriously ill patients with advanced immunodeficiency. Urine samples were tested using the Alere Determine LAM Ag, and participants were categorized as confirmed TB, confirmed NTM infection, unclassified mycobacteria infection, and no mycobacteria infection based on microbiologic reference standards. ResultsA total of 382 participants were included. The prevalence of confirmed TB and NTM infection was 5.24% (20 of 382) and 4.45% (17 of 382), respectively. The sensitivity and specificity of the urine LAM for TB diagnosis were 65.00% (95% confidence interval [CI] 40.78-84.61) and 89.36% (95% CI 85.68-92.36), respectively. The LAM test for NTM yielded a sensitivity of 58.82% (95% CI 32.92-81.56) and specificity of 88.61% (95% CI 84.87-91.70). Notably, the negative predictive values of the urine LAM for TB and NTM were 97.85% (95% CI 95.63-99.13) and 97.85% (95% CI 95.63-99.13), respectively. ConclusionsCross-reactivity with NTM cause high false-positive LAM for TB diagnosis in PLWH. The correct identification of mycobacteria species is crucial for deciding treatment strategies.

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.

TB or not TB?

<scp>TB</scp> or not <scp>TB</scp>?

Experimental studies on immunizing effects of unclassified Mycobacteria against tuberculous infection

Experimental studies on immunizing effects of unclassified Mycobacteria against tuberculous infection

Five Rare Non-Tuberculous Mycobacteria Species Isolated from Clinical Specimens

Background: Recently, the rate of infections with non-tuberculous mycobacteria (NTM) has been increasing in Korea. Precise identification of NTM is critical to determination of the pathogen and to target treatment of NTM patients.Methods: Sixty-eight unclassified mycobacteria isolates by rpoB PCR-RFLP assay (PRA) collected in 2008 were analyzed by National Center for Biotechnology Information (NCBI) Basic Local Alignment Search Tool (BLAST) search after sequencing of 16S rRNA, hsp65, rpoB genes.Results: Nineteen strains of 68 isolates were specified as species after sequencing analysis of 3 gene types. We found 3 M. lentifulavum, 5 M. arupense, 4 M. triviale, 4 M. parascrofulaceum, and one M. obuense. One M. tuberculosis and another M. peregrinum were mutated at the Msp I recognition site needed for rpoB PRA. The remaining 49 isolates did not coincide with identical species at the 3 kinds genes.Conclusion: Sequencing analysis of 16S rRNA, hsp65, rpoB was useful for identification of NTM unclassified by rpoB PRA.Key Words: Mycobacteria, Atypical; RNA, Ribosomal, 16S; rpoB protein; Heat-Shock Protein 64

Mycobacterium kubicae sp. nov., a slowly growing, scotochromogenic Mycobacterium.

A previously uncharacterized, slowly growing, scotochromogenic Mycobacterium species was detected by HPLC analysis of the cell-wall-bound mycolic acids. The mycolic acid pattern standard was shown to be a late-eluting, contiguous peak cluster occurring at approximately 8-9 min. The mycolic acid pattern was noted to be most similar in number of peaks and range of elution to that reported previously for Mycobacterium asiaticum. However, the relative distribution of peaks within the elution range demonstrated a pattern with prominent peaks that started to emerge later than the characteristic M. asiaticum pattern. Standard biochemical identification test results were similar to those of the photochromogenic species M. asiaticum. Comparative 16S rRNA gene sequence analysis confirmed the genetic uniqueness of the strains and demonstrated the unclassified mycobacteria to be in a unique, intermediate position between slow and rapid growers in the phylogenetic tree of Mycobacterium. The name Mycobacterium kubicae sp. nov. is proposed for this taxon. The type strain is CDC 941078T (= ATCC 700732T = CIP 106428T).

Isolation of mycobacteria from lymph node lesions in deer

A total of 14,842 farmed deer were slaughtered and examined postmortem in Irish abattoirs between January 1993 and September 1996. Lymph node lesions were detected in 119 deer and these...

