• Title/Summary/Keyword: NTM1

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Characterization of Immune Cells From the Lungs of Patients With Chronic Non-Tuberculous Mycobacteria or Pseudomonas aeruginosa Infection

  • Alan R. Schenkel;John D. Mitchell;Carlyne D. Cool;Xiyuan Bai;Steve Groshong;Tilman Koelsch;Deepshikha Verma;Diane Ordway;Edward D. Chan
    • IMMUNE NETWORK
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    • v.22 no.3
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    • pp.27.1-27.13
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    • 2022
  • Little is known of the lung cellular immunophenotypes in patients with non-tuberculous mycobacterial lung disease (NTM-LD). Flow-cytometric analyses for the major myeloid and lymphoid cell subsets were performed in less- and more-diseased areas of surgically resected lungs from six patients with NTM-LD and two with Pseudomonas aeruginosa lung disease (PsA-LD). Lymphocytes, comprised mainly of NK cells, CD4+ and CD8+ T cells, and B cells, accounted for ~60% of all leukocytes, with greater prevalence of T and B cells in more-diseased areas. In contrast, fewer neutrophils were found with decreased number in more-diseased areas. Compared to NTM-LD, lung tissues from patients with PsA-LD demonstrated relatively lower numbers of T and B lymphocytes but similar numbers of NK cells. While this study demonstrated a large influx of lymphocytes into the lungs of patients with chronic NTM-LD, further analyses of their phenotypes are necessary to determine the significance of these findings.

A Case of Chronic Arthritis Due to Mycobacterium intracellulare after Trauma (외상 후 발생한 Mycobacterium intracellulare에 의한 만성 관절염 1예)

  • Kim, Jae-Gyung;Kim, Dae-Won;Cho, Yul-Hee;Yim, Sun-Mie;Kang, Ju-Hyun;Joo, Young-Bin;Kang, Hyeon-Hui;Song, Jeong-Sup;Yoon, Hyoung-Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.191-196
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    • 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.

Transaxillary Capsulorrhaphy with Reimplantation to Correct Bottoming-Out Deformity in Breast Mycobacterial Periprosthetic Infection: A Case Report with Literature Review

  • Tsung-Chun Huang;Jian-Jr Lee;Kuo-Hui Yang;Chia-Huei Chou;Yu-Chen Chang
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.557-562
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    • 2023
  • Augmentation mammoplasty is one of the most popular cosmetic surgeries, but there is a high reoperation rate (29.7%) commonly due to capsular contracture, implant malpositioning, infection, and unsatisfactory size. Although infection only accounts for 2% of cases, its management is very challenging, especially with nontuberculous mycobacteria (NTM) infection. Breast prosthetic NTM infection is a rare but is a disastrous condition with an incidence of approximately 0.013%. Immediate salvage reimplantation is usually not suggested, and most studies recommend a gap of 3 to 6 months after combination antibiotics therapy before reimplantation. However, delayed reimplantation often leads to great psychological stress and struggle between the doctor and patient. We present the case report of successful reimplantation in treating prosthetic NTM infections in a 28-year-old female. We discuss a novel technique "transaxillary capsulorrhaphy" to correct the bottoming-out deformity. One year after the combination of antibiotics and surgery, the follow-up computed tomography scan showed complete remission of NTM without recurrence. We discuss the surgical technique in detail. The 1-year follow-up assessment (photos and dynamic video) revealed good cosmesis and reliable correction using the new technique. This report is the first formal description and discussion of one-stage reimplantation following NTM infections. Transaxillary capsulorrhaphy allows for a successful salvage operation when an implant is displaced. This approach provides highly favorable result in eastern women undergoing revision augmentation mammoplasty. This study reflects level of evidence V, considering opinions of respected authorities based on clinical experience, descriptive studies, or reports of expert committees.

