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Abbas M, Khan MT, Iqbal Z, Ali A, Eddine BT, Yousaf N, Wei D. Sources, transmission and hospital-associated outbreaks of nontuberculous mycobacteria: a review. Future Microbiol 2024; 19:715-740. [PMID: 39015998 PMCID: PMC11259073 DOI: 10.2217/fmb-2023-0279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/20/2024] [Indexed: 07/18/2024] Open
Abstract
Nontuberculous mycobacteria (NTM) are widespread environmental organisms found in both natural and man-made settings, such as building plumbing, water distribution networks and hospital water systems. Their ubiquitous presence increases the risk of transmission, leading to a wide range of human infections, particularly in immunocompromised individuals. NTM primarily spreads through environmental exposures, such as inhaling aerosolized particles, ingesting contaminated food and introducing it into wounds. Hospital-associated outbreaks have been linked to contaminated medical devices and water systems. Furthermore, the rising global incidence, prevalence and isolation rates highlight the urgency of addressing NTM infections. Gaining a thorough insight into the sources and epidemiology of NTM infection is crucial for devising novel strategies to prevent and manage NTM transmission and infections.
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Affiliation(s)
- Munawar Abbas
- College of Food Science & Technology, Henan University of Technology, Zhengzhou, Henan, 450001, China
| | - Muhammad Tahir Khan
- Institute of Molecular Biology & Biotechnology (IMBB), The University of Lahore, 1KM Defense Road, Lahore, 58810, Pakistan
- Zhongjing Research & Industrialization Institute of Chinese Medicine, Zhongguancun Scientific Park, Meixi, Nanyang, Henan, 473006, PR China
| | - Zafar Iqbal
- School of Life Science, Anhui Normal University, Wuhu, Anhui, China
| | - Arif Ali
- Department of Bioinformatics & Biological Statistics, School of Life Sciences & Biotechnology, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Benarfa Taki Eddine
- Echahid Cheikh Larbi Tebessi University Faculty of Exact Sciences & Natural & Life Sciences, Département of Microbiology, Algeria
| | - Numan Yousaf
- Department of Biosciences, COMSATS University Islamabad, Pakistan
| | - Dongqing Wei
- College of Food Science & Technology, Henan University of Technology, Zhengzhou, Henan, 450001, China
- State Key Laboratory of Microbial Metabolism, Shanghai-Islamabad-Belgrade Joint Innovation Center on Antibacterial Resistances, Joint International Research Laboratory of Metabolic & Developmental Sciences & School of Life Sciences & Biotechnology, Shanghai Jiao Tong University, Shanghai, 200030, PR China
- Zhongjing Research & Industrialization Institute of Chinese Medicine, Zhongguancun Scientific Park, Meixi, Nanyang, Henan, 473006, PR China
- Henan Biological Industry Group, 41, Nongye East Rd, Jinshui, Zhengzhou, Henan, 450008, China
- Peng Cheng National Laboratory, Vanke Cloud City Phase I Building 8, Xili Street, Nashan District, Shenzhen, Guangdong, 518055, PR China
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Shah S, Zaidi K, Onyia W. Mycobacterium porcinum Disseminated Infection in Non-severely Immunocompromised Host. Cureus 2024; 16:e55889. [PMID: 38595874 PMCID: PMC11003393 DOI: 10.7759/cureus.55889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2024] [Indexed: 04/11/2024] Open
Abstract
Mycobacterium porcinum is a nontuberculous mycobacteria (NTM) recently identified to cause human infection. Correct speciation of NTMs can be difficult and result in misdiagnosis and delayed treatment. Because of the paucity of the literature, there is a lack of awareness of the possibility of serious infections caused by M. porcinum. Although severe infections tend to occur in individuals with certain risk factors, the primary being an immunocompromised state, our case illustrates that it can also be possible in non-severely immunocompromised individuals. A 65-year-old male with a medical history of diabetes mellitus (DM), end-stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD) was admitted to the emergency room due to a laceration on his right lower leg following a fall. He reported shortness of breath but denied other respiratory symptoms. On examination, he showed signs of infection and increased oxygen requirement compared to baseline. Blood culture was positive for acid-fast bacilli (AFB), initially reported as M. avium complex (MAC) and later confirmed as M. porcinum through gene sequencing and morphology analysis. Interval blood cultures taken a week later confirmed true M. porcinum bacteremia. Treatment initially involved intravenous antibiotics- imipenem and ciprofloxacin before transitioning to oral linezolid and ciprofloxacin based on sensitivities. Following 10 days of antibiotic therapy, subsequent blood cultures returned negative, and treatment with oral antibiotics was advised, with continued outpatient follow-up with infectious disease in two weeks. M. porcinum, typically considered a contaminant in healthy individuals, was identified as the causative agent of a disseminated infection in a non-severely immunocompromised patient. This case underscores the importance of accurately identifying the specific mycobacterial species, confirming true infection, and conducting antibiotic susceptibility testing due to the distinct antibiotic susceptibility profile of M. porcinum compared to other NTM like MAC.
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Affiliation(s)
- Shuva Shah
- Internal Medicine, AdventHealth Orlando, Orlando, USA
| | - Kashaf Zaidi
- Internal Medicine, AdventHealth Orlando, Orlando, USA
| | - Will Onyia
- Infectious Disease, AdventHealth Orlando, Orlando, USA
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Reil I, Špičić S, Barbić L, Duvnjak S, Kompes G, Benić M, Stojević D, Cvetnić Ž, Arapović J, Zdelar-Tuk M. Antimicrobial Resistance in Rapidly Growing Nontuberculous Mycobacteria among Domestic and Wild Animals Emphasizing the Zoonotic Potential. Microorganisms 2023; 11:2520. [PMID: 37894179 PMCID: PMC10609087 DOI: 10.3390/microorganisms11102520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/29/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023] Open
Abstract
Non-tuberculous mycobacteria (NTM) are opportunistic pathogens capable of causing infections in humans and animals. The aim of this study was to demonstrate the potential role of domestic and wild animals as a reservoir of multiple resistant, rapidly growing NTM strains representing a potential zoonotic threat to humans. A total of 87 animal isolates belonging to 11 rapidly growing species (visible colonies appear within three to seven days) were genotyped and tested for susceptibility to the 15 most commonly used antibiotics in the treatment of such infections in a human clinic. By determining the antimicrobial susceptibility, the most prevalent resistance was found to cephalosporins (>50%), followed by amoxicillin-clavulanate (31.0%), clarithromycin (23.0%), tobramycin (14.9%) and doxycycline (10.3%). Resistance to imipenem, ciprofloxacin, minocycline and linezolid was notably lower (<7.0%). All tested isolates were susceptible to amikacin and moxifloxacin. The most frequent resistance was proved in the most pathogenic species: M. fortuitum, M. neoaurum, M. vaccae and M. porcinum. Meanwhile, other species displayed a higher sensitivity rate. No significant resistance differences between domestic and wild animals were found. The established significant frequency of resistance highlights the significant zoonotic potential posed by circulating rapidly growing NTM strains, which could lead to challenges in the treatment of these infections.
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Affiliation(s)
- Irena Reil
- Croatian Veterinary Institute, 10000 Zagreb, Croatia; (I.R.); (S.Š.); (M.B.); (D.S.); (Ž.C.); (M.Z.-T.)
| | - Silvio Špičić
- Croatian Veterinary Institute, 10000 Zagreb, Croatia; (I.R.); (S.Š.); (M.B.); (D.S.); (Ž.C.); (M.Z.-T.)
| | - Ljubo Barbić
- The Faculty of Veterinary Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Sanja Duvnjak
- Croatian Veterinary Institute, 10000 Zagreb, Croatia; (I.R.); (S.Š.); (M.B.); (D.S.); (Ž.C.); (M.Z.-T.)
| | - Gordan Kompes
- Croatian Veterinary Institute, 10000 Zagreb, Croatia; (I.R.); (S.Š.); (M.B.); (D.S.); (Ž.C.); (M.Z.-T.)
| | - Miroslav Benić
- Croatian Veterinary Institute, 10000 Zagreb, Croatia; (I.R.); (S.Š.); (M.B.); (D.S.); (Ž.C.); (M.Z.-T.)
| | - Dora Stojević
- Croatian Veterinary Institute, 10000 Zagreb, Croatia; (I.R.); (S.Š.); (M.B.); (D.S.); (Ž.C.); (M.Z.-T.)
| | - Željko Cvetnić
- Croatian Veterinary Institute, 10000 Zagreb, Croatia; (I.R.); (S.Š.); (M.B.); (D.S.); (Ž.C.); (M.Z.-T.)
| | - Jurica Arapović
- Department of Infectious Diseases, University Clinical Hospital Mostar, 88000 Mostar, Bosnia and Herzegovina;
- School of Medicine, University of Mostar, 88000 Mostar, Bosnia and Herzegovina
| | - Maja Zdelar-Tuk
- Croatian Veterinary Institute, 10000 Zagreb, Croatia; (I.R.); (S.Š.); (M.B.); (D.S.); (Ž.C.); (M.Z.-T.)