Cultivable mycobacteria isolated from organs of armadillos uninoculated and inoculated with Mycobacterium leprae

Mycobacteria were cultivated from 16 out of 32 samples of tissues from armadillos inoculated with Mycobacterium leprae. Three out of 7 samples from non-inoculated armadillos held in captivity were also positive for cultivable mycobacteria. Some isolated strains belonged to the M. avium-intracellulare-scrofulaceum complex, while others were identified as M. gordonae and M. terrae. Unclassified mycobacteria were isolated from M. leprae-inoculated armadillos only. Taxonomic studies confirmed that these new armadillo-derived mycobacteria (ADM) are different from all presently known species of mycobacteria, including M. leprae. The same new species were isolated from different armadillo colonies and were never found in non-inoculated animals. Different factors influence the isolation of these ADM in primary culture. Analysis of some specific markers of these ADM has been suggested in order to quantitatively determine the proportion of these ADM to M. leprae in armadillo tissues. No mycobacteria were cultivated from Nude mouse footpads infected with M. leprae.

A Study on the Pathogenicity of Unclassified Mycobacteria in the Experimental Silicosis of Rats

A Study on the Pathogenicity of Unclassified Mycobacteria in the Experimental Silicosis of Rats

Pathogenicity of unclassified mycobacteria for guinea pigs

Pathogenicity of unclassified mycobacteria for guinea pigs

Chemistry and biology of phospholipids from an unclassified mycobacteria, P6

Crude phospholipid fraction from P6 (Scotochromogen) prepared by extraction with chloroform: methanol (2:1), followed by removal of non-lipid contaminants by Folch's procedure and extraction with acetone, yielded three fractions by column chromatography with silicic acid. These fractions were designated as fractions I, II and III in the decreasing order of their Rf's on thin layer plates of Silica Gel. Fraction I was identified as diphosphatidyl glycerol (cardiolipin) and was antigenic in flocculation test for syphilis and in latex agglutination test for lepromatous leprosy. Fraction II was identified as phosphatidyl ethanolamine and Fraction III as phosphatidyl inositol monomannoside.

Treatment of unclassified mycobacterial infection of the lungs.

In a review of 25 patients with pulmonary infection caused by unclassified mycobacteria the course of the disease is related to the method of treatment. Five patients were followed while not being treated; in four the disease progressed and in one it remained static, and in each case the organism persisted in the sputum. Sixteen patients were given combinations of streptomycin, isoniazid, and para-aminosalicylic acid for periods which varied between three months and two and a half years; there was bacteriological sputum conversion in six, although in each case the organism showed in vitro resistance to these drugs. Eleven patients were treated primarily with combinations of other anti-tuberculosis drugs for at least 12 consecutive weeks, after which the mycobacteria could no longer be cultured from the sputum in eight, in each case the organism showing in vitro sensitivity to the drugs. Ten patients received combined medical and surgical treatment, which was successful in eight and a failure in two, one of whom died post-operatively. A favourable response occurred most frequently when the disease was confined to one pulmonary radiographic zone and when less than 10 positive sputum cultures had been obtained. These results show that in this type of disease the response to chemotherapy is uncertain, in vitro drug sensitivity tests are of limited value, and combined medical and surgical treatment is usually effective.