Usefulness of Tuberculin Test in Adult Patients with Suspected Pulmonary Tuberculosis (폐결핵이 의심되는 성인 환자에서 투베르쿨린 검사의 유용성)

  • Kang, Eun Hae;Koh, Won-Jung;Kwon, O Jung;Kim, Kyung Chan;Lee, Byoung-Hoon;Hwang, Jung Hye;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.3
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    • pp.268-279
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    • 2004
  • Background : The tuberculin skin test has been used to diagnose latent tuberculosis infection, but is not widely used to diagnose or exclude pulmonary tuberculosis. The objective of this study was to evaluate the diagnostic utility of the tuberculin test in diagnosing and excluding pulmonary tuberculosis, and differentiating pulmonary tuberculosis from nontuberculous mycobacteria (NTM) pulmonary disease, when a sputum acid-fast bacilli (AFB) smear was positive. Material and Methods : From October 2002 to August 2003, among all the inpatients of the Division of Pulmonary and Critical Care Medicine at Samsung Medical Center, 258 patients with clinical suspicion of pulmonary tuberculosis were enrolled and underwent a tuberculin test. Results : 156 males and 102 females were included, with a mean age of 57.5 years. The final diagnoses included lung cancer in 89 cases (34.5%), pulmonary tuberculosis in 59 cases (22.9%), bacterial pneumonia in 33 cases (12.8%) and NTM pulmonary disease in 24 cases (9.3%). The positive tuberculin test rate was higher in the tuberculosis than non-tuberculosis group; 81.4 (48/59) vs. 42.4% (81/199). (p<0.001). In 208 patients with a negative sputum AFB smear, the result of the tuberculin test was positive in 69.4% (25/36) of the tuberculosis group and in 44.8% (77/172) of the non-tuberculosis group (p=0.007), so a positive result of the tuberculin test could predict pulmonary tuberculosis with 69.4% sensitivity, 55.2% specificity, a 24.5% positive predictive value and a 89.6% negative predictive value. In 50 patients with a positive sputum AFB smear, the positive rates of the tuberculin test were 83.9% (26/31) in tuberculosis group and 21.1% (4/19) in NTM pulmonary disease group (p<0.001), so a positive result of the tuberculin skin test could predict pulmonary tuberculosis with 83.9% sensitivity, 78.9% specificity, a 86.7% positive predictive value and a 75.0% negative predictive value. Conclusion : The tuberculin test could be useful in excluding pulmonary tuberculosis when the sputum AFB smear is negative, and to differentiate pulmonary tuberculosis from NTM pulmonary disease when the sputum AFB smear is positive.

Analysis of Five Years of US Immigration Medical Exams (5년간의 미국 이민 비자 신체검사 결과 분석)

  • Lim, Juwon
    • Korean journal of aerospace and environmental medicine
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    • v.31 no.3
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    • pp.77-81
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    • 2021
  • Purpose: The United States of America have pre-migration screening program are mandated through legislation. The one of purpose of this program is to prevent the importation of certain communicable diseases. Examinations of migration applicants are performed by panel physicians who are licensed physicians in the countries of origin that have agreements with the government departments of the country of destination to undertake this activity. In recent decades, the number of US migrants has increased, however COVID-19 impacted this trend of international migrants. The Aim of this study is to examine trends of US applicants and outcomes of tuberculosis and sexual transmitted infections (STIs) screening in South Korean applicants for US visa. Methods: A total of 4,442 applicants participated in US visa health check-up in 2016 to 2020. Results: The numbers of applicant for US visa in males and females was 1,814 and 2,628. The positive results in tuberculosis and STIs screening was noted with 0.66% in nontuberculous mycobacteria (NTM), 0.03% in tuberculosis, 0.03% in gonorrhea, 0.08% in syphilis, and 0.74% in chlamydia. The age groups of 2 to 14 years showed higher positive rate (13.89%) in tuberculin skin test (TST) tests compared to the rate of interferon gamma release assay (IGRA) tests (0.44%, P<0.001). The positive ratio of NTM and abnormal chest X-ray (CXR) which required sputum tests among the applicants over 15 years old has trends to increase with age. The age groups of over 70 years showed high positive rate in NTM and abnormal CXR (4.10%, 20.51%). However, ages 15 to 49 years groups showed 0.00% to 0.30% in NTM and 1.08% to 3.91% in abnormal CXR. In the study population, the positive rates of STIs were 0.03%, 0.08%, and 0.74% in gonorrhea, syphilis, and chlamydia, respectively. Among the participants who underwent sputum smears and cultures were just 1 case of active tuberculosis (0.03%) and 25 cases of NTM infection (0.66%). Conclusion: This study found that rate of positivity in tuberculosis and STIs screening among South Korean applicants for US visa in 2016 to 2020. Regarding tuberculosis, the positivity of CXR among the aged 15 to 59 years applicants was lower than that among over 60 years old. Among 2 to 14 years, positivity of IGRA was very low. And IGRA test can reduce effort of further evaluation compared to TST test in South Korea, so IGRA test among young adults can be useful. High positive rates in STI among young adult could result in high active sexuality, especially chlamydia infection is most common. Therefore Chlamydia polymerase chain reaction should be considered formal protocol among the Korean applicant for US visa.