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Liu L, Zheng Y, Ruan H, Li L, Zhao L, Zhang M, Duan L, He S. Drinking natural water unchangeably is associated with reduced all-cause mortality in elderly people: A longitudinal prospective study from China. Front Public Health 2022; 10:981782. [PMID: 36072371 PMCID: PMC9441631 DOI: 10.3389/fpubh.2022.981782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/05/2022] [Indexed: 01/25/2023] Open
Abstract
Objective Because of rapid economic growth and followed urban expansion in China, many people drinking natural water had to change their water sources to tap water. We aimed to test the unknown association that whether continued use of natural water for drinking is different from switching to tap water in all-cause mortality risks in elderly people. Methods In total, based on Chinese Longitudinal Healthy Longevity Survey, 26,688 elderly participants drinking natural water from childhood to young-old were included in the final analyses. Associations between whether changing drinking water sources or not and all-cause mortality risk were then estimated by Cox regression models with the use of multiple propensity score methods, and the primary analysis used propensity score matching, with other propensity score methods confirming the robustness of the results. Results Baseline characteristics were fairly well balanced by the three post-randomization methods. During a median follow-up period of 3.00 (IQR: 1.52, 5.73) years, 21,379 deaths were recorded. The primary analysis showed people using natural water unchangeably was associated with a lower risk of all-cause mortality than those switching to tap water in later life (HR: 0.94, 95% CI: 0.91-0.97, p < 0.001). Other propensity score methods, as well as Cox regression analysis without using propensity score methods, showed similar results. Conclusions Among elderly people depending on natural water for drinking from their childhood to young-old in China, continued use of natural water was associated with a lower all-cause mortality risk than conversion to tap water later. Further studies in different countries and populations are needed to verify our conclusions.
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Affiliation(s)
- Lu Liu
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yi Zheng
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Haiyan Ruan
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China,Department of Cardiology, Hospital of Traditional Chinese Medicine of Shuangliu District, Chengdu, China
| | - Liying Li
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Liming Zhao
- Department of Cardiovascular Medicine, Hospital of Chengdu Office of People's Government of Tibetan Autonomous Region, Chengdu, China
| | - Muxin Zhang
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China,Department of Cardiology, First People's Hospital of Longquanyi District, Chengdu, China
| | - Linjia Duan
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Sen He
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China,*Correspondence: Sen He
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Surgical site infections by atypical mycobacteria: prevalence and species characterization using MALDI-TOF and molecular LCD chip array. Infection 2022; 50:1557-1563. [PMID: 35716342 PMCID: PMC9705499 DOI: 10.1007/s15010-022-01864-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/24/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Surgical site infection (SSI) is a post-operative complication of high concern with adverse impact on patient prognosis and public health systems. Recently, SSI pathogens have experienced a change in microbial profile with increasing reports of non-tuberculous mycobacteria (NTM) as important pathogens. AIM of the study The study aimed to detect the prevalence of NTM among cases with SSIs and describe their species using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) and PCR-based microarray. METHODS The study was conducted with 192 pus samples collected from patients with SSI. Mycobacterial investigations were done in the form of Ziehl-Neelsen (ZN) smears for acid-fast bacilli, automated mycobacterial culture to isolate mycobacteria, followed by immunochromatography test to predict NTM. NTM-positive cultures were tested by MALDI -TOF MS and PCR-based microarray to reach species-level identification. RESULTS Mycobacterial growth was found in 11/192 samples (5.7%) and identified as 4 NTM and 7 M. tuberculosis isolates with prevalence of 2.1% and 3.64%, respectively. The NTM species were described by MALDI-TOF as M. abscessus, M. porcinum, M. bacteremicum, and M. gordonae. Microarray agreed with MALDI-TOF in identifying one isolate (M. abscessus), while two isolates were classified as belonging to broad groups and one isolate failed to be identified. CONCLUSIONS The prevalence of NTM among SSI was found to be low, yet have to be considered in the diagnosis of mycobacteria. Employing advanced technologies in diagnosis is recommended to guide for appropriate treatment.
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Alarico S, Nunes-Costa D, Silva A, Costa M, Macedo-Ribeiro S, Empadinhas N. A genuine mycobacterial thermophile: Mycobacterium hassiacum growth, survival and GpgS stability at near-pasteurization temperatures. MICROBIOLOGY-SGM 2021; 166:474-483. [PMID: 32100712 DOI: 10.1099/mic.0.000898] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Mycobacterium hassiacum is so far the most thermophilic among mycobacteria as it grows optimally at 50 °C and up to 65 °C in a glycerol-based medium, as verified in this study. Since this and other nontuberculous mycobacteria (NTM) thrive in diverse natural and artificial environments, from where they may access and infect humans, we deemed essential to probe M. hassiacum resistance to heat, a strategy routinely used to control microbial growth in water-supply systems, as well as in the food and drink industries. In addition to possibly being a threat in its own right in rare occasions, M. hassiacum is also a good surrogate for studying other NTM species more often associated with opportunistic infection, namely Mycobacterium avium and Mycobacterium abscessus as well as their strictly pathogenic counterparts Mycobacterium tuberculosis and Mycobacterium leprae. In this regard, this thermophilic species is likely to be useful as a source of stable proteins that may provide more detailed structures of potential drug targets. Here, we investigate M. hassiacum growth at near-pasteurization temperatures and at different pHs and also characterize its thermostable glucosyl-3-phosphoglycerate synthase (GpgS), an enzyme considered essential for M. tuberculosis growth and associated with both nitrogen starvation and thermal stress in different NTM species.
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Affiliation(s)
- Susana Alarico
- IIIUC - Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal.,CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Daniela Nunes-Costa
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,PDBEB - PhD Programme in Biomedicine and Experimental Biology, Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
| | - Alexandra Silva
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
| | - Mafalda Costa
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Sandra Macedo-Ribeiro
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IBMC - Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
| | - Nuno Empadinhas
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,IIIUC - Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal
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Gerasimova EN, Ismatullin DD, Lyamin AV, Zhestkov AV. General characteristics, features of cultivation and antibiotic resistance representatives of mycobacterium fortuitum group representatives (review of literature). Klin Lab Diagn 2021; 66:223-228. [PMID: 33878244 DOI: 10.51620/0869-2084-2021-66-4-223-228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Recently, more and more scientific works have been devoted to non-tuberculous mycobacteria, both by domestic and foreign researchers. One of the main reasons for this is the increase in patients with immunosuppression of various origins, improvement of the quality of laboratory and instrumental diagnostics of mycobacteriosis. This article focuses on the representatives of the M. fortuitum group, as the main pathogens among the group of fast-growing mycobacteria. The data on the modern classification based on the use of molecular genetic studies are indicated. The M. fortuitum group includes: Mycobacterium fortuitum, M. peregrinum, M. senegalense, M. porcinum, M. houstonense, M. neworleansense, M. boenickei, M. conceptionense, M. septicum, M. alvei. According to the new data, mycobacteria were divided into 5 clades (Abscessus-Chelonae, Fortuitum-Vaccae, Terrae, Triviale, Tuberculosis-Simiae), and based on molecular genetic studies, new genera in the Mycobacteriaceae family were isolated: Mycolicibacter spp., Mycolicibacillus spp., Mycolicibacillus spp., Mycobacteroides spp., Mycolicibacterium spp. In accordance with the new classification, representatives of the Mycobacterium fortuitum group belong to the genus Mycolicibacterium. The main epidemiological features of the main sources of the spread of mycobacteria, factors and ways of their transmission are indicated. Due to their wide distribution in the environment, representatives of the M. fortuitum group are capable of causing diseases of the pulmonary and extrapulmonary localization. The distinctive features of pathogenicity factors, due to which the course of the disease is determined, are noted. The article also indicates the main difficulties and features of determining the sensitivity to antimicrobial chemotherapy drugs, provides data on the main features of antibiotic resistance of M.fortuitum group. In preparing the review, literature sources obtained from international and domestic databases were used: Scopus, Web of Science, Springer, RSCI.
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Li S, Yang Z, Hu D, Cao L, He Q. Understanding building-occupant-microbiome interactions toward healthy built environments: A review. FRONTIERS OF ENVIRONMENTAL SCIENCE & ENGINEERING 2020; 15:65. [PMID: 33145119 PMCID: PMC7596174 DOI: 10.1007/s11783-020-1357-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/30/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
Built environments, occupants, and microbiomes constitute a system of ecosystems with extensive interactions that impact one another. Understanding the interactions between these systems is essential to develop strategies for effective management of the built environment and its inhabitants to enhance public health and well-being. Numerous studies have been conducted to characterize the microbiomes of the built environment. This review summarizes current progress in understanding the interactions between attributes of built environments and occupant behaviors that shape the structure and dynamics of indoor microbial communities. In addition, this review also discusses the challenges and future research needs in the field of microbiomes of the built environment that necessitate research beyond the basic characterization of microbiomes in order to gain an understanding of the causal mechanisms between the built environment, occupants, and microbiomes, which will provide a knowledge base for the development of transformative intervention strategies toward healthy built environments. The pressing need to control the transmission of SARS-CoV-2 in indoor environments highlights the urgency and significance of understanding the complex interactions between the built environment, occupants, and microbiomes, which is the focus of this review.
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Affiliation(s)
- Shuai Li
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
| | - Zhiyao Yang
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN 47907 USA
| | - Da Hu
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
| | - Liu Cao
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
| | - Qiang He
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
- Institute for a Secure & Sustainable Environment, University of Tennessee, Knoxville, TN 37996 USA
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Campos-Gutiérrez S, Ramos-Real MJ, Abreu R, Jiménez MS, Lecuona M. Pseudo-outbreak of Mycobacterium fortuitum in a hospital bronchoscopy unit. Am J Infect Control 2020; 48:765-769. [PMID: 31882175 DOI: 10.1016/j.ajic.2019.11.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/16/2019] [Accepted: 11/16/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Mycobacterium fortuitum survive in different environmental conditions, biofilm formation and resistance to chlorinated disinfectants makes its isolation frequent in hospital environments, even being involved in outbreaks by contamination of medical equipment such as bronchoscopes. We describe a pseudo-outbreak by M fortuitum isolated in samples from 9 patients who underwent bronchoscopy in the pneumology bronchoscopy unit of the University Hospital Complex of the Canary Islands from December 2016 to March 2017. METHODS We proceeded to investigate the pseudo-outbreak with a combination of epidemiologic, environmental, and molecular typing data. RESULTS The source/reservoir of pseudo-outbreak was the hospital water used by the bronchoscope automatic washing machine (without antibacterial filter), so control measures were taken. Molecular typing was performed on 7 strains from 7 patients, and a sample of water was collected from a tap in the pneumology bronchoscopy unit: all of which had the same pattern. CONCLUSIONS Our study demonstrates the presence of nontuberculous mycobacteria in the hospital water supply, and thus the need to take measures against them because they compromise patients' health. We also suggest the need for hospital water quality guidelines in which methods to control and/or eliminate them are established.