Clinical study of cases discharging unclassified mycobacteria

Clinical study of cases discharging unclassified mycobacteria

EPIDEMIOLOGICAL STUDY ON THE UNCLASSIFIED MYCOBACTERIA IN KOREA

An extensive study has been done for one year from 1965 to 1966 to estimate the geographical distribution in the four different districts with Japan-made Purified Tuberculin Protein-π.The skin tests were done on 4,822 healthy persons covering the selected areas of urban, rural, seacoast, and mountain. The criteria of positive limits adopted tentatively in reading was that the reaction to the unclassified mycobacteria-π should be more than 10mm in size and this reaction should be more than 25% compared with the reaction to the human tuberculin-π simultaneously injected.followings are the results obtained.:1. The rate of positive reaction of unclassified mycobacteria to the healthy persons examined was found to be 31.7% in all areas.2. The higher rates of positive reaction by the Runyon's classification groups were noted in scotochromogens and non- photochromogens, while the lower reactions were in the photochromogens and rapid grower.3. The rate of positive reaction by districts was found to be 13.0% in the urban area. 36.8% in the rural area, 36.8% in the mountain area. 4. The highest rate of positive reaction among four different groups by districts was noted in the nonphotochromogens in the urban area, while the scotochromogens were higher in the other areas.5. The younger the age of persons examined the higher the rate of positive reaction in the urban area, while in the other areas, the older, the higher. 6. The rate of positive reaction by unclassified mycobacteria in the low grade tuberculin reactors to the human tuberculin-π was found to be 58.7% in the urban area and almost 100% in the other areas.7. No significant changes in the positive rate were noted in general by sex, however in the female groups, slightly higher incidences were found in the rural and mountain area.

Clinical Tuberculosis: Essentials of Diagnosis and Treatment.

During the past 20 or so years, advances in the understanding and treatment of tuberculosis have appeared at a great rate. The volume of journalistic outpouring threatened to overwhelm students of the subject. A great need arose for organization and presentation of this material in condensed form. As a statement of standardization, this book has advantages of simplicity and clarity although difference of opinion is not excluded. The references are ample and well chosen but not encyclopedic. The editors, editorial committee, and contributing authors have produced a most welcome textbook. In addition to an analysis of pulmonary tuberculosis, there are sections on extra pulmonary tuberculosis, tuberculosis associated with other diseases, the unclassified mycobacteria, rehabilitation, and tuberculosis control. It is inevitable and perhaps desirable that when ideas change rapidly, procedures and attitudes of the past should disappear slowly. The need for careful evaluation of the new before discarding the old explains

Pulmonary Disease due to Unclassified Mycobacteria

In recent years much attention has been given to the problem of pulmonary disease associated with unclassified mycobacteria. In 1935, Pinner pointed out that chromogenic acid-fast bacilli could be found in various human materials, and emphasized the need for careful study in diagnostic procedures. The authers found out 2 patients who have been admitted to a Tuberculosis Hospital, from whose sputum unclassified mycobacteria were found. In case 1, Rapid grower by Runyon were cultured in the sputum. In case 2, culture study revealed photochromogenic unclassified mycobacteria, and the same bacteria were cultured from the surgical specimen. Susceptibility tests revealed these bacilli to be resistant to Streptomycin, PAS, and Isoniazid.

On the Inapparent Infection of Unclassified Mycobacteria on the Pupils of a Junior Middle School in Haramachi-City Fukushima Prefecture

The epidemiological investigation using purified tuberculin protein was carried out in Fukushima Prefecture in 1965 and 1966. The subjects of this investigation were 856 healthy pupils of junior middle school in Haramachi-City. The skin reaction of purified tuberculin protein prepared from several strains (Ishii--Scotochromogens, Gamou--Nonphotochromogens, P16--Photochromogens, Sato--Rapidd growers) of unclssif ied mycobacteria and human type mycobacteria (H37Rv) measured on the populations of normal healthy pupils. o.15γ of one purified tuberculin protein prepared from unclassified mycobacteria was used as antigen for intracutaneously on the flexion surface of forearm. The same amunt of purified tuberulin protein prepared from tubercle bacillus was injected on the other forearm as the control. For an injection site, the middle one-third part of the forearm was used avoiding the usual site of tuberculin reaction. The results obtained were as follows ; 1) The rate of positive reaction of Ishii was the highest among these four unclassified mycobacteria. 2) The mean value of the diameter of skin reaction by unclassified mycobacteria was almost same size with except rapid grower Sato. 3) Great changes of the coefficients of correlation were found between the human type mycobacteria and unclssified mycobacteria of different kinds.

