First report of Mycobacterium canariasense catheter-related bacteremia in the Americas

Nontuberculosis mycobacteria (NTM) infections in patients with leukemia: a single center case series

Patients with leukemia experience profound immunosuppression both from their underlying disease as well as chemotherapeutic treatment. Little is known about the prevalence and clinical presentation of nontuberculous mycobacteria (NTM) in this patient population. We identified six cases of NTM infection from 29,743 leukemia patients who had acid-fast bacilli (AFB) cultures. Four cases had bloodstream infections and five had disseminated disease, including one who presented with an unusual case of diffuse cellulitis/myositis. All patients were lymphopenic at time of diagnosis, and two patients ultimately died from their NTM infection. NTM infections are a rare, but potentially life-threatening infection in patients with leukemia. Sending AFB cultures early is important to direct appropriate antimicrobial therapy and allow for future leukemia-directed therapy.

Overlapping infections of Mycobacterium canariasense and Nocardia farcinica in an immunocompetent patient: A case report

BACKGROUND

Infections by non-tuberculous mycobacteria (NTM) have become more common in recent years. Mycobacterium canariasense (M. canariasense) was first reported as an opportunistic pathogen in 2004, but there have been very few case reports since then. Nocardia is a genus of aerobic and Gram-positive bacilli, and these species are also opportunistic pathogens and in the Mycobacteriales order. Conventional methods for diagnosis of NTM are inefficient. Metagenomic next-generation sequencing (mNGS) can rapidly detect many pathogenic microorganisms, even rare species. Most NTM and Nocardia infections occur in immunocompromised patients with atypical clinical symptoms. There are no previous reports of infection by M. canariasense and Nocardia farcinica (N. farcinica), especially in immunocompetent patients. This case report describes an immunocompetent 52-year-old woman who had overlapping infections of M. canariasense, N. farcinica, and Candida parapsilosis (C. parapsilosis) based on mNGS.

CASE SUMMARY

A 52-year-old woman presented with a productive cough and chest pain for 2 wk, and recurrent episodes of moderate-grade fever for 1 wk. She received antibiotics for 1 wk at a local hospital, and experienced defervescence, but the productive cough and chest pain persisted. We collected samples of a lung lesion and alveolar lavage fluid for mNGS. The lung tissue was positive for M. canariasense, N. farcinica, and C. parapsilosis, and the alveolar lavage fluid was positive for M. canariasense. The diagnosis was pneumonia, and application of appropriate antibiotic therapy cured the patient.

CONCLUSION

Etiological diagnosis is critical for patients with infectious diseases. mNGS can identify rare and novel pathogens, and does not require a priori knowledge.

Challenging diagnosis of Mycolicibacterium cosmeticum/canariasense infection: A case report and literature review

We present the case of an immunocompromised child with Mycolicibacterium cosmeticum/ canariasense infection. Our case highlights the difficulty in adequate speciation. Most isolates described in the literature were identified using 16 s-rRNA PCR, which if performed on our sample would at best be inconclusive. Misidentifications could have a real impact on the body of evidence collected on these isolates thus far.

Case report and literature review: double jeopardy – Exophiala dermatitidis and Mycobacterium canariasense central line-associated bloodstream infection in a patient

Central line-associated bloodstream infection (CLABSI) is the most common nosocomial-acquired infection, affecting 38 000 patients in the USA annually. Approximately 8–10 % of inserted catheters lead to bloodstream infections, and ~25–30 % of infections are associated with mortality. Although proper line maintenance is essential to prevent infection, it is quite a challenge to avoid infection in patients with a long-term catheter. We present a case of a female in her 40s with a previous history of irritable bowel syndrome (IBS) who has had a central line for total parenteral nutrition for the past 2 years. The patient recently visited the emergency room with fever and generalized fatigue. Blood cultures sent to microbiology were positive for black mould, Exophiala dermatitidis. However, after a few days, microbiology reported an additional micro-organism, Mycobacterium canariasense, a pathogen rarely associated with bacteraemia. The patient was administered voriconazole and moxifloxacin for black mould and mycobacterium infection, respectively. We present an unusual case of rare opportunistic organisms causing bacteraemia and fungaemia in a patient with a long-term catheter. CLABSI remains a serious challenge for clinical facilities. Implementation and monitoring of effective strategies can prevent catheter-related bloodstream infections in patients with long-term catheters and can reduce the morbidity and mortality associated with CLABSI.

