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Nontuberculous mycobacteria (NTM) are a diverse group of bacterial species that are distributed in the environment. Many of these environmental bacteria can cause disease in humans. The identification of NTM in environmental sources is important for both clinical and epidemiological purposes. In this study, the distribution of NTM species from envi...
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Context 1
... was no information available regarding environmental NTM from Israel, Pakistan, Egypt and Lebanon. Qatar, and the remaining from Lebanon, Bahrain, Pakistan, Kuwait and Egypt (Table 6). The case reports were published during the study period beginning in the year 2000 through 2014. ...
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Recent studies suggest an increasing prevalence of nontuberculous mycobacteria (NTM) lung disease. The aim of the present study was to describe incidence rates of NTM lung disease and trends therein in our area over a 20-year period.
This was a retrospective study of all cases of NTM lung disease between 1997 and 2016 that met the 2007 American Tho...
Citations
... 9 In Iran, M. simiae is the second most common NTM and the most common slow-growing mycobacteria that accounted for 40% of slow-growing mycobacteria isolated from clinical specimens. 10 According to a recent systematic review that reported 82 cases of pulmonary disease caused by M. simiae, it accounts for 25% of culture-positive NTM pulmonary diseases in Iran. 11 Data on the clinical and radiographic characteristics, treatment response, and clinical outcome of patients infected with M. simiae are limited. ...
... As the only niacin-positive NTM similar to Mycobacterium tuberculosis, and with a strong potential of causing pulmonary diseases in both healthy and human immunodeficiency virus (HIV)-positive patients, early differentiation between M. simiae and M. tuberculosis is an essential step in effective M. simiae therapy (5)(6)(7)(8). Epidemiologically, among NTM species, M. simiae ranks as the most frequent clinical slow-growing mycobacterium in Iran, while among other Middle Eastern countries, M. simiae ranks the second (9)(10)(11). ...
... Among the other Middle Eastern countries, Turkey, Saudi Arabia, Oman, and Kuwait recently reported a few identified M. simiae cases. In contrast, the actual increasing rate of M. simiae infection in Lebanon raised to 47% (11,28,29). This highlights the notion that people with a particular ethnic origin, especially in the Middle East, are more prone to infection with M. simiae (28), indicating the importance of performing widespread research on these pathogenic mycobacteria. ...
... (3) The limitation of M. simiae studies, particularly in the Middle East region, including Iran (11,12,27,34). ...
Background: Despite the clinical and epidemiological importance of Mycobacterium simiae worldwide, including in Iran, there is no clear and effective treatment regimen for M. simiae and its different subtypes. Objectives: Concerning the superiority of molecular approaches, this study aims to identify the common M. simiae subtypes submitted to the National Reference Tuberculosis (TB) Laboratory of Iran and study the presence of drug resistance by molecular detection methods. Methods: We included sputum samples with M. simiae confirmation submitted to the National Reference TB Laboratory of Iran from May 2014 to May 2016. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay was used for drug susceptibility testing (DST). Results: Among 7200 TB suspected patients, a total of 60 M. simiae cases belonging to subtype I were identified. All the included clinical isolates met the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) diagnostic criteria and were considered the disease’s causative pathogen. Males (58.33%), elderly (68.54%), and patients with a history of TB (51.42%) were shown to be more prone to infection with the disease. All clinical isolates of M. simiae were resistant to rifampin (RIF) and isoniazid (INH). Amikacin/kanamycin (AMK/KAN) and ciprofloxacin (CIP) susceptibility was found to be 91.66% and 88.33%, respectively. Conclusions: Subtype I was exclusively identified among M. simiae patients in Iran. Molecular detection of drug resistance suggests that amikacin/kanamycin and ciprofloxacin could be used to treat patients infected with M. simiae subtype I.
... Among detected NTM, M. kansasii, M. gordonae, and M. avium complex are SGM, while the M. peregrinum is RGM. Recently, an increasing trend in NTM isolation from the Middle East countries was observed [23]. ...
... Similarly, a previous study from Egypt reported M. kansasii (37.5%) as the most prevalent NTM [17]. M. kansasii was also previously reported in other countries such as Iran and Turkey as the third most common SGM in clinical isolates in the Middle East region [23]. On the other hand, another Egyptian study reported that M. marinum is the most prevalent atypical mycobacteria clinically detected from extrapulmonary infections [16]. ...