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Larsen MH, Lacourciere K, Parker TM, Kraigsley A, Achkar JM, Adams LB, Dupnik KM, Hall-Stoodley L, Hartman T, Kanipe C, Kurtz SL, Miller MA, Salvador LCM, Spencer JS, Robinson RT. The Many Hosts of Mycobacteria 8 (MHM8): A conference report. Tuberculosis (Edinb) 2020; 121:101914. [PMID: 32279870 PMCID: PMC7428850 DOI: 10.1016/j.tube.2020.101914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/07/2020] [Accepted: 02/09/2020] [Indexed: 12/18/2022]
Abstract
Mycobacteria are important causes of disease in human and animal hosts. Diseases caused by mycobacteria include leprosy, tuberculosis (TB), nontuberculous mycobacteria (NTM) infections and Buruli Ulcer. To better understand and treat mycobacterial disease, clinicians, veterinarians and scientists use a range of discipline-specific approaches to conduct basic and applied research, including conducting epidemiological surveys, patient studies, wildlife sampling, animal models, genetic studies and computational simulations. To foster the exchange of knowledge and collaboration across disciplines, the Many Hosts of Mycobacteria (MHM) conference series brings together clinical, veterinary and basic scientists who are dedicated to advancing mycobacterial disease research. Started in 2007, the MHM series recently held its 8th conference at the Albert Einstein College of Medicine (Bronx, NY). Here, we review the diseases discussed at MHM8 and summarize the presentations on research advances in leprosy, NTM and Buruli Ulcer, human and animal TB, mycobacterial disease comorbidities, mycobacterial genetics and 'omics, and animal models. A mouse models workshop, which was held immediately after MHM8, is also summarized. In addition to being a resource for those who were unable to attend MHM8, we anticipate this review will provide a benchmark to gauge the progress of future research concerning mycobacteria and their many hosts.
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Affiliation(s)
- Michelle H Larsen
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Karen Lacourciere
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20892, USA
| | - Tina M Parker
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20892, USA
| | - Alison Kraigsley
- Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, MN, USA
| | - Jacqueline M Achkar
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Linda B Adams
- Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, National Hansen's Disease Programs, Baton Rouge, LA, USA
| | - Kathryn M Dupnik
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Luanne Hall-Stoodley
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA
| | - Travis Hartman
- Center for Global Health, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Carly Kanipe
- Department of Immunobiology, Iowa State University, Ames, IA, USA; Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA; Bacterial Diseases of Livestock Research Unit, National Animal Disease Center, Agricultural Research Service, United States Department of Agriculture, Ames, IA, USA
| | - Sherry L Kurtz
- Laboratory of Mucosal Pathogens and Cellular Immunology, Division of Bacterial, Parasitic and Allergenic Products, Center for Biologics Evaluation and Research, Food and Drug Administration, Washington, DC, USA
| | - Michele A Miller
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Liliana C M Salvador
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA; Institute of Bioinformatics, University of Georgia, Athens, GA, USA; Center for the Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - John S Spencer
- Department of Microbiology, Immunology, and Pathology, Mycobacteria Research Laboratories, Colorado State University, Fort Collins, CO, USA
| | - Richard T Robinson
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA.
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Paul GR, Leber A, Nemastil CJ, Novak KJ, Brady M, Stack-Simone S, Greninger AL, Antonara S. Identification of Mycobacterium porcinum in patients with cystic Fibrosis: Pathogen or contaminant? J Cyst Fibros 2020; 19:580-586. [PMID: 31982335 DOI: 10.1016/j.jcf.2020.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/03/2020] [Accepted: 01/13/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mycobacterium porcinum is a non-tuberculous mycobacterium (NTM) identified in potable water. The identification and clinical impact of M. porcinum in patients with cystic fibrosis (CF) has not been described. In our institution, M. porcinum was isolated exclusively during hospitalization in a cluster of patients with CF. METHODS Patients with CF who were hospitalized between September 2016 and September 2018 and could expectorate sputum were included, and samples were processed per institutional guidelines. Post-hospitalization and one-year clinical outcomes on those who isolated M. porcinum in respiratory cultures were reviewed. Whole genome sequencing was performed on M. porcinum isolates obtained from patients and environmental sources to identify source of acquisition. RESULTS Review of 14 CF patients with 16 M. porcinum isolates revealed rapid time to culture positivity within 0.8 (0.04-8.0) days after admission. M. porcinum was isolated in teenagers and adults irrespective of baseline pulmonary function, body mass index, or CF genotype. Whole genome sequencing suggested all isolates belong to the same M. porcinum strain and confirmed the source of acquisition to the ice machine. Review of patients' clinical course, including three patients who underwent lung transplantation, suggested a pseudo-outbreak with minimal clinical impact. CONCLUSIONS NTM, including M. porcinum, are ubiquitous in potable water and institutional water reservoirs. Our findings suggest M. porcinum is a transient colonizer rather than a pathogen. Challenges exist in discerning the role of NTM as a contributor of pulmonary morbidity in patients with CF, and adherence to established guidelines regarding NTM related pulmonary disease remains important.
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Affiliation(s)
- Grace R Paul
- Division of Pulmonary Medicine, Nationwide Children's Hospital, 700 Children's Drive Columbus, OH 43205 USA.
| | - Amy Leber
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Christopher J Nemastil
- Division of Pulmonary Medicine, Nationwide Children's Hospital, 700 Children's Drive Columbus, OH 43205 USA.
| | - Kimberly J Novak
- Division of Pulmonary Medicine, Nationwide Children's Hospital, 700 Children's Drive Columbus, OH 43205 USA.
| | - Michael Brady
- Division of Infectious disease, Nationwide Children's Hospital, Columbus, OH, USA.
| | | | | | - Stella Antonara
- Department of Laboratory Services, OhioHealth, Columbus, OH, USA.
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Cox A, Udenberg TJ. Mycobacterium porcinum causing panniculitis in the cat. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2020; 61:39-43. [PMID: 31892752 PMCID: PMC6909422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 4-year-old domestic shorthair cat was presented with a 7-month history of nodules and draining fistulous tracts of the ventral abdomen. Histopathological examination of affected tissue revealed acid-fast bacilli stained by the Ziehl-Neelsen procedure. Deep tissue culture confirmed infection with a rapidly growing mycobacterium, and gene sequencing characterized the organism as Mycobacterium porcinum. Treatment with pradofloxacin and doxycycline resulted in clinical resolution of the lesions. On continued antibiotic therapy 7 months later, there was no local recurrence nor were there clinical signs associated with distant spread of the infection. This is the first clinical description of a feline infection with this organism. Key clinical message: This is the first clinical description of mycobacterial panniculitis in a cat due to genetically characterized Mycobacterium porcinum. This case report highlights a disease entity that can present a diagnostic and therapeutic challenge to clinicians.
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Affiliation(s)
- Allison Cox
- North West Veterinary Dermatology Services, 1380 Kootenay Street, Vancouver, British Columbia V5K 4R1
| | - Tyler J Udenberg
- North West Veterinary Dermatology Services, 1380 Kootenay Street, Vancouver, British Columbia V5K 4R1
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Kloth H, Elbadawi LI, Bateman A, Louison L, Shrivastwa N. Notes from the Field: Hospital Water Contamination Associated with a Pseudo-Outbreak of Mycobacterium porcinum — Wisconsin, 2016–2018. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2019; 68:1149. [PMID: 31830010 PMCID: PMC6919292 DOI: 10.15585/mmwr.mm6849a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Clusters of nontuberculous mycobacteria linked to water sources at three Veterans Affairs medical centers. Infect Control Hosp Epidemiol 2019; 41:320-330. [DOI: 10.1017/ice.2019.342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
AbstractObjective:To characterize nontuberculous mycobacteria (NTM) associated with case clusters at 3 medical facilities.Design:Retrospective cohort study using molecular typing of patient and water isolates.Setting:Veterans Affairs Medical Centers (VAMCs).Methods:Isolation and identification of NTM from clinical and water samples using culture, MALDI-TOF, and gene population sequencing to determine species and genetic relatedness. Clinical data were abstracted from electronic health records.Results:An identical strain of Mycobacterium conceptionense was isolated from 41 patients at VA Medical Centers (VAMCs A, B, and D), and from VAMC A’s ICU ice machine. Isolates were initially identified as other NTM species within the M. fortuitum clade. Sequencing analyses revealed that they were identical M. conceptionense strains. Overall, 7 patients (17%) met the criteria for pulmonary or nonpulmonary infection with NTM, and 13 of 41 (32%) were treated with effective antimicrobials regardless of infection or colonization status. Separately, a M. mucogenicum patient strain from VAMC A matched a strain isolated from a VAMC B ICU ice machine. VAMC C, in a different state, had a 4-patient cluster with Mycobacterium porcinum. Strains were identical to those isolated from sink-water samples at this facility.Conclusion:NTM from hospital water systems are found in hospitalized patients, often during workup for other infections, making attribution of NTM infection problematic. Variable NTM identification methods and changing taxonomy create challenges for epidemiologic investigation and linkage to environmental sources.
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Revisiting John Snow to Meet the Challenge of Nontuberculous Mycobacterial Lung Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214250. [PMID: 31683836 PMCID: PMC6862550 DOI: 10.3390/ijerph16214250] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 01/09/2023]
Abstract
Nontuberculous mycobacteria (NTM) are ubiquitous components of the soil and surface water microbiome. Disparities by sex, age, and geography demonstrate that both host and environmental factors are key determinants of NTM disease in populations, which predominates in the form of chronic pulmonary disease. As the incidence of NTM pulmonary disease rises across the United States, it becomes increasingly evident that addressing this emerging human health issue requires a bold, multi-disciplinary research framework that incorporates host risk factors for NTM pulmonary disease alongside the determinants of NTM residence in the environment. Such a framework should include the assessment of environmental characteristics promoting NTM growth in soil and surface water, detailed evaluations of water distribution systems, direct sampling of water sources for NTM contamination and species diversity, and studies of host and bacterial factors involved in NTM pathogenesis. This comprehensive approach can identify intervention points to interrupt the transmission of pathogenic NTM species from the environment to the susceptible host and to reduce NTM pulmonary disease incidence.
