• Tuberculosis and Respiratory Diseases
• /
• v.68 no.4
• /
• pp.236-239
• /
• 2010

Hot tub lung is a lung disorder associated with exposure to hot tub water contaminated with Mycobacterium avium complex (MAC). Although its pathogenesis remains unclear, it may be considered hypersensitivity pneumonitis (HP) rather than an infectious disease. We report a case which fulfilled the current diagnostic criteria of hot tub lung. A patient had worked as a cleaner in the public bath for approximately one year and presented with dyspnea for over one month. The computed tomographic finding of bilateral ground glass attenuation and pathologic finding of granulomatous inflammation were consistent with HP. MAC was isolated from bronchoalveolar lavage fluid and hot tub water. After corticosteroid treatment without antimycobacterial medication, the patient improved and there has been no recurrence. The patient has since discontinued working in the public bath.

• Journal of Veterinary Science
• /
• v.24 no.5
• /
• pp.70.1-70.14
• /
• 2023

Background: Mycobacterium avium subspecies paratuberculosis (MAP) causes a chronic and progressive granulomatous enteritis and economic losses in dairy cattle in subclinical stages. Subclinical infection in cattle can be detected using serum MAP antibody enzyme-linked immunosorbent assay (ELISA) and fecal polymerase chain reaction (PCR) tests. Objectives: To investigate the differences in blood parameters, according to the detection of MAP using serum antibody ELISA and fecal PCR tests. Methods: We divided 33 subclinically infected adult cattle into three groups: seronegative and fecal-positive (SNFP, n = 5), seropositive and fecal-negative (SPFN, n = 10), and seropositive and fecal-positive (SPFP, n = 18). Hematological and serum biochemical analyses were performed. Results: Although the cows were clinically healthy without any manifestations, the SNFP and SPFP groups had higher platelet counts, mean platelet volumes, plateletcrit, lactate dehydrogenase levels, lactate levels, and calcium levels but lower mean corpuscular volume concentration than the SPFN group (p < 0.017). The red blood cell count, hematocrit, monocyte count, glucose level, and calprotectin level were different according to the detection method (p < 0.05). The SNFP and SPFP groups had higher red blood cell counts, hematocrit and calprotectin levels, but lower monocyte counts and glucose levels than the SPFN group, although there were no significant differences (p > 0.017). Conclusions: The cows with fecal-positive MAP status had different blood parameters from those with fecal-negative MAP status, although they were subclinically infected. These findings provide new insights into understanding the mechanism of MAP infection in subclinically infected cattle.

• Journal of Food Hygiene and Safety
• /
• v.33 no.4
• /
• pp.221-228
• /
• 2018

Since the discovery that Mycobacterium aviumsubsp. paratuberculosis (Map) is the causative agent of Johne's disease (JD) in cattle at the end of the nineteenth century, movement of livestock latently infected with Map has led to the spread of JD throughout the world. A new form of enteritis with clinical features of JD in cattle appeared in humans concurrent with the appearance of Map as a disease problem in livestock. The demonstration that Map is a zoonotic pathogen and the causative agent of the new form of enteritis in humans, however, wasn't recognized until late in the twentieth century when methods were developed to detect the presence Map in tissues from patients with the new form of clinical enteritis. The objective of this short review is to provide a brief history explaining how Map has become a major disease problem in livestock and humans and then provide a review of the progress that has been made in treating patients with an enteritis caused by Map and the strategies underway to develop a vaccine to control infection in livestock.

• Tuberculosis and Respiratory Diseases
• /
• v.77 no.4
• /
• pp.161-166
• /
• 2014

Since tuberculosis (TB) remains a major global health concern and the incidence of multi-drug resistant (MDR)-TB is increasing globally, new modalities for the detection of TB and drug resistant TB are needed to improve TB control. The Xpert MTB/RIF test can be a valuable new tool for early detection of TB and rifampicin resistance, with a high sensitivity and specificity. Late-generation fluoroquinolones, levofloxacin, and moxifloxacin, which are the principal drugs for the treatment of MDR-TB, show equally high efficacy and safety. Systemic steroids may reduce the overall TB mortality attributable to all forms of TB across all organ systems, although inhaled corticosteroids can increase the risk of TB development. Although fixed dose combinations were expected to reduce the risk of drug resistance and increase drug compliance, a recent meta-analysis found that they might actually increase the risk of relapse and treatment failure. Regarding treatment duration, patients with cavitation and culture positivity at 2 months of TB treatment may require more than 6 months of standard treatment. New anti-TB drugs, such as linezolid, bedaquiline, and delamanid, could improve the outcomes in drug-resistant TB. Nontuberculous mycobacterial lung disease has typical clinical and immunological phenotypes. Mycobacterial genotyping may predict disease progression, and whole genome sequencing may reveal the transmission of Mycobacterium abscessus. In refractory Mycobacterium avium complex lung disease, a moxifloxacin-containing regimen was expected to improve the treatment outcome.

