• Archives of Plastic Surgery
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• 제38권4호
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• pp.519-522
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• 2011

Purpose: Breast implant surgery is increasing in Korea. NTM (non tuberculous mycobacteria) infection after breast implant surgery is rare, but it has been there reported in several foreign countries. However, no report has been issued on NTM infection after breast reconstruction surgery with an implant in Korea. The purpose of this article is to report a case of NTM infection after breast reconstruction surgery with an implant. Methods: A female patient who underwent total mastectomy and immediate breast reconstruction with a latissimus dorsi myocutaneous flap and an implant exhibited signs of inflammation after the surgery. Fluid cultures taken at the time of wound exploration were initially negative, but NTM was isolated by culture 10 days later. Results: The implant was removed. M. fortuitum was identified by acid-fast culture and NTM-PCR. The patient was treated with combined antibiotic therapy. Conclusion: Although it is difficult to diagnose NTM infection after breast surgery, it is important that surgeons include NTM infection in the differential diagnosis of a post mammoplasty infection after breast implant surgery.

• International Journal of Advanced Culture Technology
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• 제11권3호
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• pp.260-267
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• 2023

We aimed to investigate the proportions of MTB- and NTM-positive tests and the distribution patterns of species isolated by contracted testing agencies in South Korea. Respiratory specimens submitted to contracted testing agencies in South Korea for AFB culture from January 2014 to December 2021 were included (533,713 specimens in total). Trends based on MTB and NTM detection, patient sex and age, culture medium type, and testing year were analyzed. MTB and NTM positive detection increased in the patients. The average ages of MTB- and NTM-positive patients increased in those aged ≥61 years. For solid culture, the MTB detection rate decreased from 5.9% in 2014 to 3.3% in 2018 and increased to 4.7% in 2021; the NTM detection rate increased from 2.1% in 2014 to 3.4% in 2018 and 3.7% in 2021. For liquid culture, the MTB detection rate decreased from 8.3% in 2014 to 5.5% in 2018 and increased to 6.0% in 2021; the NTM detection rate increased from 3.5% in 2014 to 5.5% in 2018 and decreased to 5.3% in 2021. An isolation ratio reversal between MTB and NTM was observed in 2018. In this study, we provide information on mycobacterial isolation rates and species distributions using AFB culture test results from Korea's referral laboratories. Increased MTB- and NTM-isolation rates were observed in individuals aged ≥60 years, indicating the need for regular testing and focused management for them. Expanding liquid culture applications, which show higher positivity rates than solid culture methods, is necessary.

• Tuberculosis and Respiratory Diseases
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• 제59권1호
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• pp.39-46
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• 2005

배 경: 암색소성이면서 집락수가 적은 비결핵항산균이 분리되는 경우 실제 NTM폐질환의 원인일 가능성이 낮다고 추정되나 아직 이에 대한 보고는 없는 실정이다. 본 연구는 암색소성 저집락군 NTM배양의 임상적 의미를 알아보고자 시행되었다. 방 법 : 3개월간 항산균 검사가 의뢰된 6,898예를 대상으로 하여 분석하였으며 무작위로 집락수가 20개 이하인 경우를 저집락군으로 정의하였다. 모든 검체에서 결핵균, NTM의 배양 빈도를 확인하고, NTM에서는 암색소성 여부와 집락수를 분석하였다. NTM은 PRA법으로 동정하였으며 NTM폐질환의 진단은 미국흉부학회의 기준을 따랐다. 결 과: 총 6,898검체 중 NTM은 263(3.8%)예(206명) 결핵균은 382(5.5%)예 분리되었다. NTM 263 균주 중 암 색소성 균주는 124예(47.1%, 112명)이었다. 암색소성중 도말양성은 6예(4.8%)로 비암색소성 139균주 중 33예 (23.7%)에 비하여 의미 있게 낮았다(p<0.05). 균동정은 암색소성은 M. gordonae 83예(81.4%)가 가장 많이 분리되었고, 비암색소성은 MAC 52예(43.0%), M. abscessus 29예(24.0%), M. fortuitum complex 17예(14.0%)의 순이었다. 암색소성-저집락군 113명중 NTM폐질환은 3예 있었으나 모두 비암색소성으로 알려진 다른 균이 원인균이었다. 결 론 : 본 연구에서 암색소성-저집락 NTM은 대부분 M. gordonae였으며 NTM폐질환의 원인균이 아닌 오염균으로 추정되었다. 저집락수, 암색소성 비결핵항산균의 분리비율이 높을 경우 오염의 가능성을 생각하여 검사실의 정도관리에 최선을 다해야 할 것이다.

• 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.