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Retrospective Analysis of Nontuberculous Mycobacterial Infection and Monochloramine Disinfection of Municipal Drinking Water in Michigan. mSphere 2019; 4:4/4/e00160-19. [PMID: 31270167 PMCID: PMC6609225 DOI: 10.1128/msphere.00160-19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Infections by nontuberculous mycobacteria (NTM) result in significant morbidity, mortality, and health care costs. NTM are primarily acquired from environmental sources, including exposure to municipally treated drinking water. Higher levels of NTM have been reported in drinking water disinfected with monochloramine than in drinking water disinfected with chlorine. Our results suggest that municipal drinking water disinfection with monochloramine compared to chlorine is not associated with higher risk of NTM infection. This is important given that regulations that limit drinking water concentrations of disinfection by-products, which are formed primarily when chlorine disinfection is used, incentivize drinking water utilities to change from chlorine disinfection to monochloramine disinfection. Infections by nontuberculous mycobacteria (NTM) are primarily acquired from environmental sources, including exposure to municipally treated drinking water. Higher levels of NTM have been reported in drinking water disinfected with monochloramine than in that disinfected with chlorine. However, the relationships between water treatment practices and NTM infection are unclear. The objective of this study was to examine a possible relationship between residual disinfectant used for municipal drinking water treatment (monochloramine or chlorine) and NTM infection. We retrospectively reviewed NTM diagnostic tests performed at a single health care center during a 15-year period. Information on municipal water treatment practices, including disinfectant and primary source water type, was obtained for 140 cities. Based on a logistic regression model, municipal drinking water disinfection with monochloramine compared to chlorine was not associated with NTM infection (P = 0.24). An additional model variable examining water source showed that the likelihood of having an NTM infection was 1.46 times higher for patients residing in cities with drinking water derived from surface water than for those residing in cities with drinking water derived from groundwater (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.03 to 2.08; P = 0.04). In an inverse propensity score weighted regression, monochloramine disinfection was also not associated with NTM infection. A moderate effect on NTM infection rates was observed in the weighted regression for municipal drinking water derived from surface water, though the results were not statistically significant (OR, 1.24; 95% CI, 0.92 to 1.69; P = 0.17). IMPORTANCE Infections by nontuberculous mycobacteria (NTM) result in significant morbidity, mortality, and health care costs. NTM are primarily acquired from environmental sources, including exposure to municipally treated drinking water. Higher levels of NTM have been reported in drinking water disinfected with monochloramine than in drinking water disinfected with chlorine. Our results suggest that municipal drinking water disinfection with monochloramine compared to chlorine is not associated with higher risk of NTM infection. This is important given that regulations that limit drinking water concentrations of disinfection by-products, which are formed primarily when chlorine disinfection is used, incentivize drinking water utilities to change from chlorine disinfection to monochloramine disinfection.
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Garcia-Coca M, Rodriguez-Sevilla G, Muñoz-Egea MC, Perez-Jorge C, Carrasco-Anton N, Esteban J. Historical evolution of the diseases caused by non-pigmented rapidly growing mycobacteria in a University Hospital. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2019; 32:451-457. [PMID: 31535542 PMCID: PMC6790884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Non-pigmented rapidly growing mycobacteria (NPRGM) are a group of organisms of increasing interest due to the growing number of potential patients and the difficulties for a proper treatment in many of them. However, the evolution of these diseases in a long period of time and its evolutionary changes has been described only in a scanty number of reports. METHODS We performed a retrospective study between January 1st 2004 and December 31st 2017 in order to evaluate the clinical significance and types of diseases caused by NPRGM. Patients with isolates of NPRGM during this period were selected for the study, and clinical charts were reviewed using a predefined protocol. RESULTS During this period we identified 59 patients (76 clinical samples) with isolates of NPRGM, with 12 cases of clinical disease and one patient with doubtful significance (including 6 respiratory tract infections, 2 catheter infections, 1 skin and soft tissue infection, 1 disseminated infection, 1 conjunctivitis, 1 prosthetic joint infection and 1 mastitis). Fifty percent of M. chelonae isolates, 37.5% of M. abscessus isolates and 23.33% of M. fortuitum isolates were clinically significant. None of the isolates of other species were significant. CONCLUSIONS Most isolates in respiratory samples were contaminants/colonizations. M. abscessus was the main etiological agent in respiratory syndromes, whereas M. chelonae and M. fortuitum were more frequently associated with other infections, especially clinical devices and skin and soft tissue infections.
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Affiliation(s)
- Marta Garcia-Coca
- Departments of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM. Madrid, Spain
| | | | | | | | | | - Jaime Esteban
- Departments of Clinical Microbiology, IIS-Fundación Jiménez Díaz, UAM. Madrid, Spain,Correspondencia: Jaime Esteban Dept. Of Clinical Microbiology. IIS-Fundación Jiménez Díaz. Av. Reyes Católicos 2. 28040-Madrid (Spain). Phone: +34915504900. E-mail: ;
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Honda JR, Virdi R, Chan ED. Global Environmental Nontuberculous Mycobacteria and Their Contemporaneous Man-Made and Natural Niches. Front Microbiol 2018; 9:2029. [PMID: 30214436 PMCID: PMC6125357 DOI: 10.3389/fmicb.2018.02029] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 08/10/2018] [Indexed: 11/15/2022] Open
Abstract
Seminal microbiological work of environmental nontuberculous mycobacteria (NTM) includes the discovery that NTM inhabit water distribution systems and soil, and that the species of NTM found are geographically diverse. It is likely that patients acquire their infections from repeated exposures to their environments, based on the well-accepted paradigm that water and soil bioaerosols - enriched for NTM - can be inhaled into the lungs. Support comes from reports demonstrating NTM isolated from the lungs of patients are genetically identical to NTM found in their environment. Well documented sources of NTM include peat-rich soils, natural waters, drinking water, hot water heaters, refrigerator taps, catheters, and environmental amoeba. However, NTM have also been recovered in biofilms from ice machines, heated nebulizers, and heater-cooler units, as well as seat dust from theaters, vacuum cleaners, and cobwebs. New studies on the horizon aim to significantly expand the current knowledge of environmental NTM niches in order to improve our current understanding of the specific ecological factors driving the emergence of NTM lung disease. Specifically, the Hawaiian Island environment is currently being studied as a model to identify other point sources of exposure as it is the U.S. state with the highest number of NTM lung disease cases. Because of its geographic isolation and unique ecosystem, the Hawaiian environment is being probed for correlative factors that may promote environmental NTM colonization.
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Affiliation(s)
- Jennifer R. Honda
- Department of Biomedical Research and the Center for Genes, Environment, and Health, National Jewish Health, Denver, CO, United States
| | - Ravleen Virdi
- Department of Biomedical Research and the Center for Genes, Environment, and Health, National Jewish Health, Denver, CO, United States
| | - Edward D. Chan
- Medicine and Academic Affairs, National Jewish Health, Denver, CO, United States
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver, Aurora, CO, United States
- Department of Medicine, Denver Veterans Affairs Medical Center, Denver, CO, United States
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Mittelman MW, Jones ADG. A Pure Life: The Microbial Ecology of High Purity Industrial Waters. MICROBIAL ECOLOGY 2018; 76:9-18. [PMID: 26879941 DOI: 10.1007/s00248-016-0736-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 02/01/2016] [Indexed: 06/05/2023]
Abstract
The microbial ecology of various natural environments has been an active area of research since the earlier part of the twentieth century. Remote and sometimes extreme environments such as the deep ocean and the deep terrestrial subsurface have revealed a remarkable array of microorganisms. The majority of these environments are nutrient limited, and microorganisms-principally, bacteria-have developed a number of survival strategies that enable their survival and, in some cases, replication. While planktonic microorganisms exist in oligotrophic environments, the predominant mode of survival and growth is associated with biofilms. There are a number of similarities between the physicochemistry of industrial water systems and some natural aquatic ecosystems, and these similarities extend to the microbial populations and the survival mechanisms that are employed. The "starvation-survival" mechanisms, including biofilm formation, may be associated with deleterious effects on industrial water systems. These effects include heat transfer inhibition, microbially influenced corrosion, and contamination of various products manufactured in a wide array of industries. Biological fouling of industrial water systems has significant direct and indirect (through antimicrobial chemical applications) impacts on engineered materials and on the etiology of some waterborne diseases. This review provides an overview of the microbial ecology of purified waters and discusses the impacts of biological activity on industrial systems.
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Affiliation(s)
- M W Mittelman
- Exponent, 9 Strathmore Rd., Natick, MA, 01760, USA.
