• 한국정보통신학회:학술대회논문집
• /
• 한국정보통신학회 2013년도 춘계학술대회
• /
• pp.1012-1014
• /
• 2013

DNA-DNA hybridization method with four oligonucleotide-specific probes was used simultaneously for differentiation and identification of four Mycobacterium species (Mycobacterium tuberculosis, M. avium, M. intracellulare, and M. kansasii). This DNA-DNA hybridization method with 4 oligonucleotide-specific probes, which targets in the rpoB region of 4 Mycobacteria species, respectively, was tested on 322 clinical isolates. Using DNA-DNA hybridization method, we detected M. tuberculosis (282 strains), M. avim (7 strains), M. intracellulare (9 strains), and M. kansasii (3 strain) from 322 clinical isolates. This result was compared with conventional biochemical test and rpoB DNA sequence analysis of this clinical isolates. We confirmed identification of Mycobacterium tuberculosis, M. avium, M. intracellulare, and M. kansasii with high sensitivity (100 %) and specificity (100 %). This DNA-DNA hybridization method could be performed within 4 hours at least. Therefore, we suggest that DNA- DNA hybridization method using 4 rpoB DNA probes of Mycobacteria could be used for accurate, rapid, convenient detection and identification of Mycobacterium tuberculosis, M. avium, M. intracellulare, and M. kansasii in clinical samples.

• Journal of Korean Neurosurgical Society
• /
• 제50권5호
• /
• pp.460-463
• /
• 2011

There are few reported cases of post-operative spondylitis caused by $Mycobacterium$ $Intracellulare$. A 75-year-old female presented to our hospital with low back pain and paraparesis after a fall. The radiologic examination revealed compression fractures of L1, L3 and L4 and an epidural hematoma compressing the spinal cord. The dark-red epidural hematoma was urgently evacuated. Four weeks post-operatively, neurologic deficits recurred with fever. On magnetic resonance image, an epidural abscess and osteomyelitis were detected in the previous operative site. Five weeks post-operatively, revision was performed with multiple biopsies. The specimen were positive for acid-fast bacilli and traditional anti-tuberculous medications were started. Because the Polymerase Chain Reaction for non-tuberculous mycobacterium (NTM) was positive, the anti-tuberculous medications were changed to anti-NTM drugs. However, the neurologic deficits did not improve and persistent elevation of erythrocyte sedimentation rate and C-reactive protein were noted. Eight weeks after the revision, $Mycobacterium$ $Intracellulare$ was detected in the specimen cultures. Despite supportive care with medication, the patient died due to multiple organ failure.

• Tuberculosis and Respiratory Diseases
• /
• 제74권3호
• /
• pp.124-128
• /
• 2013

Pleural effusion is a rare complication in non-tuberculous mycobacterial infection. We report a case of Mycobacterium intracellulare pleuritis with idiopathic pulmonary fibrosis in a 69-year-old man presenting with dyspnea. Pleural effusion revealed lymphocyte dominant exudate. M. intracellulare was identified using a polymerase chain reaction-restriction fragment length polymorphism method and liquid cultures of pleural effusion and pleural biopsy. After combination therapy for M. intracellulare pulmonary disease, the patient was clinically well at a 1-month follow-up.

• Tuberculosis and Respiratory Diseases
• /
• 제72권2호
• /
• pp.191-196
• /
• 2012

While nontuberculous mycobacterium (NTM) infections are recently on the rise, arthritis caused by NTM is hardly reported in Korea. NTM arthritis has no distinctive clinical characteristics from chronic arthritis. Tuberculosis of the joint specifically produces similar clinical and pathologic presentations to NTM arthritis, so it is not easy to distinguish between them. We report a case of Mycobacterium intracellulare in an arthritis patient after trauma and surgical repair of the injury. At the beginning, the patient was diagnosed as tuberculous tenosynovitis through pathology without microbiologic evidence. The final diagnosis was made after subsequent recurrences for several years. The misdiagnosis and delayed diagnosis led to irreversible joint destruction and functional impairment. NTM infection must be included in the differential diagnosis of chronic arthritis at the outset.

• Tuberculosis and Respiratory Diseases
• /
• 제67권1호
• /
• pp.32-36
• /
• 2009

본 증례는 AIDS가 아닌 면역저하 환자에서 M. intracellulare에 의하여 관절염 및 흉수가 발생한 파종성 질환의 예로 국내에서 두 번째로 보고되는 바이다.