Emergence of Mycobacterium canariasense infections in central Israel

In 2018, Mycobacterium canariasense bloodstream infection was diagnosed in Israel. Further investigation had identified additional five cases in three medical centers, including isolates from blood (1), cornea (1), and sputum (3). Isolates were susceptible to all the antimicrobial tested. All but one isolate was related by whole-genome phylogeny.

Complete Genome Sequence of Mycolicibacterium sp. Strain NIID-NTM18, Isolated from Cardiac Implantable Electronic Device Infection and Most Similar to Mycolicibacterium litorale

Mycolicibacterium litorale is a rapidly growing mycobacterial organism with unknown pathogenic features. Here, we report the complete genome sequence of Mycolicibacterium sp. strain NIID-NTM18, which was isolated from a cardiac implantable electronic device infection and which is most similar to M. litorale This sequence will provide essential information for future studies of the pathogenicity of these mycobacteria.

Pulmonary Infection Associated with Mycobacterium canariasense in Suspected Tuberculosis Patient, Iran

Mycobacterium canariasense had only been isolated in humans from blood and contaminated catheters. We report a case of pulmonary disease associated with M. canariasense infection that was identified by multilocus sequence analysis; the illness was initially ascribed to M. tuberculosis. M. canariasense should be considered a cause of respiratory infection.

Septic Nonunion Caused by Mycobacterium canariasense: A Case Report

CASE

A 43-year-old former drug user presented with a mycobacterium-caused septic nonunion of the humeral shaft. The patient had undergone 2 previous surgeries for a hematogenous fracture-related infection due to Staphylococcus aureus. The procedures had included debridement, double-plate osteosynthesis, and placement of a gentamicin-loaded bone substitute. Culture specimens produced growth of Mycobacterium canariasense. Because the microbiological diagnosis was obtained after the patient had been discharged, no antibiotic treatment could be prescribed. Nevertheless, solid bone fusion was observed in the most recent outpatient examination.

CONCLUSION

This case illustrates the importance of considering atypical pathogens in patients who are immunoincompetent. To the best of our knowledge, this is the first reported case of septic nonunion caused by M. canariasense.

Mycobacterium grossiae sp. nov., a rapidly growing, scotochromogenic species isolated from human clinical respiratory and blood culture specimens

A previously undescribed, rapidly growing, scotochromogenic species of the genus Mycobacterium (represented by strains PB739^T and GK) was isolated from two clinical sources - the sputum of a 76-year-old patient with severe chronic obstructive pulmonary disease, history of tuberculosis exposure and Mycobacterium avium complex isolated years prior; and the blood of a 15-year-old male with B-cell acute lymphoblastic leukaemia status post bone marrow transplant. The isolates grew as dark orange colonies at 25-37 °C after 5 days, sharing features in common with other closely related species. Analysis of the complete 16S rRNA gene sequence (1492 bp) of strain PB739^T demonstrated that the isolate shared 98.8 % relatedness with Mycobacterium wolinskyi. Partial 429 bp hsp65 and 744 bp rpoB region V sequence analyses revealed that the sequences of the novel isolate shared 94.8 and 92.1 % similarity with those of Mycobacterium neoaurum and Mycobacterium aurum, respectively. Biochemical profiling, antimicrobial susceptibility testing, HPLC/gas-liquid chromatography analyses and multilocus sequence typing support the taxonomic status of these isolates (PB739^T and GK) as representatives of a novel species. Both isolates were susceptible to the Clinical and Laboratory Standards Institute recommended antimicrobials for susceptibility testing of rapidly growing mycobacteria including amikacin, ciprofloxacin, moxifloxacin, doxycycline/minocycline, imipenem, linezolid, clarithromycin and trimethropin/sulfamethoxazole. Both isolates PB739^T and GK showed intermediate susceptibility to cefoxitin. We propose the name Mycobacterium grossiae sp. nov. for this novel species and have deposited the type strain in the DSMZ and CIP culture collections. The type strain is PB739^T (=DSM 104744^T=CIP 111318^T).