- Harvard School of Engineering and Applied Sciences, 58 Oxford St., Rm. 301, Cambridge, MA, 02138, USA.
| | - A D G Jones
- Exponent, 9 Strathmore Rd., Natick, MA, 01760, USA
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Li H, Li S, Tang W, Yang Y, Zhao J, Xia S, Zhang W, Wang H. Influence of secondary water supply systems on microbial community structure and opportunistic pathogen gene markers. WATER RESEARCH 2018; 136:160-168. [PMID: 29501760 DOI: 10.1016/j.watres.2018.02.031] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 02/10/2018] [Accepted: 02/12/2018] [Indexed: 06/08/2023]
Abstract
Secondary water supply systems (SWSSs) refer to the in-building infrastructures (e.g., water storage tanks) used to supply water pressure beyond the main distribution systems. The purpose of this study was to investigate the influence of SWSSs on microbial community structure and the occurrence of opportunistic pathogens, the latter of which are an emerging public health concern. Higher numbers of bacterial 16S rRNA genes, Legionella and mycobacterial gene markers were found in public building taps served by SWSSs relative to the mains, regardless of the flushing practice (P < 0.05). In residential buildings, genes of L. pneumomhila, Acanthamoeba and Vermamoeba vermiformis were primarily detected in tanks and taps compared to the mains. Long water retention time, warm temperature and loss of disinfectant residuals promoted microbial growth and colonization of potential pathogens in SWSSs. Varied levels of microbial community shifts were found in different types of SWSSs during water transportation from the distribution main to taps, highlighting the critical role of SWSSs in shaping the drinking water microbiota. Overall, the results provided insight to factors that might aid in controlling pathogen proliferation in real-world water systems using SWSSs.
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Affiliation(s)
- Huan Li
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai 200092, China
| | - Shang Li
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China
| | - Wei Tang
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China
| | - Yang Yang
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Jianfu Zhao
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai 200092, China
| | - Siqing Xia
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai 200092, China
| | - Weixian Zhang
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai 200092, China
| | - Hong Wang
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai 200092, China; Shanghai Institute of Pollution Control and Ecological Security, Shanghai 200092, China.
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Abstract
Mycobacterium porcinum is a rapidly growing environmental mycobacterium responsible for opportunistic infections. The 7,025,616-bp draft genome of M. porcinum strain CSURP1564 exhibits a 66.71% G+C content, 6,687 protein-coding genes, and 65 predicted RNA genes. In silico DNA-DNA hybridization confirms its assignment to the Mycobacterium fortuitum complex.
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A novel wall water system for cardiopulmonary bypass may reduce the risk of aerosolized infection. J Thorac Cardiovasc Surg 2018; 156:318-324. [PMID: 29615331 DOI: 10.1016/j.jtcvs.2018.02.077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 01/23/2018] [Accepted: 02/09/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Oxygenators for cardiopulmonary bypass require water flow for their integral heat exchanger. Heater-cooler units are nearly universally used for this requirement. Heater-cooler units pose the risk of aerosolized infection. The Centers for Disease Control and Prevention recommended discontinuing use of Stöckert 3T heater-cooler units (LivaNova PLC, London, United Kingdom) in October 2016 because of this risk. We aimed to reduce the risk of aerosolized infection posed by heater-cooler units by eliminating those devices from our operating rooms. METHODS The cardiac surgery division collaborated with in-house specialties to engineer a novel wall water system. The design called for service to 4 operating rooms with the actual water mixing valve in an operating room closet. Remote temperature control was mounted next to the heart-lung machine. Primary safety systems built into the water system include 5 μm filtration, pressure regulating and relief valves, flow quantifiers, limits to the hot and chilled input temperatures, and a novel bridge near the heart-lung machine that allows the perfusionist to test the system before patient use and to quickly disconnect the patient in case of system malfunction. In addition, all water line connections can be made with the tubing drained and never under pressure. RESULTS This novel wall water system has successfully provided heat exchanger water flow on 625 patients undergoing congenital heart surgery requiring cardiopulmonary bypass during its first 9 months of use. CONCLUSIONS Wall water systems are an option for oxygenator heat exchangers that allow for improved heat exchange performance while reducing the risk of heater-cooler unit-associated infection during cardiac surgery.
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Comparison of microbial community shifts in two parallel multi-step drinking water treatment processes. Appl Microbiol Biotechnol 2017; 101:5531-5541. [DOI: 10.1007/s00253-017-8258-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/15/2017] [Accepted: 03/17/2017] [Indexed: 01/27/2023]
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Pseudooutbreak of rapidly growing mycobacteria due to Mycobacterium abscessus subsp bolletii in a digestive and respiratory endoscopy unit caused by the same clone as that of a countrywide outbreak. Am J Infect Control 2016; 44:e221-e226. [PMID: 27524260 DOI: 10.1016/j.ajic.2016.06.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 06/21/2016] [Accepted: 06/21/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND The nontuberculous mycobacteria (NTM) are widely spread. In Brazil, 2,520 cases of rapidly growing mycobacteria (RGM) infections after medical procedures were reported, with 5.4% of cases related to nonsurgical invasive procedures and with an occurrence of 1 clone (BRA100) of Mycobacterium abscessus subsp bolletii. OBJECTIVE To describe a pseudooutbreak of M abscessus subsp bolletii in an endoscopy and bronchoscopy unit. METHODS The alert for a pseudooutbreak was given when 3 patients, in the same week, had a positive bronchoalveolar lavage culture for M abscessus subsp bolletii. The patients had no symptoms/signs of mycobacterial infection; thus, contamination of bronchoscopes was suspected. Samples for culturing were collected from bronchoscopes, digestive endoscopes, automated disinfection machines, and the water supply. Clinical samples were identified by polymerase chain reaction restriction-enzyme analysis (PRA) of the hsp65 gene and their pulsed-field gel electrophoresis pattern was compared with environmental samples. RESULTS The investigation demonstrated a contamination of bronchoscopes, digestive endoscopes, and disinfection machines. Molecular typing demonstrated that all strains belonged to the same clone (MAB01), identical to clone BRA100. DISCUSSION Cross-transmission due to poor disinfection as well as resistance to glutaraldehyde may play roles in the spread of MAB01 M abscessus subsp bolletii, which may have a unique resistance to the environment and adaption to human hosts. However the water supply may have played a role. Attention is needed to ensure the quality of water used to rinse disinfected equipment.
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Honda JR, Hasan NA, Davidson RM, Williams MD, Epperson LE, Reynolds PR, Smith T, Iakhiaeva E, Bankowski MJ, Wallace RJ, Chan ED, Falkinham JO, Strong M. Environmental Nontuberculous Mycobacteria in the Hawaiian Islands. PLoS Negl Trop Dis 2016; 10:e0005068. [PMID: 27780201 PMCID: PMC5079566 DOI: 10.1371/journal.pntd.0005068] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/23/2016] [Indexed: 01/26/2023] Open
Abstract
Lung disease caused by nontuberculous mycobacteria (NTM) is an emerging infectious disease of global significance. Epidemiologic studies have shown the Hawaiian Islands have the highest prevalence of NTM lung infections in the United States. However, potential environmental reservoirs and species diversity have not been characterized. In this cross-sectional study, we describe molecular and phylogenetic comparisons of NTM isolated from 172 household plumbing biofilms and soil samples from 62 non-patient households and 15 respiratory specimens. Although non-uniform geographic sampling and availability of patient information were limitations, Mycobacterium chimaera was found to be the dominant species in both environmental and respiratory specimens. In contrast to previous studies from the continental U.S., no Mycobacterium avium was identified. Mycobacterium intracellulare was found only in respiratory specimens and a soil sample. We conclude that Hawai’i’s household water sources contain a unique composition of Mycobacterium avium complex (MAC), increasing our appreciation of NTM organisms of pulmonary importance in tropical environments. In the U.S., the Hawaiian Islands have the highest number of nontuberculous mycobacterial (NTM) lung disease cases per capita. The tropical climate, geographical isolation of the islands, and aquifer water sources may have influence such prevalence. Previous studies suggest that NTM thrive in water biofilms and soil. To broaden our understanding of potential environmental reservoirs and species composition of NTM in the Hawaiian Islands, we sampled environmental sites and examined patient isolates. Our recovery and identification of Mycobacterium chimaera and several other clinically relevant NTM species and the absence of Mycobacterium avium in both the indigenous environment and clinical specimens underscore the need for further studies to define the environmental factors that drive NTM lung disease and species composition in high prevalence locations such as the Hawaiian Islands.
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Affiliation(s)
- Jennifer R. Honda
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, United States Of America
- Denver Veterans Affairs Medical Center, Denver, Colorado, United States Of America
- National Jewish Health, Denver, Colorado, United States Of America
- * E-mail: , )
| | - Nabeeh A. Hasan
- National Jewish Health, Denver, Colorado, United States Of America
| | | | | | | | - Paul R. Reynolds
- National Jewish Health, Denver, Colorado, United States Of America
| | - Terry Smith
- Virginia Tech, Blacksburg, Virginia, United States Of America
| | - Elena Iakhiaeva
- Virginia Tech, Blacksburg, Virginia, United States Of America
| | - Matthew J. Bankowski
- Diagnostic Laboratory Services Inc., Aiea, Hawai’i, United States Of America
- Departments of Pathology and Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, the University of Hawai’i at Manoa, Honolulu, Hawai’i, United States Of America
| | - Richard J. Wallace
- University of Texas Health Science Center, Tyler, Texas, United States Of America
| | - Edward D. Chan
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, United States Of America
- Denver Veterans Affairs Medical Center, Denver, Colorado, United States Of America
- National Jewish Health, Denver, Colorado, United States Of America
| | | | - Michael Strong
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, United States Of America
- National Jewish Health, Denver, Colorado, United States Of America
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Kanamori H, Weber DJ, Rutala WA. Healthcare Outbreaks Associated With a Water Reservoir and Infection Prevention Strategies. Clin Infect Dis 2016; 62:1423-35. [DOI: 10.1093/cid/ciw122] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 02/19/2016] [Indexed: 12/13/2022] Open
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Lu J, Struewing I, Vereen E, Kirby AE, Levy K, Moe C, Ashbolt N. Molecular Detection of Legionella
spp. and their associations with Mycobacterium
spp., Pseudomonas aeruginosa
and amoeba hosts in a drinking water distribution system. J Appl Microbiol 2016; 120:509-21. [DOI: 10.1111/jam.12996] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/08/2015] [Accepted: 10/27/2015] [Indexed: 01/12/2023]
Affiliation(s)
- J. Lu
- U.S. EPA National Exposure Research Laboratory; Cincinnati OH USA
| | | | - E. Vereen
- Center for Global Safe Water; Sanitation and Hygiene; Emory University; Atlanta GA USA
| | - A. E. Kirby
- Center for Global Safe Water; Sanitation and Hygiene; Emory University; Atlanta GA USA
| | - K. Levy
- Center for Global Safe Water; Sanitation and Hygiene; Emory University; Atlanta GA USA
| | - C. Moe
- Center for Global Safe Water; Sanitation and Hygiene; Emory University; Atlanta GA USA
| | - N. Ashbolt
- School of Public Health; University of Alberta; Edmonton AB Canada
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Koay WLA, Aigbivbalu L, Patel J. A neonate born with Mycobacterium cosmeticum bacteraemia. BMJ Case Rep 2015; 2015:bcr-2015-213452. [PMID: 26698212 DOI: 10.1136/bcr-2015-213452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Mycobacterium cosmeticum is a rapidly growing mycobacterium that was recently identified. However, its role in human infection has not been well described. We present a case of an extremely premature neonate born with bacteraemia due to M. cosmeticum that resolved without sequelae. The infection likely occurred during a prolonged intrauterine transfusion procedure.