• 대한미생물학회지
• /
• 제18권1호
• /
• pp.47-52
• /
• 1983

During the last three years, it has become evident that patients with tuberculosis-like diseases due to the Mycobacterium avium-intracellulare complex(referred to M. avium complex; MAC) in Korea are more frequently observed than were assumed earlier. However, the incidence of various serotypes of the MAC isolated from patients with tuberculosis-like diseases has not been clarified. In this study, the serotypes of 16 strains of the MAC isolated from sputa of persons who had radiographic abnormalities of the lungs were determined by bacterial agglutination test with reference sera. The serotypable strains belonged to 7 serotypes, i.e., M. avium 13 were 4 strains(25.0%), M. avium 8 and 14 each 3 strains(18.8%), M. avium 5, 7, 12 and 18 one strain(6.3%), respectively. Two strains(12.5%) were not typable.

• 대한의생명과학회지
• /
• 제19권2호
• /
• pp.132-141
• /
• 2013

Mycobacterium isolates were retrospectively identified, antibiotics susceptibility test results and basic clinical data were analyzed for the 715, excepted 308 in 1,023 specimens, from a mycobacterial laboratory at a tertiary care hospital from September 2002 to December 2008. Their male to female ratio was 1.12 to 1 (379 male, 336 female). The median age of study population was 47 years (range from 10 to 93 years). Distribution of Mycobacterium species was 90.1% of total were isolates Mycobacterium tuberculosis, and 9.9% of the total non-tuberculosis Mycobacterium isolated, and Among nontuberculosis Mycobacterium isolates, 60.6% were Mycobacterium avium complex, 14.1% were isolates Mycobacterium abscessus, and 12.7% were isolates Mycobacterium intracellulare. Among 526 Mycobacterium tuberculosis isolates, 81.7% isolates were susceptible to first line antibiotics, 18.3% were resistant to one or more antibiotics. Non-tuberculosis Mycobacterium isolates, all were resistant to two or more antibiotics. Multi-antibiotic resistant tuberculosis rate was show 10.2% of total specimens. Isolated Mycobacterium species, 19.2% were multi-antibiotic resistant tuberculosis, and the rate of nontuberculosis Mycobacterium resistant to isoniazid and rifampin was very highly 84.5%. Thus among acid fast bacilli culture positive cases, Mycobacterium tuberculosis and non-tuberculosis Mycobacterium were must exactly identification and antibiotic sensitivity test. It was considered to help to select of the antibiotic in preventive medicine.

• Tuberculosis and Respiratory Diseases
• /
• 제74권1호
• /
• pp.28-31
• /
• 2013

We present a case of congenital cystic adenomatoid malformation (CCAM) in a 25-year-old male who was presented with chronic cough. Chest radiography revealed an abnormal mass-like shadow in the right lower pulmonary zone. A contrast enhanced computed tomography showed an 11 cm solid, cystic mixed mass on the right lower lobe. A right lower lobectomy was performed by video-assisted thoracoscopic surgery without complications. The gross specimen showed a massive cavitation with multiloculated cysts of varying size, consistent with CCAM, along with noticeable granulomatous inflammation. Non-tuberculosis mycobacteria were isolated from a bronchial wash specimen, and the resected tissue homogenates were positive for Mycobacterium avium-intracellulare complex by polymerase chain reaction.