Background and objectives:
Immunocompromised patients are considered a high-risk group to develop mycobacterial infections with either pulmonary and/or extra-pulmonary diseases. Low-cost and low-density (LCD) DNA-microarray is considered an easy and efficient method to detect typical and atypical Mycobacterial species.
Materials and methods:
Thirty immunocompromised patients were recruited to provide their clinical specimens (sputum, serum, urine and lymph node aspirate). Both Real-Time PCR and LCD-microarray techniques were performed and compared to the conventional methods of Ziehl-Neelsen (ZN) staining and Lowenstein Jensen (LJ) culturing.
Results and conclusion:
Mycobacterium tuberculosis complex (MTBC) was detected in all 30 clinical specimens (100% sensitivity) by Real-Time PCR and LCD-microarray. Additionally, co-infection with 4 atypical species belonging to mycobacteria other than tuberculosis (MOTT) was identified in 7 sputum specimens. These atypical mycobacterial species were presented as M. kansasii 10% (n=3), M. avium complex 6.6% (n=2), M. gordanae 3.3% (n=1) and M. peregnium 3.3% (n=1). This study documents the presence of certain species of atypical mycobacteria among immunocompromised patients in Egypt. To the best of our knowledge, this is the first detection of M. peregenium among clinical specimen in Egypt.
... In different studies, NTM rates were reported to range from 1.1-2.5% [36][37] . The sample type in which NTM was observed in our study was compatible with the literature, 100% of its growth was isolated from respiratory tract samples, and the prevalence of nonrespiratory NTM infections is low, as in our study [38][39] . ...
Purpose: The aim of this study as to compare microscopy and culture results of samples, determine drug resistance rates of the isolates, evaluate epidemiological relationship between the strains with ERIC-PCR, RAPD-PCR, OUT-PCR based on in house PCR technique.
Materials and Methods: Direct microscopy and culture results of 2010 samples were analyzed. Drug sensitivity results were obtained from TULSA. The typing of isolates based on in house PCR was carried out in the microbiology laboratory of a faculty of medicine in a state university.
Results: Of positive samples, 2.68% had Acid-resistant bacilli (ARB) positive + culture positivity, 2.93% had ARB positive and culture negative in smear, and 1.34% had ARB negative and culture positivity in smear. Resistance to primary antituberculous (anti-TB) drugs wasn’t observed in 33 culture positive isolates, whereas resistance to one or more primary anti-TB drugs was observed in 9.09%. Single drug resistance was 3.03%, resistance to Isoniazid (INH) and INH critical drugs was 6.06%. Isolates were divided 3 groups by ERIC-PCR, 5 groups for OUT-PCR and 6 by RAPD-PCR.
Conclusion: Positivity rates were low due to low rate of studied samples, negative samples taken during treatment process. Molecular techniques like ERIC-PCR, RAPD-PCR and OUT-PCR are easy, fast and inexpensive methods for the epidemiological typing of Mycobacterium tuberculosis (MTB) in evaluating distinctions, similarities between origins.
... Mycobacterium tuberculosis complex is a genetically related group of Mycobacterium spp. that can cause tuberculosis (TB) in humans or other animals, and the extensive societal impact of this infectious disease is legendary [1][2][3]. However, in the recent years, other mycobacterial species, referred to nontuberculous mycobacteria (NTM) or mycobacteria other than tuberculosis (MOTT), can cause severe lung disease especially in individuals with impaired immune systems [4][5][6][7]. Up to date, more than 175 species of NTM have been identified which are ubiquitous microorganisms in the environment with the heaviest concentrations in water sources as well as in soil. ...