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Affiliation(s)
- Wei Li Adeline Koay
- Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lemuel Aigbivbalu
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas, USA
| | - Janak Patel
- Department of Pediatrics, University of Texas Medical Branch, Galveston, Texas, USA
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Phelippeau M, Aboubaker Osman D, Musso D, Drancourt M. Epidemiology of Nontuberculous Mycobacteria in French Polynesia. J Clin Microbiol 2015; 53:3798-804. [PMID: 26400787 PMCID: PMC4652114 DOI: 10.1128/jcm.01560-15] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 09/16/2015] [Indexed: 11/20/2022] Open
Abstract
As few data are available in the Pacific countries and territories of the Oceania region regarding nontuberculous mycobacteria,we retrospectively identified 87 such isolates from French Polynesia from 2008 to 2013 by hybridization using DNA-strip, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and partial rpoB gene sequencing. Partial rpoB gene sequencing classified 42/87 (48.3%) isolates in the Mycobacterium fortuitum complex, 28 (32.2%) in the Mycobacterium abscessus complex, 8 (9.2%) in the Mycobacterium mucogenicum complex, and 5 (5.7%) in the Mycobacterium avium complex. Two isolates were identified as Mycobacterium acapulcensis and Mycobacterium cosmeticum by partial 16S rRNA gene sequencing. One isolate, unidentified by MALDI-TOF MS and yielding less than 92% and 96% sequence similarity with rpoB and hsp65 reference sequences, respectively, was regarded as a potentially new species. Samples from three patients exhibiting>2 Mycobacterium porcinum isolates and from one patient with emphysema and a lung abscess exhibiting 2 Mycobacterium senegalense isolates fulfilled the American Thoracic Society microbiological criteria for nontuberculous mycobacterial lung infection.Remote geographic areas, such as French Polynesia, are potential sources for the discovery of new mycobacterial species.
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MESH Headings
- Adult
- Aged
- Bacterial Proteins/genetics
- Chaperonin 60/genetics
- Cluster Analysis
- DNA, Bacterial/chemistry
- DNA, Bacterial/genetics
- DNA, Ribosomal/chemistry
- DNA, Ribosomal/genetics
- DNA-Directed RNA Polymerases/genetics
- Female
- Humans
- Male
- Middle Aged
- Mycobacterium Infections, Nontuberculous/epidemiology
- Mycobacterium Infections, Nontuberculous/microbiology
- Nontuberculous Mycobacteria/classification
- Nontuberculous Mycobacteria/isolation & purification
- Nucleic Acid Hybridization
- Phylogeny
- Polynesia/epidemiology
- RNA, Ribosomal, 16S/genetics
- Retrospective Studies
- Sequence Analysis, DNA
- Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
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Affiliation(s)
- Michael Phelippeau
- Aix-Marseille Université, URMITE, UMR CNRS 7278, IRD 198, Inserm 1095, Marseille, France
| | | | - Didier Musso
- Pôle de recherche et de veille sur les maladies infectieuses émergentes, Institut Louis Malardé, Tahiti, French Polynesia
| | - Michel Drancourt
- Aix-Marseille Université, URMITE, UMR CNRS 7278, IRD 198, Inserm 1095, Marseille, France
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Lecuona M, Abreu R, Rodríguez-Álvarez C, Castro B, Campos S, Hernández-Porto M, Mendoza P, Arias A. First isolation of Mycobacterium canariasense from municipal water supplies in Tenerife, Canary Islands, Spain. Int J Hyg Environ Health 2015; 219:48-52. [PMID: 26324115 DOI: 10.1016/j.ijheh.2015.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 08/16/2015] [Accepted: 08/17/2015] [Indexed: 01/13/2023]
Abstract
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.
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Affiliation(s)
- María Lecuona
- University Hospital of Canary Islands, Tenerife, Ofra, s/n 38320, San Cristóbal de La Laguna, Canary Islands, Spain; Preventive Medicine and Public Health, University of La Laguna, Santa Cruz de Tenerife 38071, Canary Islands, Spain
| | - Rossana Abreu
- University Hospital of Canary Islands, Tenerife, Ofra, s/n 38320, San Cristóbal de La Laguna, Canary Islands, Spain; Preventive Medicine and Public Health, University of La Laguna, Santa Cruz de Tenerife 38071, Canary Islands, Spain
| | | | - Beatriz Castro
- University Hospital of Canary Islands, Tenerife, Ofra, s/n 38320, San Cristóbal de La Laguna, Canary Islands, Spain
| | - Silvia Campos
- University Hospital of Canary Islands, Tenerife, Ofra, s/n 38320, San Cristóbal de La Laguna, Canary Islands, Spain
| | - Miriam Hernández-Porto
- University Hospital of Canary Islands, Tenerife, Ofra, s/n 38320, San Cristóbal de La Laguna, Canary Islands, Spain
| | - Pablo Mendoza
- Vircell S.L. Molecular Diagnostic Department, The Technology Park of Health Sciences, Granada, Spain
| | - Angeles Arias
- Preventive Medicine and Public Health, University of La Laguna, Santa Cruz de Tenerife 38071, Canary Islands, Spain.
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Halstrom S, Price P, Thomson R. Review: Environmental mycobacteria as a cause of human infection. Int J Mycobacteriol 2015; 4:81-91. [PMID: 26972876 DOI: 10.1016/j.ijmyco.2015.03.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/12/2015] [Indexed: 10/23/2022] Open
Abstract
Pulmonary infections with nontuberculous mycobacteria (NTM) are recognized as a problem in immunodeficient individuals and are increasingly common in older people with no known immune defects. NTM are found in soil and water, but factors influencing transmission from the environment to humans are mostly unknown. Studies of the epidemiology of NTM disease have matched some clinical isolates of NTM with isolates from the patient's local environment. Definitive matching requires strain level differentiation based on molecular analyses, including partial sequencing, PCR-restriction fragment length polymorphism (RFLP) analysis, random amplified polymorphic DNA (RAPD) PCR, repetitive element (rep-) PCR and pulsed field gel electrophoresis (PFGE) of large restriction fragments. These approaches have identified hospital and residential showers and faucets, hot-tubs and garden soil as sources of transmissible pathogenic NTM. However, gaps exist in the literature, with many clinical isolates remaining unidentified within environments that have been tested, and few studies investigating NTM transmission in developing countries. To understand the environmental reservoirs and transmission routes of pathogenic NTM, different environments, countries and climates must be investigated.
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Affiliation(s)
- Samuel Halstrom
- School of Medicine, University of Queensland, Room 513, Level 5, Mayne Medical Building, Herston Campus, Herston, Brisbane, QLD 4006, Australia; Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Newdegate Street, Greenslopes, Brisbane, QLD 4120, Australia.
| | - Patricia Price
- School of Biomedical Science, Curtin University of Technology, GPO Box U1987, Perth, WA 6845, Australia.
| | - Rachel Thomson
- School of Medicine, University of Queensland, Room 513, Level 5, Mayne Medical Building, Herston Campus, Herston, Brisbane, QLD 4006, Australia; Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Newdegate Street, Greenslopes, Brisbane, QLD 4120, Australia.
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Mwikuma G, Kwenda G, Hang'ombe BM, Simulundu E, Kaile T, Nzala S, Siziya S, Suzuki Y. Molecular identification of non-tuberculous mycobacteria isolated from clinical specimens in Zambia. Ann Clin Microbiol Antimicrob 2015; 14:1. [PMID: 25592857 PMCID: PMC4302154 DOI: 10.1186/s12941-014-0059-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 12/18/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The emergence of Acquired Immunodeficiency Syndrome has highlighted the increased incidence and importance of the disease caused by Non-tuberculous Mycobacteria (NTM). While disease due to M. avium-intracellulare complex is apparently common throughout the world, other Non-tuberculous mycobacterial species have been isolated from both immunocompromised and immunocompetent individuals. The increasing number of infections caused by these organisms has made it clinically important to quickly identify mycobacterial species. The diagnosis of a pathogenic versus a non-pathogenic species not only has epidemiological implications but is also relevant to the demands of patient management. Since antibiotic treatment varies according to the species encountered, species identification would reduce the burden of some of these emerging opportunistic pathogens especially in immunocompromised patients and improve their quality of life. FINDINGS A total of 91 NTM suspected isolates from four regions of Zambia were included in the study. These isolates were identified using the sequence analysis of the 16S-23S rRNA intergenic transcribed spacer (ITS) region of Mycobacteria. Fifty-four of the 91 (59%) isolates were identified as NTM and these included M. intracellulare (27.8%), M. lentiflavum (16.7%), M. avium (14.8%), M. fortuitum (7.4%), M. gordonae (7.4%), M. kumamotonense (3.7%), M. indicus pranii (3.7%), M. peregrinum (3.7%), M. elephantis (1.85%), M. flavescens (1.85%), M. asiaticum (1.85%), M. bouchedurhonense (1.85%), M. chimaera (1.85%), M. europaeum (1.85%), M. neourum (1.85%), M. nonchromogenicum (1.5%). CONCLUSION The study has shown that DNA sequencing of the ITS region may be useful in the preliminary identification of NTM species. All species identified in this study were potentially pathogenic.