• Korean Journal of Clinical Laboratory Science
• /
• v.40 no.1
• /
• pp.1-5
• /
• 2008

Thirty two of bathroom water samples from public bathroom in Seoul areas were examined using acid-fast staining, Lowenstein-Jensen (L-J) medium culture and PCR-restriction fragment length polymorphism (PCR-RFLP). In 6.25% (2/32) bathroom water samples, acid-fast bacilli were detected by AFB stain, and in 21.9% (7/32) bathroom water samples, acid fast bacilli grew on L-J media. Of them, six acid-fast bacilli were identified as Mycobacterium avium, and the other AFB as Mycobacterium szulgai by PCR-RFLP. These results are suggested that accidental nontuberculosis mycobacterial infection to a weakness person will be possible in public area.

• Korean Journal of Clinical Laboratory Science
• /
• v.46 no.2
• /
• pp.47-53
• /
• 2014

The purpose of this study was to evaluate the clinical utility of TB/NTM PCR by comparing the results of TB PCR to detect Mycobacterium tuberculous (MTB) and nontuberculous mycobacteria (NTM) from paraffin-embedded tissue specimens. A total of 60 cases were tested using TB PCR and TB/NTM PCR. The MTB and NTM rate of TB/NTM PCR was 84.2% (16/19), 10.5% (2/19) in TB positive of TB PCR. The NTM rate of TB/NTM PCR was 29.3% (12/41) in TB negative of TB PCR. Fourteen different species of NTM were identified, the common isolate was M. gordonae (21.4%), M. avium (14.3%), M. ulcerans (7.1%), M. interjectum (7.1%), M. gilvum (7.1%), M. fortuitum (7.1%), M. mucogenicum (7.1%). The rare species identified were M. farcinogenes (7.1%), M. tokaiense (7.1%). Therefore, TB/NTM PCR is useful to differentiate MTB and NTM from paraffin-embedded tissue specimens and it is more effective in detecting NTM with TB PCR.

• Tuberculosis and Respiratory Diseases
• /
• v.53 no.5
• /
• pp.497-509
• /
• 2002

Background : The mechanisms through which cellular activation results in intracellular mycobacterial killing is only partially understood. However, in vitro studies of human immunity to Mycobacterium tuberculosis have been largely modeled on the work reported by Crowle, which is complicated by several factors. The whole blood culture is simple and allows the simultaneous analysis of the relationship between bacterial killing and the effect of effector cells and humoral factors. In this study, we attempted to determine the extent to which M. tuberculosis is killed in a human whole blood culture and to explore the role of the host and microbial factor in this process. Methods : The PPD positive subject were compared to the umbilical cord blood and patients with tuberculosis, diabetes and lung cancer. The culture is performed using heparinized whole blood diluted with a culture medium and infected with a low number of M. avium or M. tuberculosis $H_{37}Ra$ for 4 days by rotating the culture in a $37^{\circ}C$, 5% $CO_2$ incubator. In some experiments, methlprednisolone- or pentoxifyline were used to inhibit the immune response. To assess the role of the T-cell subsets, CD4+, CD8+ T-cells or both were removed from the blood using magnetic beads. The ${\Delta}$ log killing ratio was defined using a CFU assay as the difference in the log number of viable organisms in the completed culture compared to the inoculum. Results : 1. A trend was noted toward the improved killing of mycobacteria in PPD+ subjects comparing to the umbilical cord blood but there was no specific difference in the patients with tuberculosis, diabetes and lung cancer. 2. Methylprednisolone and pentoxifyline adversely affected the killing in the PPD+ subjects umbilical cord blood and patients with tuberculosis. 3. The deletion of CD4+ or CD8+ T-lymphocytes adversely affected the killing of M. avium and M. tuberculosis $H_{37}Ra$ by PPD+ subjects. Deletion of both cell types had an additive effect, particularly in M. tuberculosis $H_{37}Ra$. 4. A significantly improved mycobacterial killing was noted after chemotherapy in patients with tuberculosis and the ${\Delta}$ logKR continuously decreased in a 3 and 4 days of whole blood culture. Conclusion : The in vitro bactericidal assay by human whole blood culture model was settled using a CFU assay. However, the host immunity to M. tuberculosis was not apparent in the human whole blood culture bactericidal assay, and patients with tuberculosis showed markedly improved bacterial killing after anti-tuberculous chemotherapy compared to before. The simplicity of a whole blood culture facilitates its inclusion in a clinical trial and it may have a potential role as a surrogate marker in a TB vaccine trial.