Mycobacterium simiae is an emerging nontuberculous mycobacterium (NTM) and an opportunistic pathogen which is described mainly in Asia and presents in the environment that can cause pulmonary infection. The objective of this study is to characterize M. simiae clinical isolates using mycobacterial interspersed repetitive unit variable-number tandem repeats (MIRU-VNTR) typing for the differentiation of the strains. A total of 169 clinical isolates of NTM were recovered from patients suspected of having tuberculosis (TB)-like and related infections. After isolation and identification of mycobacterial strains by conventional biochemical and PCR-based tests, M. simiae strains were confirmed using restriction fragment length polymorphism (RFLP)-based identification assay. Furthermore, drug susceptibility and MIRU-VNTR typing was performed using on the clinical isolates of M. simiae. Out of 169 NTM strains, 92 (54.4%) isolates were identified as M. simiae. Antibiotic susceptibility experiments indicated that all 92 M. simiae isolates were resistant to first line antimycobacterial agents. Moreover, 8 (8.6%) M. simiae isolates were resistant to ciprofloxacin; and 6 (6.5%) were resistant to both amikacin and kanamycin, while the remaining were susceptible to second line antimycobacterial agents. MIRU-VNTR analysis showed that the M. simiae isolates were classified in four distinct M. simiae clusters and two single types. The minimum spanning analysis revealed that the isolates were grouped in three complexes. The data suggested that MIRI-VNTR typing is useful for typing of M. simiae isolates, however, MIRU-16 locus was absolutely absent in M. simiae.
... Given their widespread presence in the environment and global distribution, epidemiological surveillance of NTM is of particular importance [14,19,20]. In Iran, prevalence of NTM from 2002 to 2006 was 12% [7]. ...
Objective: To investigate the prevalence of non-tuberculosis mycobacteria (NTM) among the samples deposited from the National Tuberculosis Reference Laboratory of Iran between 2011 and 2018.
Methods: The study evaluated the prevalence of NTM among specimens from patients with pulmonary tuberculosis symptoms (n=15 771) deposited at the National Tuberculosis Reference Laboratory of Iran from 2011 to 2018. Detection of Mycobacterium (M.) tuberculosis was based on presence of a 190-bp amplicon from IS6110 insertion sequence using Tb1 and Tb2 primers, and amplicon-negative specimens were tested for NTM and M. tuberculosis (refractory to IS6110 amplification) using restriction fragment length polymorphism PCR of hsp65 amplicon fragment.
Results: A total of 7 307 (46.33%) M. tuberculosis and 658 (4.17%) NTM specimens were found, the latter mainly comprising M. abscessus (10.18%), M. avium (2.28%), M. chelonae (8.97%), M. intracellulare (10.49%), M. kansasii (4.71%), and M. simiae (56.08%).
Conclusions: As treatment for NTM differs from that for M. tuberculosis, accurate detection of Mycobacterium sp. is of public health significance.
... However, it may not be possible to apply DST everywhere in our country. On the other hand, according to the review published by Velayeti [13] , a total of 280 NTM isolates were mentioned in the publications made in our country between 1984 and 2014. Although this number does not show the true incidence, it indicates that there is need for routine DSTs for NTM in our country. ...
Introduction: Nontuberculous Mycobacteria (NTM) infections have recently increased significantly in the world. Especially, lung diseases caused by various NTM are noteworthy. Susceptibility to antimicrobials can vary greatly by species, geographic region and time for NTMs. In this study, it was aimed to determine the resistance percentages of antimicrobials by performing drug susceptibility tests (DST) for NTM isolated from lower respiratory tract samples.
Materials and Methods: Sputum and other lower respiratory tract samples sent to the National Tuberculosis Reference Laboratories from various provinces in Turkey between January 2014 and December 2015 were studied. Among them, 121 NTM were considered as infectious agent, and identification at species level was performed using GenoType Mycobacterium CM/AS kit (Ver 1.0) (HAIN Lifescience, Germany). For rapid growing mycobacterium (RGM), RAPMYCO- and for slow growing mycobacterium (SGM), SLOMYCO-SENSITITRE Broth Microdilution (MIC) (Trek Diagnostic Systems Limited, UK) were used to study DSTs according to the recommendations of the manufacturer.