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Affiliation(s)
- Grace Mwikuma
- School of Medicine, University of Zambia, Lusaka, Zambia.
| | - Geoffry Kwenda
- School of Medicine, University of Zambia, Lusaka, Zambia.
| | | | - Edgar Simulundu
- School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
| | - Trevor Kaile
- School of Medicine, University of Zambia, Lusaka, Zambia.
| | | | - Seter Siziya
- School of Medicine, Copperbelt University, Kitwe, Zambia.
| | - Yasuhiko Suzuki
- Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan.
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Guerrero I, García-Agudo L, Galán F, García-Martos P. Diferenciación de especies del complejo Mycobacterium fortuitum mediante espectrometría de masas. Enferm Infecc Microbiol Clin 2015; 33:67. [DOI: 10.1016/j.eimc.2014.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 04/21/2014] [Accepted: 04/30/2014] [Indexed: 11/16/2022]
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Brown-Elliott BA, Philley JV, Benwill JL, Wallace RJ. Current Opinions in the Treatment of Pulmonary Nontuberculous Mycobacteria in Non-Cystic Fibrosis Patients: Mycobacterium abscessus Group, Mycobacterium avium Complex, and Mycobacterium kansasii. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2014. [DOI: 10.1007/s40506-014-0032-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rapidly growing mycobacteria among pediatric hematopoietic cell transplant patients traced to the hospital water supply. Pediatr Infect Dis J 2014; 33:1043-6. [PMID: 24781138 DOI: 10.1097/inf.0000000000000391] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rapidly growing mycobacteria (RGM) have a predilection for those with immunocompromised states. We report increased isolation of RGM among pediatric hematopoietic cell transplant patients that was traced to the hospital water supply. METHODS Cases of RGM-positive patients were differentiated based on whether they were community-acquired or nosocomial, colonized or infected based on predefined criteria. Medical records of all RGM-positive patients were reviewed and data extracted. Infection control outbreak measures were instituted and an environmental investigation was conducted. RESULTS Between July 2011 and April 2012, 16 RGM isolates were identified among 15 hematopoietic cell transplant patients, compared with none in the preceding year. After environmental samples were initially grown on media for heterotrophic counts and further speciated, RGM species were identified in the hospital water supply. CONCLUSIONS This outbreak of RGM was traced to an environmental source and was successfully controlled through institution of infection control measures.
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Abstract
Nosocomial waterborne pathogens may reach patients through several modes of transmission. Colonization of healthcare facility waterworks can occur in the proximal infrastructure, in the distal water outlets, or both. Infections with waterborne organisms such as Legionella, mycobacteria, Pseudomonas, and others cause significant morbidity and mortality, particularly in immunocompromised patients. Hospitals should have prospective water safety plans that include preventive measures, as prevention is preferable to remediation of contaminated hospital water distribution systems. Whole-genome sequencing may provide more informative epidemiologic data to link patient infections with hospital water isolates.
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Affiliation(s)
- Brooke K Decker
- National Institutes of Health Clinical Center, 10 Center Drive, 12C103A, Bethesda, MD, 20892, USA
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Khosravi AD, Vatani S, Feizabadi MM, Abasi Montazeri E, Jolodar A. Application of Pulsed Field Gel Electrophoresis for Study of Genetic Diversity in Mycobacterium tuberculosis Strains Isolated From Tuberculosis Patients. Jundishapur J Microbiol 2014; 7:e9963. [PMID: 25147723 PMCID: PMC4138641 DOI: 10.5812/jjm.9963] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 04/25/2013] [Accepted: 05/05/2013] [Indexed: 12/03/2022] Open
Abstract
Background: Mycobacterium tuberculosis genotyping can effectively improve tuberculosis (TB) control programs by controlling disease transmission. Pulsed field gel electrophoresis (PFGE) is a particularly powerful tool for determination of clonal identity of bacteria providing information for understanding and controlling the spread of disease. Objectives: The aim of present study was to investigate the genetic diversity of M. tuberculosis strains in Khuzestan province by the PFGE technique. Patients and Methods: In total, 80 M. tuberculosis positive cultures were obtained from tuberculosis patients. PFGE was performed on 60 PCR-confirmed isolates by using DraI and XbaI restriction enzymes according to standard protocols. Plugs containing digested DNA were then loaded on agarose gels and run using contour-clamped homogenous electric fields. Results: Fifty distinct DNA banding patterns were obtained by digestion of DNA with DraI and 38 DNA banding patterns by digestion with XbaI restriction enzymes. The patterns comprised of 17 different clusters in which cluster I was the major one, containing six strains. Three clusters contained three strains each and the 13 remaining clusters comprised of two strains each. Digestion with DraI yielded 15-20 DNA fragments with 50-485 kb size, while digestion by XbaI produced DNA fragments with a size smaller than 50-242 kb. Conclusions: Despite the ability of PFGE for study of genetic diversity of many mycobacterial species and it being considered as a robust and useful tool, in this study we only found a 15% epidemiological relationship amongst the isolates. Thus, for higher discrimination of genotypic clusters among M. tuberculosis clinical isolates, the application of more sophisticated complementary techniques is required.
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Affiliation(s)
- Azar Dokht Khosravi
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Health Research Center, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Azar Dokht Khosravi, Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran, Tel: +98-6113330074, Fax: +98-6113332036, E-mail:
| | - Shideh Vatani
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Mohammad Mehdi Feizabadi
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Effat Abasi Montazeri
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Abbas Jolodar
- School of Veterinary Medicine, Shahid Chamran University, Ahvaz, IR Iran
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Narciso-da-Rocha C, Vaz-Moreira I, Manaia CM. Genotypic diversity and antibiotic resistance in Sphingomonadaceae isolated from hospital tap water. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 466-467:127-135. [PMID: 23892027 DOI: 10.1016/j.scitotenv.2013.06.109] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 06/26/2013] [Accepted: 06/26/2013] [Indexed: 06/02/2023]
Abstract
The aim of this study was to infer about the modes and extent of dispersion of Sphingomonadaceae via tap water. Sphingomonadaceae isolated from tap water samples in different places of a hospital were compared, based on intra-species genetic variability and antibiotic resistance phenotypes. These isolates were also compared with others isolated before from houses and dental chairs, served by the same municipal water supply system. Sphingomonadaceae from hospital tap water comprised members of the genera Sphingomonas, Sphingobium, Novosphingobium and Blastomonas. In general, distinct genotypes of Sphingomonadaceae were detected in different hospital areas and in tap water outside the hospital, suggesting these bacteria are not persistent or widespread in the urban water distribution system. Possible intrinsic antibiotic resistance, observed in most or all members of the family or of a genus, was observed for colistin in Sphingomonadaceae, aminoglycosides in the genus Blastomonas and beta-lactams in the genus Sphingobium. Possible acquired resistance phenotypes, not common to all members of a given species, comprised fluoroquinolones, cephalosporins and sulphonamides. Although the potential of Sphingomonadaceae as opportunistic pathogens may be low, the capacity of these bacteria to thrive in water supply systems, combined with the intrinsic or acquired antibiotic resistance, may raise the risk associated with their occurrence in hospital tap water.
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Affiliation(s)
- Carlos Narciso-da-Rocha
- CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa/Porto, Rua Dr. António Bernardino Almeida, Porto 4200-072, Portugal
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Abstract
PURPOSE OF REVIEW The aim is to discuss the epidemiology of infections that arise from contaminated water in healthcare settings, including Legionnaires' disease, other Gram-negative pathogens, nontuberculous mycobacteria, and fungi. RECENT FINDINGS Legionella can colonize a hospital water system and infect patients despite use of preventive disinfectants. Evidence-based measures are available for secondary prevention. Vulnerable patients can develop healthcare-associated infections with waterborne organisms that are transmitted by colonization of plumbing systems, including sinks and their fixtures. Room humidifiers and decorative fountains have been implicated in serious outbreaks, and pose unwarranted risks in healthcare settings. SUMMARY Design of hospital plumbing must be purposeful and thoughtful to avoid the features that foster growth and dissemination of Legionella and other pathogens. Exposure of patients who have central venous catheters and other invasive devices to tap water poses a risk for infection with waterborne pathogens. Healthcare facilities must conduct aggressive clinical surveillance for Legionnaires' disease and other waterborne infections in order to detect and remediate an outbreak promptly. Hand hygiene is the most important measure to prevent transmission of other Gram-negative waterborne pathogens in the healthcare setting.
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Wang S, Huang J, Yang Y, Hui Y, Ge Y, Larssen T, Yu G, Deng S, Wang B, Harman C. First report of a Chinese PFOS alternative overlooked for 30 years: its toxicity, persistence, and presence in the environment. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2013; 47:10117-28. [PMID: 23952109 DOI: 10.1021/es402455r] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
This is the first report on the environmental occurrence of a chlorinated polyfluorinated ether sulfonate (locally called F-53B, C8ClF16O4SK). It has been widely applied as a mist suppressant by the chrome plating industry in China for decades but has evaded the attention of environmental research and regulation. In this study, F-53B was found in high concentrations (43-78 and 65-112 μg/L for the effluent and influent, respectively) in wastewater from the chrome plating industry in the city of Wenzhou, China. F-53B was not successfully removed by the wastewater treatments in place. Consequently, it was detected in surface water that receives the treated wastewater at similar levels to PFOS (ca. 10-50 ng/L) and the concentration decreased with the increasing distance from the wastewater discharge point along the river. Initial data presented here suggest that F-53B is moderately toxic (Zebrafish LC50-96 h 15.5 mg/L) and is as resistant to degradation as PFOS. While current usage is limited to the chrome plating industry, the increasing demand for PFOS alternatives in other sectors may result in expanded usage. Collectively, the results of this work call for future assessments on the effects of this overlooked contaminant and its presence and fate in the environment.