• Tuberculosis and Respiratory Diseases
• /
• v.61 no.3
• /
• pp.239-247
• /
• 2006

Background: Culture filtrate proteins secreted by mycobacteria are thought to play an important role in inducing protective immunity and to develop new methods for diagnosing tuberculosis. Methods: A culture filtrate protein of M. avium that was strongly reactive with goat antiserum against M. intracellulare was constructed. Its homologous protein (TB-14) in M. tuberculosis was cloned, expressed and purified. The inductions of IFN-${\gamma}$ stimulated with $10{\mu}g$ of TB-14 recombinant protein and $10{\mu}g$ PPD were estimated by using whole bloods from seven PPD (-) subjects, seven PPD (+) healthy volunteers and nine tuberculosis patients. Results: M. avium culture filtrate protein was confirmed as a hypothetical protein that was termed contig 116. A novel 14-kDa recombinant protein (TB-14) of M. tuberculosis was composed of 148 amino acids, including 30 amino acids of the signal peptide, and it showed 78% homology with M. avium. In the PPD (+) healthy volunteers, recombinant TB-14 protein strongly induced the secretion of IFN-${\gamma}$ in whole blood cultures. Conclusion: These results suggest that TB-14 recombinant protein might play an important role in inducing cell-mediated immunity against tuberculosis. Furthermore, TB-14 protein antigen and its antiserum will be available for the development of new diagnostic tools for tuberculosis.

• Tuberculosis and Respiratory Diseases
• /
• v.39 no.6
• /
• pp.517-525
• /
• 1992

Background: Since its development by Saiki et al, polymerase chain reaction (PCR) has been very useful in various fields of molecular biology. PCR can be used for the detection of a very small amount of microbial agent, and is especially useful in those patients who are difficult to diagnose microbiologically or serologically. Mycobacterium tuberculosis is a very slowly growing organism and AFB staining frequently shows false negative results, and therefore PCR would be a very rapid, easy, and sensitive diagnostic method for the diagnosis of Mycobacterium tuberculosis. Method: To compare PCR with conventional methods in diagnosing Mycobacterium tuberculosis in sputum, we used sputa of patients who visited or were admitted to Seoul National University Hospital. The amplification targets were 383 base pair DNA, a part of 2520 base pair DNA encoding 65 kD Mycobacterium tuberculosis specific protein (the primers are TB-1, -2), and 123 base pair DNA, a part of IS6110 fragment, which multiple copies are known to exsist PCR one genome (the primers are Sal I-1, -2). We also requested AFB staing and culture to the lab of Seoul National University Hospital with the same sample and compared the results. Results: 1) Using TB-1, -2 primers, PCR was positive in 73.1% (19/26) of culture positive sputa, in 12.5% (1/8) of culture negative. but clinically diagnosed tuberculous sputa, and was negative in all sputa of patients who were clinically diagnosed as non-tuberculous etiology. 2) Using Sal I-I, -2 primers, PCR was positive in 94.1% (32/34) of culture positive sputa, in 23.1% (6/26) of culture negative, but clinically diagnosed tuberculous sputa, and was negative in 87.5% (14/16) of sputa from patients who were clinically diagnosed as non-tuberculous etiology. Conclusion: PCR could be a very rapid, sensitive and specific method for the diagnosis of Mycobacterium tuberculosis in sputa, and further studies should be followed for the development of easier method.

• Tuberculosis and Respiratory Diseases
• /
• v.71 no.4
• /
• pp.249-253
• /
• 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.