• Title/Summary/Keyword: Atypical mycobacteria

검색결과 21건 처리시간 0.026초

폐결핵환자에서 비정형항산균의 분리, 동정 및 약제감수성에 관하여 (Studies on Identification and Drug Resistance of Atypical Mycobacteria isolated from Patients with Pulmonary Tuberculosis)

  • 정동현;김성광;김주덕
    • Journal of Yeungnam Medical Science
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    • 제1권1호
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    • pp.49-58
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    • 1984
  • 폐결핵 환자의 객담으로 부터 비정형항산균의 배균여부를 규명하기 위하여 세균학적 시험 및 임상적 조사를 시행하여 다음과 같은 결론을 얻었다. 1. 객담 334예에서 항산균 103주 (30.8%)를 분리 배양하였다. 2. 분리배양된 항산균주에서 비정형항산균으로 감별된 균주는 10주(9.7%)이며 인형결핵균주는 93주(90.3%)이였다. 3. 감별된 비저형항산균주는 Runyon군별로는 암착색균군, 광비발색균군이 각각 3주 (30.0%)씩이며 신속발육균군이 4주(40.0%)였으며 광발색균군은 분리되지 않았다. 4. 생물학석 성상 및 생화학적 특성시험 양상에 의해 암착색균군 3주 중 2주는 Mycobacterium scrofulaceum, 1주는 Mycobacterium szulgai로, 광비발색균 3주 중 2주는 Mycobacterium avium complex, 1주는 Mycobacterium terrae로 동정되였으며, 신속발육균주 4주중 3주는 Mycobacterium fortuitum, 1주는 Mycobacterium chelonei로 등정되었다. 5. 항결핵제에 대한 시험관내 약제감수성검사에서 INH, SM에서는 10주가 전부 내성을 나타내었으며, EB, TH, 및 CS의 저농도인 10mcg, 50mcg, 및 40mcg에서 완전내성을 나타내었다. 그리고 EB, TH, 및 RFP의 고농도인 20mcg, 및 100mcg,에서 감수성을 나타내었다. 6. 비정형항산균이 배균된 환자의 X-선소견 및 임상적 소견 조사에서는 인형결핵균 감성으로 인한 폐결핵 환자의 증상에 비해 경하지 않는 것으로 사료되었으며 장기간 항결핵제의 투여치로 되어 왔으나 대부분 호전되지 않았다.

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서울시내(布內) 초중고등학교(初中高等學校) 토양(土壤)으로부터 비정형(非定型) Mycobacteria와 Nocardia의 분리(分離) 및 생화학적(生化學的) 동정(同定) (Isolation and Identification of Opportunist Mycobacteria and Nocardia from Soil Specimens of School Ground in Seoul City)