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Affiliation(s)
- Siwen Wang
- State Key Joint Laboratory of Environment Simulation and Pollution Control (SKJLESPC), School of Environment, POPs Research Centre, Tsinghua University , Beijing 100084, P.R. China
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Healthcare-associated infections and their prevention after extensive flooding. Curr Opin Infect Dis 2013; 26:359-65. [DOI: 10.1097/qco.0b013e3283630b1d] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Lorencova A, Klanicova B, Makovcova J, Slana I, Vojkovska H, Babak V, Pavlik I, Slany M. Nontuberculous mycobacteria in freshwater fish and fish products intended for human consumption. Foodborne Pathog Dis 2013; 10:573-6. [PMID: 23614799 DOI: 10.1089/fpd.2012.1419] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Nontuberculous mycobacteria (NTM) are potentially pathogenic agents commonly found in natural ecosystems, while food is considered to be another source of NTM for humans. We investigated a total of 92 tissue samples of freshwater fish and fish products: fish directly obtained from ponds (n=25), retail fresh (n=23) and frozen fish (n=23) and smoked fish products (n=21). Culture examination for the presence of mycobacteria was positive in 11 (11.9%) from all the examined samples. The 15 obtained isolates were identified as Mycobacterium fortuitum (n=5), M. immunogenum (n=2), M. phocaicum/ mucogenicum (n=1), M. neoaurum (n=2), M. peregrinum (n=2), M. porcinum (n=1) and M. senegalense/houstonense/conceptionense (n=2). NTM DNA was found in one (4.0%) sample of fresh fish from ponds and in 60.9% and 91.3% of retail fresh and frozen fish, respectively. None of the smoked fish products contained NTM DNA. The results of our study suggest that freshwater fish and fish products, especially retail frozen fish, might be a reservoir of NTM for humans, and proper handling and treatment before consumption of such products is recommended.
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Affiliation(s)
- Alena Lorencova
- Department of Food and Feed Safety, Veterinary Research Institute, Brno, Czech Republic
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Apisarnthanarak A, Mundy LM, Khawcharoenporn T, Glen Mayhall C. Hospital infection prevention and control issues relevant to extensive floods. Infect Control Hosp Epidemiol 2012; 34:200-6. [PMID: 23295568 DOI: 10.1086/669094] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The devastating clinical and economic implications of floods exemplify the need for effective global infection prevention and control (IPC) strategies for natural disasters. Reopening of hospitals after excessive flooding requires a balance between meeting the medical needs of the surrounding communities and restoration of a safe hospital environment. Postflood hospital preparedness plans are a key issue for infection control epidemiologists, healthcare providers, patients, and hospital administrators. We provide recent IPC experiences related to reopening of a hospital after extensive black-water floods necessitated hospital closures in Thailand and the United States. These experiences provide a foundation for the future design, execution, and analysis of black-water flood preparedness plans by IPC stakeholders.
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Affiliation(s)
- Anucha Apisarnthanarak
- Division of Infectious Diseases, Thammasat University Hospital, Pratumthani, Thailand, 12120.
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Kothavade RJ, Dhurat RS, Mishra SN, Kothavade UR. Clinical and laboratory aspects of the diagnosis and management of cutaneous and subcutaneous infections caused by rapidly growing mycobacteria. Eur J Clin Microbiol Infect Dis 2012; 32:161-88. [PMID: 23139042 DOI: 10.1007/s10096-012-1766-8] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2012] [Accepted: 10/15/2012] [Indexed: 10/27/2022]
Abstract
Rapidly growing mycobacteria (RGM) are known to cause pulmonary, extra-pulmonary, systemic/disseminated, and cutaneous and subcutaneous infections. The erroneous detection of RGM that is based solely on microscopy, solid and liquid cultures, Bactec systems, and species-specific polymerase chain reaction (PCR) may produce misleading results. Thus, inappropriate therapeutic measures may be used in dermatologic settings, leading to increased numbers of skin deformity cases or recurrent infections. Molecular tools such as the sequence analyses of 16S rRNA, rpoB and hsp65 or PCR restriction enzyme analyses, and the alternate gene sequencing of the superoxide dismutase (SOD) gene, dnaJ, the 16S-23S rRNA internal transcribed spacers (ITS), secA, recA1, dnaK, and the 32-kDa protein gene have shown promising results in the detection of RGM species. PCR restriction enzyme analyses (PRA) work better than conventional methods at identifying species that are closely related. Recently introduced molecular tools such as matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), pyrosequencing, DNA chip technology, and Beacon probes-combined PCR probes have shown comparable results in the detection of various species of RGM. Closely related RGM species (e.g., Mycobacterium fortuitum, M. chelonae, and M. abscessus) must be clearly differentiated using accurate molecular techniques because their therapeutic responses are species-specific. Hence, this paper reviews the following aspects of RGM: (i) its sources, predisposing factors, clinical manifestations, and concomitant fungal infections; (ii) the risks of misdiagnoses in the management of RGM infections in dermatological settings; (iii) the diagnoses and outcomes of treatment responses in common and uncommon infections in immunocompromised and immunocompetent patients; (iv) conventional versus current molecular methods for the detection of RGM; (v) the basic principles of a promising MALDI-TOF MS, sampling protocol for cutaneous or subcutaneous lesions and its potential for the precise differentiation of M. fortuitum, M. chelonae, and M. abscessus; and (vi) improvements in RGM infection management as described in the recent 2011 Clinical and Laboratory Standards Institute (CLSI) guidelines, including interpretation criteria of molecular methods and antimicrobial drug panels and their break points [minimum inhibitory concentrations (MICs)], which have been highlighted for the initiation of antimicrobial therapy.
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Affiliation(s)
- R J Kothavade
- Microbiology Lab, Epcor, 10065 Jasper Ave NW, Edmonton, AB, T5J 3B1, Canada.
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Wang H, Masters S, Hong Y, Stallings J, Falkinham JO, Edwards MA, Pruden A. Effect of disinfectant, water age, and pipe material on occurrence and persistence of Legionella, mycobacteria, Pseudomonas aeruginosa, and two amoebas. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2012; 46:11566-74. [PMID: 23046164 DOI: 10.1021/es303212a] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Opportunistic pathogens represent a unique challenge because they establish and grow within drinking water systems, yet the factors stimulating their proliferation are largely unknown. The purpose of this study was to examine the influence of pipe materials, disinfectant type, and water age on occurrence and persistence of three opportunistic pathogens (Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa), broader genera (Legionella and mycobacteria), and two amoeba hosts (Acanthamoeba spp. and Hartmanella vermiformis). Triplicate simulated distribution systems (SDSs) compared iron, cement, and PVC pipe materials fed either chlorinated or chloraminated tap water and were sampled at water ages ranging from 1 day to 5.7 days. Quantitative polymerase chain reaction quantified gene copies of target microorganisms in both biofilm and bulk water. Legionella, mycobacteria, P. aeruginosa, and both amoebas naturally colonized the six SDSs, but L. pneumophila and M. avium were not detected. Disinfectant type and dose was observed to have the strongest influence on the microbiota. Disinfectant decay was noted with water age, particularly in chloraminated SDSs (due to nitrification), generally resulting in increased microbial detection frequencies and densities with water age. The influence of pipe material became apparent at water ages corresponding to low disinfectant residual. Each target microbe appeared to display a distinct response to disinfectant type, pipe materials, water age, and their interactions. Differences between the first and the second samplings (e.g., appearance of Legionella, reduction in P. aeruginosa and Acanthamoeba) suggest a temporally dynamic drinking water microbial community.
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Affiliation(s)
- Hong Wang
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24061, USA
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Molecular survey of the occurrence of Legionella spp., Mycobacterium spp., Pseudomonas aeruginosa, and amoeba hosts in two chloraminated drinking water distribution systems. Appl Environ Microbiol 2012; 78:6285-94. [PMID: 22752174 DOI: 10.1128/aem.01492-12] [Citation(s) in RCA: 170] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The spread of opportunistic pathogens via public water systems is of growing concern. The purpose of this study was to identify patterns of occurrence among three opportunistic pathogens (Legionella pneumophila, Mycobacterium avium, and Pseudomonas aeruginosa) relative to biotic and abiotic factors in two representative chloraminated drinking water distribution systems using culture-independent methods. Generally, a high occurrence of Legionella (≥69.0%) and mycobacteria (100%), lower occurrence of L. pneumophila (≤20%) and M. avium (≤33.3%), and rare detection of Pseudomonas aeruginosa (≤13.3%) were observed in both systems according to quantitative PCR. Also, Hartmanella vermiformis was more prevalent than Acanthamoeba, both of which are known hosts for opportunistic pathogen amplification, the latter itself containing pathogenic members. Three-minute flushing served to distinguish distribution system water from plumbing in buildings (i.e., premise plumbing water) and resulted in reduced numbers of copies of Legionella, mycobacteria, H. vermiformis, and 16S rRNA genes (P < 0.05) while yielding distinct terminal restriction fragment polymorphism (T-RFLP) profiles of 16S rRNA genes. Within certain subgroups of samples, some positive correlations, including correlations of numbers of mycobacteria and total bacteria (16S rRNA genes), H. vermiformis and total bacteria, mycobacteria and H. vermiformis, and Legionella and H. vermiformis, were noted, emphasizing potential microbial ecological relationships. Overall, the results provide insight into factors that may aid in controlling opportunistic pathogen proliferation in real-world water systems.
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Esteban J, García-Pedrazuela M, Muñoz-Egea MC, Alcaide F. Current treatment of nontuberculous mycobacteriosis: an update. Expert Opin Pharmacother 2012; 13:967-86. [DOI: 10.1517/14656566.2012.677824] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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