• 대한미생물학회지
• /
• 제17권1호
• /
• pp.87-93
• /
• 1982

Two cases of pulmonary disease in a 54 year-old female and a 70 year-old male patient due to Mycobacterium avium-intracellulare complex(MAIC) and a case of pulmonary infection ina 69 year-old male patient due to M. fortuitum(MF) were found recently in this institute. All three patients had a long history of anti-tuberculous chemotherapy because they were initially diagnosed as pulmonary tuberculosis. A 70 year-old male patient infected with MAIC had an unsuccessful chemotherapy history of isoniazid(INH), para-aminosalicylic acid(PAS) and streptomycin(SM) with an incomplete, temporary, symptomatic improvement, for three years since 1964 when he was first diagnosed as pulmonary tuberculosis on physical examination. A 54 year-old female patient infected with MAIC also had an unsuccessful chemotherapy history with the various anti-tuberculous drugs since 1958. Both patients discharged large number of MAIC in their sputum specimens for at least more than one year, but no M. tuberculosis at all. A 69 year-old male patient infected with MF was diagnosed as moderately advanced pulmonary tuberculsis in 1977. Combined chemotherapy with INH+PAS+pyrazinamide(PZA) improved his clinical symptoms, however, his chest radiograph was deteriorated again in 1980 one year after he stopped therapy. Therefore he started chemotherapy again with INH+ethionamide(TH)+cycloserine(CS) but no improvement was noticed. MF was cultured from his sputum in August 1981 and he continuously discharged the same bacilli until last examination of January 1982. Whether all three patients were initially !infected with nontuberculous mycobacteria or complicated with predisposing tuberculosis was not clear because there were no reliable bacteriological examination records.

• Tuberculosis and Respiratory Diseases
• /
• 제39권6호
• /
• pp.517-525
• /
• 1992

연구배경 : 1985년 Saiki등에 의해, 특정한 DNA를 연속적으로 복제할 수 있는 방법인 polymerase chain reaction (PCR)이 개발된 이래, PCR은 검체내에 극미량으로 존재하고 있는 병원체의 진단에 큰 도움을 줄 것으로 기대되었다. 결핵균의 진단방법중, 도말염색 방법은 감수성이 낮아서 문제가 되고 있으며, 배양은 감수성은 높으나 기간이 오래 걸려서 임상적으로 도움을 주지 못하는 경우가 많다. 이에 저자들은 Mycobacterium tuberculosis의 특이 단백질인 65 kD mycobacterial antigen을 encoding하는 2520 base pair DNA중, 383 base pair DNA를 이용한 PCR과 IS6110 fragment의 일부인 123 base pair DNA를 이용한 PCR을 시행하여, 이의 감수성과 특이도를 알아보고 폐결핵 환자의 객담을 검체로한 결핵의 조기진단 방법을 개발하고자 하였다. 방법 : M. tuberculosis (H37Rv, H37Ra), M. avium, M. intracellulare, M. scrofulaceum 균주와 환자의 객담에서 DNA를 추출하여, 383 base pair DNA 양끝의 20 base pair DNA primer (TB-1, -2)와 IS6110 fragment 일부의 DNA 양끝의 20 base pair DNA primer (Sal I-1, -2) 로 PCR을 시행하였으며, 전기 영동후 자외선 발광으로 확인하였다. 결과 : 1) Ethidium bromide 염색후 발광경하에서, Mycobacterium tuberculosis (H37Rv, H37Ra)와 Mycobacterium bovis는 TB-1, -2 primer와 Sal I-1, -2 primer를 이용한 PCR에서 모두 양성을 보였고 Mycobacter intracellulare와 Mycobacterium scrofulaceum은 TB-1, -2 primer를 이용한 PCR에서만 양성을 보였다. 2) Southern Blot 분석에는 두쌍의 primer 모두에서 Mycobacterium tuberculosis (H37Rv, H37Ra)와 Mycobactgerium bovis만이 양성을 나타내었으며 Mycobacterium intracellulare 와 Mycobacterium scrofulaceum은 음성을 나타내었다. 3) Mycobacterium tuberculosis (H37Rv)를 순차적으로 희석하여 시행한 PCR에서 두쌍의 primer 모두에서 Mycobacterium 균 1개체에 해 당되는 1 fg DNA까지 양성을 나타내었다. 4) 임상적으로 진단받은 결핵환자의 시행한, Sal I-1, -2 primer를 이용한 PCR에서 도말 검경 양성군의 객담 29예중 28예인 96.6%에서 양성을 나타내었으며, 도말 정경 음성-배양 양성군에서는 5예중 4예(80.0%), 그리고 도말 검경 음성-배양 음성군에서는 26예중 6예(23.1%)가 양성을 나타내었고 음성 대조군 검체 16예에서 2예(12.5%)에서 양성을 나타내였다. 결론 : 이상의 결과로, PCR은 객담에서의 결핵균의 진단에 있어, 배양과 견줄 수 있는 특이도와 예민도를 보이고 있어, 특정한 경우 진단에 도움을 줄 수 있을 것으로 기대되며, 추후 방법의 개선을 위한 연구가 계속 필요할 것으로 사료된다.