  • 최철순;양용태
    • 대한미생물학회지
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    • 제11권1호
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    • pp.69-78
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    • 1976
  • There have been increasing reports of mycobacterioses in man and animals caused by "atypical" or "opportunist" mycobacteria. At the presnt, "opportunist mycobacterioses" are not generally responsive to antituberculosis drugs, and therefore, create considerable problems with regard to chemotherapy and control measures. In recent years studies have been made to isolate opportunist mycobacteria from soil, house-dusts and tap-water. It seemed quite interesting to define the extent of circumstantial presence of "opportunist" mycobacteria and nocardia in the soils of school-ground of primary schools and middle-high schools. This communication is the results of pilot study to isolate and identify "opportunist" mycobacteria and nocardia from 504 soil specimens of 72 schools in Seoul City. 1. Of a total of 59 isolates from 504 soil specimens tested, 32 strains were identified as opportunist mycobacteria and 27 strains as nocardia. 2. Isolation rates of opportunist mycobacteria by the areas(of specimen collection) were as follows: 36.4% in the southern area of Han-River, 33.3% in the central area, 22.7% in the outskirt area and 16.6% in the intermediate area. There observed no apparent difference in the isolation rates both-between the areas and between primary schools and middle-high schools. However, a significant difference was noted in the isolation rates between the places of soil sampling in a given school(P<0.05), i.e., the highest was the soil of refuge heaps(15.2%), and tap-water pole area(11.1%), the school-lavatory entrance(9.7%), the school gate entrance(5.5%), and iron-bar play ground(2.7%). The soil specimens from the center of school ground and from school building entrance yielded none of mycobacterial isolates. 3. Isolation rates of nocardia by the areas were as follows: 33.3% in the central area, 31.8% in the outskirt area, 27.3% in the southern ares of Han-River and 11.1% in the intermediate area. As in the case of mycobacteral isolates, there observed no apparent differences in the isolation rates both between the areas and between primary schools and middle-high schools, but a significant difference was noted between the places of soil sampling(P<0.05), i.e., the highest was the soil of school building entrance(15.2%), and of school gate entrance(6.9%), refuge heaps(5.5,%), iron-bar play ground(4.1%), the school-lavatory entrance(2.7%) and tap-water pole area(2.7%), respectively. The soil specimens from the center of, school ground yielded none of nocardia isolates. 4. Of the 32 strains of isolated mycobacteria. 15 strains were slow-growing mycobacteria and the remaining 17 strains belonged to the rapid growers. Of the 15 slow-growers. 4 strains were M. scrofulaceum-szulgai complex, 3 M. gordonae, 4 M. terrae-triviale complex, 2 M. avium-intracellulare-xenopi complex, and 2 unclassified schotochromogens. Of the 17 strains of rapid growers, 12 were M. diernhoferi, 2 M. fortuitum-peregrinum complex, 2 M. vaccae and one M. flavescens. 5. Of the 27 strains of nocardia isolated, 11 strains were N. transvalensis, 5 N. convoluta, 5 N. erythropolis, one N. vaccinii, one N. polychromogens-paraffinae complex and 4 untypable strains of orange-pigmented nocardia spp.

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Comparison of Ogawa Media, BACTEC MGIT 960 System and TB/NTM Real-Time PCR for Detecting Mycobacterium Species

  • Bang, Hae-In;Choi, Tae-Youn;Shin, Jeong-Won
    • Tuberculosis and Respiratory Diseases
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    • 제71권4호
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    • pp.249-253
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    • 2011
  • Background: Mycobacterial infection is a problem throughout the world along with the increase of immunocompromised patients. For this reason, there have been many methods for faster and more accurate diagnosis. In this study, we evaluated several laboratory methods for mycobacterial infection. Methods: From January to December 2009, 635 specimens were cultured with mycobacteria growth indicator tube (MGIT) and Ogawa media. Polymerase chain reaction (PCR) was performed with the AdvanSure tuberculosis (TB)/non-tuberculosis mycobacterium (NTM) real-time PCR Kit (LG Life Sciences, Seoul, Korea). The 69 samples showing positive culture results were identified with the AdvanSure Mycobacteria Genotyping Chip Kit (LG Life Science, Seoul, Korea). Results: Sixty-nine (10.9%) out of 635 samples showed positive results for mycobacterial culture. Among the 635 samples, 64 were positive in MGIT, but only 42 were positive in Ogawa media. Of the 635 samples, 607 (95.6%) showed the same results between MGIT and Ogawa and the results of 579 (95.4%) were also consistent with the TB/NTM real-time PCR results. However, in the case of NTM, only one (1/24, 4.2%) was positive in PCR. In the Mycobacteria genotyping chip analysis, the most frequently identified NTM species in descending order were M. avium, M. intracellulare, M. chelonae and M. abscessus. Conclusion: Culturing with a combination of MGIT and Ogawa is recommended to increase the recovery rate of mycobacteria. Although PCR missed a reasonable number of NTM, it is faster and usually gives results that concur with those from the culture. The appropriate combination of diagnostic methods with clinical correlation are necessary.