Results: In the study, RGM (n= 81) were identified as Mycobacterium abscessus (n= 36), Mycobacterium chelonae (n= 26), Mycobacterium fortuitum (n= 19), while SGM (n= 40) were Mycobacterium avium (n= 16), Mycobacterium kansasii (n= 14), Mycobacterium intracellulare (n= 10). The highest susceptibility percentages for M. abscessus were found as amikacin 97%, clarithromycin 94%, tigecycline 97%; for M. chelonae, clarithromycin 92%, tigecycline 89%; and for M. fortuitum, amikacin, moxifloxacin, tigecycline 100%. Clarithromycin susceptibility was the highest for M. avium 94%, M. intracellulare 90% and M. kansasii 100%, while for M. fortuitum 58%. M. kansasii was detected susceptible to rifabutin 100%, linezolid 100% and etioniamid 86%.
Conclusion: The drugs to be selected in treatment should show differences specific to our country based on these susceptibility percentages, as following: for empirical treatment, clarithromycin would be better to be added to combined therapy until species identification. Amikacin, moxifloxacin or tigecycline could be used instead of clarithromycin for M. fortuitum.
... Cutaneous involvement of MAC infections has been rarely reported, with the infection been a result of trauma, cosmetic procedures, and postsurgical infections [251]. Several reports indicate a tendency to increase the prevalence of MAC species in the USA, Europe, and South Korea [256]. MAA is also connected to lymphadenitis in young children; and M. chimaera was recently implicated in disease in patients subjected to cardiac surgery [257]. ...
... It can cause infections in the skin, soft tissues, and bones, and was previously related to infected piercing wounds, contaminated tattoo inks, plastic surgery, or liposuction [252]. Moreover, it is usually found in hospital settings [256]. These species are extremely resistant to antibiotics and disinfectants, being major nosocomial pathogens [256]. ...
... Moreover, it is usually found in hospital settings [256]. These species are extremely resistant to antibiotics and disinfectants, being major nosocomial pathogens [256]. ...
Non-tuberculous mycobacteria (NTM) are paradigmatic colonizers of the total environment, circulating at the interfaces of the atmosphere, lithosphere, hydrosphere, biosphere, and anthroposphere. Their striking adaptive ecology on the interconnection of multiple spheres results from the combination of several biological features related to their exclusive hydrophobic and lipid-rich impermeable cell wall, transcriptional regulation signatures, biofilm phenotype, and symbiosis with protozoa. This unique blend of traits is reviewed in this work, with highlights to the prodigious plasticity and persistence hallmarks of NTM in a wide diversity of environments, from extreme natural milieus to microniches in the human body. Knowledge on the taxonomy, evolution, and functional diversity of NTM is updated, as well as the molecular and physiological bases for environmental adaptation, tolerance to xenobiotics, and infection biology in the human and non-human host. The complex interplay between individual, species-specific and ecological niche traits contributing to NTM resilience across ecosystems are also explored. This work hinges current understandings of NTM, approaching their biology and heterogeneity from several angles and reinforcing the complexity of these microorganisms often associated with a multiplicity of diseases, including pulmonary, soft-tissue, or milliary. In addition to emphasizing the cornerstones of knowledge involving these bacteria, we identify research gaps that need to be addressed, stressing out the need for decision-makers to recognize NTM infection as a public health issue that has to be tackled, especially when considering an increasingly susceptible elderly and immunocompromised population in developed countries, as well as in low-or middle-income countries, where NTM infections are still highly misdiagnosed and neglected.
... Sol parmaklarda ve elde morumsu kırmızı, sertleşmiş deri lezyonları [21] 3.4. Lactococcus garvieae: L. garvieae fakültatif anaerobik, hareketsiz, sporsuz, Gram pozitif oval kok şeklinde mikroorganizmalardır. Balıklarda L. garvieae tarafından meydana getirilen laktokokkozis enfeksiyonu, özellikle, tatlı su kültürlerindeki salmonid balıklar ve denizde yetiştiriciliği yapılan balık türlerinde yıkımlayıcı bir etkiye sahip olan bir tür streptokokkozis enfeksiyonu olarak tanımlanmaktadır [57] Etken aynı zamanda ineklerdeki subklinik meme içi enfeksiyonlardan, mandalarda subklinik mastitisten, tavuk etlerinden, çiğ inek sütünden, et ürünlerinden, domuz kanı işleyen endüstriyel mezbahanelerden ve kedi ve köpeklerin tonsillerinden izole edilmiştir [57]. Son yıllarda ise endocarditis, kolesistit ve diskospondilitis'e neden olan bir insan patojeni olarak tanımlanmaktadır [19]. ...