Species diversity and molecular characterization of nontuberculous mycobacteria in hospital water system of a developing country, Iran

BACKGROUND

Hospital environment is of crucial importance in cross-transmission of opportunistic pathogens to the patients. Nontuberculous mycobacteria have the remarkable capability to withstand the adverse condition of hospital environments and pose a potential threat to the health of patients. The current study aimed to assess the frequency and diversity of mycobacteria in hospital water of a developing country using a combination of conventional and molecular methods.

METHODS

A total of 148 hospital water samples collected from 38 hospitals were analyzed for the presence of mycobacteria using standard protocols for isolation and characterization of the isolates. The conventional tests were used for preliminary identification and Runyon's classification, the PCR amplification of hsp65 gene and sequence analysis of 16S rRNA were applied for the genus and species identification.

RESULTS

A total of 71 [48%] isolates including 30 rapidly growing and 41 slowly growing mycobacteria were recovered. The three most prevalent species were M. lentiflavum, 28.2%, M. paragordonae, 21.1%, and M. fredriksbergense, 9.8%, followed by M. simiae and M. novocastrense, 7%, M. canariasense and M. cookii like, 5.6%, M. setense, 4.2%, M. fortuitum and M. gordonae, 2.8%, and the single isolates of M. austroafricanum, M. massiliense, M. obuense, and M. phocaicum like.

CONCLUSION

The results of our study show that the hospital water resources, drinking or non-drinking can be the reservoir of a diverse range of mycobacteria. This reaffirms the fact that these organisms due to intrinsic resistance to common antiseptic and disinfectant solutions persist in hospitals and create a threat to the patient's health and in particular to those that suffer from weakness of immunity.

First isolation of Mycobacterium canariasense from municipal water supplies in Tenerife, Canary Islands, Spain

BACKGROUND

Nontuberculous mycobacteria (NTM) are common bacteria in water and especially water supply distribution systems. Some species can cause infections, especially in immunocompromised patients and other risk groups. This study examined the frequency of occurrence of NTM in 135 household potable water samples collected from household water taps in Tenerife Island.

METHODS

Mycobacteria species were identified by polymerase chain reaction targeting the 16S rRNA and 16S-23S rRNA regions, and by double-reverse hybridization on a dipstick using colloidal gold-bound and membrane-bound probes (Speed-Oligo(®) Mycobacteria). Some species were identified by sequencing the gene that encodes the 16S rRNA region.

RESULTS

NTM were present in 47.4% of the samples. Mycobacterium fortuitum was the NTM isolated most frequently (70.3%), followed by Mycobacterium canariasense (6.3%) and Mycobacterium chelonae (6.3%). Other species were isolated at lower percentage frequencies.

CONCLUSION

We isolated and identified the species M. canariasense in water supplies for public consumption. This species has previously been reported only in hospital settings. The elevated presence of NTM in the water supply indicates that it may be a reservoir for infections caused by recently described species of mycobacteria.

A NovelMycobacterium cosmeticum-Like Bacterium Isolated from the Ear Swab of a Patient with Otitis Externa

We describe the identification and characterization of a novel nontuberculous mycobacterium (NTM), isolated from an ear swab of an adult male patient with chronic otitis externa. Genetically, the bacterium is most closely related to Mycobacterium cosmeticum; however, growth and biochemical features indicate that it is distinctly different. Here, we highlight for the first time an unusual NTM that is a probable cause of ear infection.

First report of isolation of Mycobacterium canariasense from hospital water supplies

Mycobacterium canariasense was first isolated as a novel species in 2004 from clinical specimens in Spain. Since then there have only been a few additional reports from Spain, the USA, and Lebanon on the isolation of this rare species from clinical specimens. We herein present the first report on isolation of this organism from hospital water, which provides evidence for determining the natural habitat of this rare species. The water samples were collected from hospital departments and cultured on Löwenstein-Jensen and Sauton's media. The isolates, i.e. WP5, WP20, and AW2-3, were subjected to identification by conventional and molecular tests including sequencing analysis of 16S rRNA. The water isolates revealed phenotypic and molecular features consistent with M. canariasense including a genus-specific amplicon of the hsp65 gene and 100% similarities with those of M. canariasense CIP: 107998(T) 16S rRNA gene sequences. The current report might be of value in tracing the probable source of infection in patients.