임상에서 분리된 희귀 비결핵 마이코박테리아 5종 (Five Rare Non-Tuberculous Mycobacteria Species Isolated from Clinical Specimens)

  • 박영길;이영주;유희경;정미영;류성원;김창기;김희진
    • Tuberculosis and Respiratory Diseases
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    • 제69권5호
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    • pp.331-336
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    • 2010
  • Background: Recently, the rate of infections with non-tuberculous mycobacteria (NTM) has been increasing in Korea. Precise identification of NTM is critical to determination of the pathogen and to target treatment of NTM patients. Methods: Sixty-eight unclassified mycobacteria isolates by rpoB PCR-RFLP assay (PRA) collected in 2008 were analyzed by National Center for Biotechnology Information (NCBI) Basic Local Alignment Search Tool (BLAST) search after sequencing of 16S rRNA, hsp65, rpoB genes. Results: Nineteen strains of 68 isolates were specified as species after sequencing analysis of 3 gene types. We found 3 M. lentifulavum, 5 M. arupense, 4 M. triviale, 4 M. parascrofulaceum, and one M. obuense. One M. tuberculosis and another M. peregrinum were mutated at the Msp I recognition site needed for rpoB PRA. The remaining 49 isolates did not coincide with identical species at the 3 kinds genes. Conclusion: Sequencing analysis of 16S rRNA, hsp65, rpoB was useful for identification of NTM unclassified by rpoB PRA.

Treatment of the Mycobacterium chelonae Infection after Fat Injection

  • Kim, Seok-Kwun;Choi, Ji-An;Kim, Myung-Hoon;Kim, Min-Su;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • 제42권1호
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    • pp.68-72
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    • 2015
  • For recent years, use of autologous fat injection has increased significantly in facial contouring surgery. Along with such increase in use, complications like atypical mycoplasma infection have been also on the increasing trend. The authors report two cases of Mycobacterium chelonae infection that occurred after autologous fat injection. Patients were treated as infection that resistant to common antibiotics and results were negative to routine culture and Gram staining. Acid-fast bacillus stain, polymerase chain reaction (PCR) test and mycobacterial cultures were conducted for diagnosis under suspicion of atypical mycoplasma infection. Then, combination antibiotics therapy, surgical treatment, and steroid injection were performed for treatment. Both patients were diagnosed with Mycobacterium chelonae in PCR test. They were positive to mycobacterial cultures. Combination antibiotics therapy was repeated to improvement of symptom. However, they could not be free from side effects such as deformation in facial contour, scar and pigmentation even after full recovery. When chronic wound infections after autologous fat injection, we must suspect atypical or mycobacterial infection and conduct examinations for a early diagnosis and proper antibiotic therapy that is effective to the nontuberculous mycobacteria.

신속발육 비결핵항산균에 의한 폐감염의 임상상 (Clinical Manifestations of Pulmonary Infection Due to Rapidly Growing Nontuberculous Mycobacteria)

  • 김은경;심태선;임채만;이상도;고윤석;김우성;김원동;김동순
    • Tuberculosis and Respiratory Diseases
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    • 제54권3호
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    • pp.283-294
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    • 2003
  • 연구 배경 : 최근 비결핵항산균증(NTM)의 증가가 보고되면서 신속발육 비결핵항산균(RGM) 또한 폐감염의 중요한 원인균의 하나로 밝혀졌다. 이들은 대부분이 전통적인 항결핵약제에 내성을 보이고, 특정 항균제들에 대해서도 다양한 양상의 감수성을 보여 치료가 어렵다. 국내에서는 아직까지 RGM에 의한 폐감염만을 대상으로 한 연구가 없었으므로 국내에서 RGM에 의한 폐감염의 임상상을 알아보고자 본 연구를 수행하였다. 방 법 : 1996년 11월부터 2002년 9월까지 서울아산병원에 내원한 환자 중 호흡기검체에서 RGM이 동정된 57예 중 미국흉부학회가 제안한 진단기준을 만족하는 RGM 폐감염증 환자 20명을 대상으로 하여 이들의 의무기록을 후향적으로 분석하였다. 결 과 : 총 20명의 RGM폐감염환자의 평균 연령은 57.7(${\pm}7.5$)세이었고 여자가 15명(75%)이었다. 모든 환자에서 과거 폐결핵으로 치료한 과거력이 있었으며 대부분의 환자(90%)에서 선행 폐질환이 있었다. 원인 균종은 M. abscessus 16명, M. fortuitum 4명이었다. M. abscessus군이 M. fortuitum군보다 어렸으며 두 군 모두 여성이 많았다. 기저질환으로 기관지확장증의 빈도가 M. abscessus군에서 높았으며 임상증상은 차이가 없었다. 방사선학적으로는 두 군 모두에서 양측 폐를 침범한 경우가 많았고 공동보다는 기관지확장증과 소결절병변이 더 흔하게 관찰되었다. 14명에서는 처음 결핵으로 진단하고 항결핵치료를 시작하였었고 6명만이 처음부터 RGM증으로 진단되었다. M. abscessus군에서 9명이(56%) 치료에 성공하였다(평균 치료기간 $591{\pm}311$일). M. fortuitum군은 모두 치료 중이었다. 항균제의 투여기간은 203일부터 706일까지로 평균 439(${\pm}168$)일이었으며 평균 3.5개의 항균제가 사용되었다. 결 론 : 신속발육 비결핵항산균에 의한 폐감염도 다른 NTM폐 감염증과 유사하게 기관지확장증과 소결절을 동반한 비전형적인 소견이 많았다. 치료 초기에 결핵으로 진단되어 적절한 치료가 지연되는 경우가 많아 향후 항산균 배양후 균 동정이 필수적이라 생각된다. 일부에서 항생제 병합치료에 좋은 효과를 보였으므로 적극적인 치료가 권장되며, 향후 더 많은 환자를 대상으로 한 임상연구가 필요할 것으로 사료된다.