... Sol parmaklarda ve elde morumsu kırmızı, sertleşmiş deri lezyonları [21] 3.4. Lactococcus garvieae: L. garvieae fakültatif anaerobik, hareketsiz, sporsuz, Gram pozitif oval kok şeklinde mikroorganizmalardır. Balıklarda L. garvieae tarafından meydana getirilen laktokokkozis enfeksiyonu, özellikle, tatlı su kültürlerindeki salmonid balıklar ve denizde yetiştiriciliği yapılan balık türlerinde yıkımlayıcı bir etkiye sahip olan bir tür streptokokkozis enfeksiyonu olarak tanımlanmaktadır [57] Etken aynı zamanda ineklerdeki subklinik meme içi enfeksiyonlardan, mandalarda subklinik mastitisten, tavuk etlerinden, çiğ inek sütünden, et ürünlerinden, domuz kanı işleyen endüstriyel mezbahanelerden ve kedi ve köpeklerin tonsillerinden izole edilmiştir [57]. Son yıllarda ise endocarditis, kolesistit ve diskospondilitis'e neden olan bir insan patojeni olarak tanımlanmaktadır [19]. ...
Zoonotic diseases are diseases that are transmitted from animals to humans and from humans to animals. Zoonotic bacterial infections are an important public health problem in the world. Zoonotic infections from fish can cause problems for fish producers and consumers. Fish diseases are important in terms of economic losses they cause, adversely affect exports, residue problems of unconscious drugs, environmental pollution and increase antibiotic resistance, and some of the diseases are zoonotic. In this review, potential bacterial fish zoonoses are summarized according to the information obtained from publications.
... [20] There are several reports from middle east about the increasing trends of environmental NTM species, specially Mycobacterium avium complex (MAC) species which are pathogenic in nature and cause infection in human and might playing role as immonomodulator as providing protection or susceptibility from mycobacterial or other diseases. [21] Various attempts were made previously to isolate the NTM from various soil and water samples to study the distribution of NTM in environment. Several pathogenic and nonpathogenic NTM species were isolated from leprosy-endemic pockets of India. ...
... [29] Further, scientist isolated MAI and M. scrofulaceum in water and dust. [21] It was shown that NTM were isolated including M. fortuitum, M. avium, Mycobacterium kansasii, Mycobacterium terrae, and Mycobacterium chelonae in water and M. avium, M. terrae, and M. chelonae in soil samples from leprosy endemic regions of Ghatampur, Uttar Pradesh. [24] The highest (45%) M. leprae DNA PCR positivity was obtained from bathing places along with NTM such as M. timonense, M. [25,26] Finally, 20% M. leprae DNA PCR positivity along with M. fortuitum, M. scrofulacaeum, and M. spp were noted from sitting area [ Table 2]. ...
... Their presence probably provides an evolutionary drive toward development of immune system or susceptibility toward leprosy in human. [21] conclusIon The isolation of RGM was more on with glycerol at 30°C as compared to SGM at 30°C. SGM was recovered more on with glycerol than RGM species at 37°C. ...
Background:
Mycobacterium leprae is a noncultivable mycobacteria, and diagnosis of the disease is based on its clinical and histopathological characteristics and finding the bacteria in skin scrapings and in biopsies taken from the patients. The aim of this study was to shed light on the clinical classification (based on the number of skin lesions) used extensively in the field where patients classified as paucibacillary (PB) were positive on skin smears and histopathology leading to treatment failure and drug resistance.
Methods:
In this study, we enrolled untreated 62 leprosy patients with 1-5 skin lesions and did a detailed bacterio-histopathological analysis by slit-skin smears (SSSs) and histopathology.
Results:
Of 62 patients analyzed, 15 patients came out to be multibacillary (MB) and 47 were PB by SSS and histopathology.
Conclusion:
The findings of the present study showed that the WHO classification of leprosy based on the number of lesions seems to be inappropriate as it considers a number of MB lesions as PB only, thus misleading the treatment strategies. Hence, it is essential that a comprehensive clinicobacteriological assessment of leprosy cases should be done to ensure the appropriate bacillary status and guiding the appropriate treatment strategy.