Research on ANIOS Disinfection Efficiency to Prevent Infection in Radiography Room (방사선촬영실 감염 방지를 위한 에니오설프의 소독효율 연구)

  • Jung, Woo-Chan;Ahn, Ki-Song;Yang, Eun-Ju;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.15 no.1
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    • pp.55-61
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    • 2021
  • In this study, microbes were collected before and after disinfection using ANIOS(ANIOSURF Premium NPC) and compared the areas where the radiological technologist and the patient frequently contacted the chest X-ray. From September 1st to September 7th, 2020. in P Hospital in Deagu, 4 region were collected in a 10×10 size using a sterile cotton swab of the transport medium, and before and after disinfection results were obtained through the colorimetric method. As a result, n the X-ray tube handle Proteus mirabilis, Staphylococcus epidermidis, Bacillus spp., Candida spp., and in the Chin region Proteus mirabilis, Enterococcu faecium, Pseudomonas aeruginosa, NTM, and in the Chest region Proteus mirabilis, Enterococcu faecium, Pseudomonas aeruginosa, and in the Palm region NTM, Candida spp. were detected, and 103 CFU(Colony Forming Unit) or more were measured. After disinfection, only X-ray tube handle was detect Bacillus spp. and more than 102 CFU was measured. Microorganisms found prior to disinfection can cause opportunistic infections, Experimental results showed that Aniosulf(0.25%) is more economical and disinfectant than ethanol(70-90%) and isopropyl alcohol(70-90%). However, further research is needed on the detection of Bacillus spp. resultingly this research is useful basic data of infection control in Radiography room and prevention secondary infections.

Comparison of Aerodynamic Loads for Horizontal Axis Wind Turbine (I): with and without Turbulent Inflow (수평축 풍력터빈의 공력 하중 비교 (I): 난류 유입 유·무)

  • Kim, Jin;Kang, Seung-Hee;Ryu, Ki-Wahn
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.44 no.5
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    • pp.391-398
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    • 2016
  • This study focused on the aerodynamic loads of the horizontal axis wind turbine blade due to the normal turbulence inflow condition. Normal turbulence model (NTM) includes the variations of wind speed and direction, and it is characterized by turbulence intensity and standard deviation of flow fluctuation. IEC61400-1 recommends the fatigue analysis for the NTM and the normal wind profile (NWP) conditions. The aerodynamic loads are obtained at the blade hub and the low speed drive shaft for MW class horizontal axis wind turbine which is designed by using aerodynamically optimized procedure. The 6-components of aerodynamic loads are investigated between numerical results and load components analysis. From the calculated results the maximum amplitudes of oscillated thrust and torque for LSS with turbulent inflow condition are about 5~8 times larger than those with no turbulent inflow condition. It turns out that the aerodynamic load analysis with normal turbulence model is essential for structural design of the wind turbine blade.