형광항보체법(螢光抗補體법)에 의한 Mycobacterium scrofulaceum 소수성균주(疏水性菌株)의 형별동정(型別同定) (A Rapid Serotyping of Hydrophobic Strains of Mycobacterium acrofulaceum by Fluorescent Anti-Complement Technique)

  • 최철순;김용재;양용태
    • 대한미생물학회지
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    • 제15권1호
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    • pp.9-17
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    • 1980
  • In the ecology and epidemiologic studies on various serotypes of atypical mycobacteria(AM), Schaefer's bacterial agglutination test(BA) provided the basis of the serologic procedures. Recently, attempts have been made to modify and to simplify the Schaefer's BA such as a slide agglutination test(Engel & Beerwald, 1970), a "simplified" BA(Reznikov & Leggo, 1972), an agglutination inhibition test(Richards & Eacret, 1972) and "micromethod"(Thoen et al., 1975). The BA, however, was not widely applied as a routine laboratory test mainly because it requires much times and labors to perform and partley because it is not applicable to hydrophobic strains either often encountered in the isolation of AM in the clinical bacteriology or stock strains maintained in the laboratory. On the contrary, fluorescent antibody technique with mycobacteria may have advantages over the BA because it is far more simpler in serologic procedures and is applicable to all strains of mycobacteria regardless of smooth or rough types of cultures. At the present, it is well known that the type-specific antigens are lacking on the surface of rough type of AM compared to that on smooth type of strain, but the antigenicity on the surface of the hydrophobic strains of AM which resulted from a series of subculture and the strain in the laboratory for 3 to 6 months has not been clarified. In this study, an attempt to serotype the hydrophobic strains of M. scrofulaceum serotype 41, 42 and 43 by fluorescent anti-complement(FAC) technique was made. The FAC technique with mycobacteria was also described in detail. In the summary, the complement fixing antibody titres of reference sera to smooth types of homologous serotype was highest, but the antibody titres of reference sera to hydrophobic strains of serotypes, 41, 42 and 43 gave two-to 8-folds lower than those to smooth type of strains. Although the sensitivity of type-specific antigens on the hydrophobic strains to reference sera was much lower, using the two units of reference sera determined by titration with hydrophobic strains, three serotypes, i. e., 41, 42 and 43 were specifically differentiated one another by FAC technique. This result indicated that the hydrophobic strains which were maintained in the laboratory at least for 6 months still retain type-specific antigen detectable by FAC technique.

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A Case of Mycobacterium massiliense Infection Presenting as Pneumonia Resistant to Antibiotics in an Immunocompetent Host

  • Yoo, Jung-Wan;Kim, Yong-Hee;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • 제69권1호
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    • pp.39-42
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    • 2010
  • Mycobacterium massiliense is newly identified rapid-growing nontuberculous mycobacterium, but there are no reports of this mycobacterium species being the cause of human illness. We describe one case of Mycobacterium massiliense infection presenting as antibiotic-resistant acute pneumonia that resulted in surgical treatment.