UNCLASSIFIED MYCOBACTERIA IN KOREA

Purified tuberculin protein-π prepared from unclassified mycobacteria and human tubercle bacillus was examined on 4,461 normal healthy persons and 391 tuberculous inpatients of the some hospitals in Korea during 1963 to 1964.The results obtained in the group of normal healthy persons are as follow: The rate of positive reaction of unclassified mycobacteria was found to be 0.9 to 6.2 percent in the primary school children, 0.2 to 7.7 percent in the middle school pupil, 0.4 to 5.7 percent in the college students. The older the age of the persons examined, the lower became the rate of positive reaction. The Positive rates observed from three different purified tuberculin protein-π photochromogens-π, scotochromogens-π and nonphotochromogens-π, were 0.4 0.9 and 6.1 percent. All positive reactors to unclassified mycobacteria-π in the primary school children showed a low-grade tuberculin reaction was decreased as the age of reactors became older, seventy-five percent of the positive reactors who had BCG vaccination were those who had vaccination three years previously. The raters of positive reaction in the tuberculous inpatients were 0.5 percent with photochromogens-π and scotochromogens-π, and 2.85 percent with nonphotochoro-mogens-π. Most of them were composed of advanced cases.

STUDIES ON SOlL ACID-FAST BACILLl Park Ⅱ. Virulence to Mouse of the Pigmented Strain from Soil Samples and the Virulence Fluctuation of Isolated Strain by Mouse Passage

Among the soil acid-fast bacilli, pigmented strains were much similar to human origin unclassified mycobacteria concerning such characteristics as growth rate, growth temperature range, growth characteristics on various kinds of media and sensitivity patterns to antituberculous agents. Out of the pigmented strains, three representative strains were selected to compare the virulence to mice with standard unclassified mycobacteria and one of the test strain was passed to mice for ten generations to observe the virulence fluctuation. 1. Three representative strains were positive to one reaction arbitrarily out of neutral red test and cord formation. 2. Test strains were belong to Group I, II and III of Runyon's schema biochemically, and exhibited same patterns of acid-fastness, growth temperature range and sensitivity to antituberculous agents as compared to standard strains. 3. Test strains were slightly weaker than standard strains in its virulence to mice by intraperitoneal inoculation. 4. Mice passage of the test strain exhibited neither enhancement of virulence nor fluctuation in biochemical characteristics.

STUDIES ON SOIL ACID-FAST BACILLI Part 1. The Distribution and the Biological Charadcristies of Soil Acid-Fast Bacilli.

In order to observe the distribution of the unclassified mycobacteria in the soil, various origins of soil sample were cultured for the detection of mycobacteria and the isolated strains were studied as follows: 1. Among 210 soil samples, 45 strains(21.4%) were isolated by direct method, and 88 strains(41.9%) by indirect method respectively. 2. No remarkable difference was noted in isolation ratio according to the source of soil samples. 3. According to Runyon's schema, 133 isolated strains were classified as follows: photochromogen 1(0.75%) scotochromogen 26(19.5%) non-photochromogen 12(9.0%) rapid grower 94(70.7%) 4. Out of the 133 isolated strains, 47 were pigmented strain and among the pigmented strains 37 were slow grower. 5. All of the isolated strains exhibited strong positive catalase reaction and the growth characteristics on various media were diverse patterns, however, non-pigmented rapid grower were usually more active grower on the media tested. 6. The range of growth temperature of the slow grower was between 22℃ to 37℃, whereas, the range of rapid grower was up to 42℃ or above. 7. Acid fastness of the pigmented strains were generally stronger than rapid grower but weaker than tubercle bacilli. 8. Among the pigmented strains, five strains formed cord. Five strains were neutral red test positive and three strains were niacin test positive. 9. pigmented strains were generally more sensitive to tuberculous agents than non-pigmented ones.