Mycobacterial Infection among Retired Dusty Workers Ineligible for Medical Care Benefits for Work-related Pneumoconiosis (요양 비대상인 분진작업 이직근로자에서 마이코박테리아 감염)

  • Joo Hwan Hwang
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.33 no.3
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    • pp.355-364
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    • 2023
  • Objectives: The objective of the present study was to identify mycobacterial infection in retired dusty workers who were ineligible for medical care benefits for work-related pneumoconiosis. Methods: Sputum samples were collected from 170 retired dusty workers living in Gangwon-do. The mycobacterial culture was grown in 2% Ogawa medium and Mycobacteria Growth Indicator Tube(MGIT). Mycobacterial species were identified using MolecuTech REBA Myco-ID. Results: Thirty-one(18.2%) out of 170 sputum samples were identified as positive for culture. Among the positive culture samples, eleven(6.5%) were identified as mycobacterial species. The proportion of mycobacteria was M. avium 2.3%(4/170), M. fortuitum complex 1.2%(2/170), M. intracellulare 1.2%(2/170), M. abscessus 0.6%(1/170), M. tuberculosis(MTB) complex 0.6%(1/170), and MYC(NTM except 19 species) 0.6%(1/170). Conclusions: In comparison with previous studies, the incidence rate of tuberculosis(TB) in retired dusty workers who were ineligible for medical care benefits for work-related pneumoconiosis was higher than in close contact with TB patients, workers exposed to silica, and patients with silicosis. And the proportion of non-tuberculosis mycobacteria(NTM) was higher than that of MTB.

An Unusual Case of Post-Operative Spondylitis Caused by $Mycobacterium$ $Intracellulare$ in an Immunosuppressed Patient

  • Kim, Sung-Hoon;Son, Dong-Wuk;Lee, Sang-Weon;Song, Geun-Sung
    • Journal of Korean Neurosurgical Society
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    • v.50 no.5
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    • pp.460-463
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    • 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.

Clinical Utility of Polymerase Chain Reaction for the Differentiation of Nontuberculous Mycobacteria in Patients with Acid-fast Bacilli Smear-positive Specimens (객담 항산균 도말 양성 환자에서 비결핵항산균과의 감별을 위한 결핵균 중합효소연쇄반응 검사의 유용성)

  • Lee, Jae Seung;Ji, Hyun Shuk;Hong, Sang Bum;Oh, Yeon-Mok;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.452-458
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    • 2005
  • Background : In Korea, polymerase chain reaction (PCR) test for M. tuberculosis has been used for the diagnosis of acid-fast bacilli (AFB) smear-negative tuberculosis in order to increase diagnostic sensitivity. However, there have been no data dealing with the clinical utility of PCR in AFB smear-positive patients to differentiate between M. tuberculosis and nontuberculous mycobacteria. Method : We retrospectively analyzed the PCR test results which have been performed in patients who had AFB smear-positive sputum but had ambiguous clinical manifestations of active tuberculosis. PCR test was done using $AMPLICOR^{\hat{a}}$ M. tuberculosis kit. The sensitivity, specificity, and positive and negative predictive values of the PCR test were calculated based on culture and final clinical diagnosis result. Results : Fifty-six consecutive patients (62 PCR tests) were included in the study. Active tuberculosis was diagnosed in 23 patients (41.0%), while 9 patients had NTM infection (16.0%). The sensitivity, specificity, positive- and negative-predictive value of PCR test were 88.8%, 86.8%, 76.1% and 94.3%, respectively, according to the culture result. In comparison, they were 91.3%, 100%, 100%, 94.3%, respectively, according to the final clinical diagnosis. All 15 patients with NTM isolates, including 6 patients who had other lung diseases but expectorated NTM isolate, were negative for PCR test. Conclusion : Even though tuberculosis is still prevalent in Korea, PCR test is useful to differentiate between M. tuberculosis and NTM in patients with AFB-smear positive sputum but with ambiguous clinical manifestations of active tuberculosis.