결핵균과 비결핵성항산균 검출에 Real-time PCR의 유용성 (Usefulness of Real-time PCR to Detect Mycobacterium tuberculosis and Nontuberculous Mycobacteria)

  • 윤은영;조수희;고세일;백종하;김유은;마정은;이기동;조유지;정이영;김호철;이종덕;김선주;황영실
    • Tuberculosis and Respiratory Diseases
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    • 제69권4호
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    • pp.250-255
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    • 2010
  • Background: The purpose of this study was to evaluate recently developed real-time polymerase chain reaction (PCR) assay kit to detect Mycobacterium tuberculosis (MTB) and nontuberculous mycobacteria (NTM) in respiratory specimens. Methods: We assessed the positive rate of the real-time PCR assay to detect MTB and NTM in 87 culture-positive specimens (37 sputum, 50 bronchial washing), which were performed real-time PCR by using $Real-Q_{TM}$ MTB&NTM Kit from January 2009 to June 2009, at Gyeongsang University Hospital. To compare the efficacy with the TB-PCR assay, we evaluated 63 culture-positive specimens (19 sputum, 44 bronchial washing) for MTB or NTM, which were performed TB-PCR by using ABSOLUTETM MTB II PCR Kit from March 2008 to August 2008. Results: Among 87 specimens tested using real-time PCR, MTB and NTM were cultured in 58 and 29, respectively. The positive rate of real-time PCR assay to detect MTB was 71% (22/31) and 92.6% (25/27) in AFB stain-negative and stain-positive specimens. For NTM, the positive rate of real-time PCR was 11.1% (2/18) and 72.7% (8/11) in AFB stain-negative and stain-positive specimens. Among 63 specimens performed using TB-PCR, MTB and NTM were cultured in 46 and 17, respectively. The positive rate of TB-PCR was 61.7% (21/34) and 100% (12/12) in AFB stain-negative and stain-positive specimens. TB-PCR was negative in all NTM-cultured 17 specimens. Conclusion: TB/NTM real-time PCR assay is useful to differentiate MTB and NTM in AFB stain-positive respiratory specimens and it is as effective in detecting MTB with TB-PCR.

일개 2차 의료기관에서의 비결핵성 마이코박테리아 분리비율 및 폐질환의 임상 경과 (Recovery Rate of Nontuberculous Mycobacteria and the Clinical Course of Nontuberculous Mycobacterial Pulmonary Disease at a Secondary Hospital)

  • 이재광;권혁용;권종규;이화정;이동욱;이유진;윤경화;송도영;이병기;김연재
    • Tuberculosis and Respiratory Diseases
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    • 제67권3호
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    • pp.199-204
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    • 2009
  • Background: To examine the recovery rate of nontuberculous mycobacteria (NTM) from respiratory specimens and the clinical course of NTM pulmonary disease at a 700-bed secondary hospital. Methods: This study analyzed the results of 843 acid-fast bacilli (AFB) culture-positive respiratory specimens from 650 subjects collected between May 2003 and April 2008. In addition, the clinical course of NTM pulmonary disease, diagnosed using criteria established by the American Thoracic Society, was examined. Results: There were 67 (7.9%) NTM isolates recovered from 52 (8.0%) subjects. Among the 535 AFB smear-positive specimens, 34 (6.3%) NTM isolates were recovered. There were 33 (10.7%) NTM isolates were recovered from 308 AFB smear-negative specimens. Of 52 subjects with isolated NTM, M. intracellulare was the most common species at 73.1% (n=33), followed by M. kansassi (n=7), M. abscessus (n=2), M. fortuitum (n=2), and M. avium (n=1). Sixteen (30.8%) patients had NTM pulmonary disease and the most common causative organism was M. intracellulare (n=14, 87.5%). Of these, 6 cases attained negative conversion in culture, 4 cases failed to attain negative conversion because of poor cooperation or expiration from complicated underlying lung disease, and 5 cases were transferred to a higher-grade hospital. Conclusion: The recovery rate of NTM from respiratory specimens was relatively low and the most common species was M. intracellulare. Patients with NTM pulmonary disease showed variable clinical outcomes.