• Tuberculosis and Respiratory Diseases
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• 제83권2호
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• pp.141-146
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• 2020

Background: The burden of nontuberculous mycobacterial (NTM) pulmonary disease (PD) is increasing globally. To understand the treatment outcomes and prognosis of NTM-PD, a unified registry is needed. In this project, we aim to construct a multicenter prospective observational cohort with NTM-PD in South Korea (NTM-KOREA). Methods: The primary objective of this study is to analyze treatment outcomes according to the species. In addition, recurrence rate, adverse events, the impact of each drug on treatment outcomes as well as the impact of characteristics of mycobacteriology will be analyzed. The inclusion criteria for the study are as follows: fulfilling the criteria for NTM-PD having one of the following etiologic organisms: Mycobacterium avium complex, M. abscessus subspecies abscessus, M. abscessus subspecies massiliense, or M. kansasii; receiving the first treatment for NTM-PD after enrollment; age >20 years; and consenting to participate in the study. Seven institutions will participate in patient enrollment and about 500 patients are expected to be enrolled. Participants will be recruited from 1 March 2020 until 19 March 2024 and will be observed through 19 March 2029. During the follow-up period, participants' clinical course will be tracked and their clinical data as well as NTM isolates will be collected. Conclusion: NTM-KOREA will be the first nationwide observational cohort for NTM-PD in South Korea. It will provide the information to optimize treatment modalities and will contribute to deeper understanding of the treatment outcomes and long-term prognosis of patients with NTM-PD in South Korea.

• 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.

• IMMUNE NETWORK
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• 제21권6호
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• pp.40.1-40.20
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• 2021

Mycobacteroides abscessus (previously Mycobacterium abscessus; Mabc), one of rapidly growing nontuberculous mycobacteria (NTM), is an important pathogen of NTM pulmonary diseases (NTM-PDs) in both immunocompetent and immunocompromised individuals. Mabc infection is chronic and often challenging to treat due to drug resistance, motivating the development of new therapeutics. Despite this, there is a lack of understanding of the relationship between Mabc and the immune system. This review highlights recent progress in the molecular architecture of Mabc and host interactions. We discuss several microbial components that take advantage of host immune defenses, host defense pathways that can overcome Mabc pathogenesis, and how host-pathogen interactions determine the outcomes of Mabc infection. Understanding the molecular mechanisms underlying host-pathogen interactions during Mabc infection will enable the identification of biomarkers and/or drugs to control immune pathogenesis and protect against NTM infection.

• Tuberculosis and Respiratory Diseases
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• 제75권5호
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• pp.199-204
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• 2013

Background: The number of patients with pulmonary disease caused by nontuberculous mycobacteria (NTM) has been increasing worldwide. The aim of this study was to evaluate long-term trends in the NTM recovery rate from respiratory specimens over a 10-year period in a tertiary referral hospital in South Korea. Methods: We retrospectively reviewed the records of mycobacterial cultures of respiratory specimens at Samsung Medical Center from January 2001 to December 2011. Results: During the study period, 32,841 respiratory specimens from 10,563 patients were found to be culture-positive for mycobacteria. These included 12,619 (38%) Mycobacterium tuberculosis and 20,222 (62%) NTM isolates. The proportion of NTM among all positive mycobacterial cultures increased from 43% (548/1,283) in 2001 to 70% (3,341/4,800) in 2011 (p<0.001, test for trend). The recovery rate of NTM isolates from acid-fast bacilli smear-positive specimens increased from 9% (38/417) in 2001 to 64% (1,284/1,997) in 2011 (p<0.001, test for trend). The proportion of positive liquid cultures was higher for NTM than for M. tuberculosis (p<0.001). The most frequently isolated NTM were Mycobacterium avium-intracellulare complex (53%) and Mycobacterium abscessus-massiliense complex (25%). Conclusion: The recovery rate of NTM from respiratory specimens in South Korea has increased steadily.

• 대한임상검사과학회지
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• 제45권2호
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• pp.48-53
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• 2013

Recently, the isolation rate of nontuberculous mycobacteria (NTM) in clinical laboratories and the incidence of NTM infections are on the increase in Korea, but there have been only a few studies that reveal the general aspect of NTM isolation or species distribution. Therefore, this study was performed to examine the species identification by PCR-restriction fragment length polymorphism analysis (PRA, PCR-RFLP), and the clinical significance of mycobacterial cultures. PRA was used during the novel region of the rpoB gene and was developed for rapid and precise identification of mycobacteria to the species level. From January 2012 to April 2012, we examined pre-identified nontuberculous mycobacteria (60 species in 3 hospital of Busan-Kyeongnam area). We confirmed 4 (6.6%) Mycobacterium tuberculosis (MTB) and 56 (93.4%) NTM from 60 pre-identified NTM species by multiplex PCR (MolecuTech $MTB-ID^R$ V3, YD Diagnostics, Korea) and PRA (Myco-ID, YD Diagnostics, Korea). The distribution of 56 NTM species were M. intracellulare type I 15 (26.7%), M. avium 14 (25%), M. abscessus 11 (19.5%), M. kansasii type I 3 (5.4%), M. pulveris 2 (3.6%), M. intracellulare type, M. chelonae, M. kansasii type V, M. gallinarum, M. wolinskyi. Respectively, 1 (1.8%) and 6 (10.7%) species were not identified.

• 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.