• Tuberculosis and Respiratory Diseases
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• v.82 no.2
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• pp.94-101
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• 2019

Nontuberculous mycobacteria (NTM) are ubiquitous organisms that are generally found not only in the natural environment but also in the human engineered environment, including water, soil, and dust. These organisms can form biofilms and can be readily aerosolized because they are hydrophobic owing to the presence of the lipid-rich outer membrane. Aerosolization and subsequent inhalation were the major route of NTM lung disease. Water distribution systems and household plumbing are ideal habit for NTM and the main transmission route from natural water to household. NTM have been isolated from drinking water, faucets, pipelines, and water tanks. Studies that used genotyping have shown that NTM isolates from patients are identical to those in the environment, that is, from shower water, showerheads, tap water, and gardening soil. Humans are likely to be exposed to NTM in their homes through simple and daily activities, such as drinking, showering, or gardening. In addition to environmental factors, host factors play an important role in the development of NTM lung disease. The incidence and prevalence of NTM lung disease are increasing worldwide, and this disease is rapidly becoming a major public health problem. NTM lung disease is associated with substantially impaired quality of life, increased morbidity and mortality, and high medical costs. A more comprehensive understanding of the infection source and epidemiology of NTM is essential for the development of new strategies that can prevent and control NTM infection.

• Korean Journal of Clinical Laboratory Science
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• v.47 no.2
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• pp.83-89
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• 2015

Although Mycobacterium tuberculosis complex strains remain responsible for the majority of diseases caused by mycobacterial infections worldwide, the increase in HIV (human immuno deficiency virus) infections has allowed for the emergence of other non-tuberculous mycobacteria as clinically significant pathogens. M. tuberculosis was detected by two-tube nested polymerase chain reaction (PCR) and non-tuberculous mycobacteria was detected by PCR-restriction fragment length polymorphism (RFLP) with Msp I. Result of niacin test is equal to result of two-tube nested PCR after culture for M. tuberculosis. In this study, acid fast bacilli stain (AFB. stain) >2+ case, Detection of Mycobacteria is similar to result before culture and after culture. AFB. stain <1+ case, result of mycobacteria is distinguished. Conclusionly, these results suggest that identification of mycobacteria must go side by side both culture and PCR for more fast and accuracy.

• Tuberculosis and Respiratory Diseases
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• v.86 no.1
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• pp.47-56
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• 2023

Background: There is a global increase in isolation of nontuberculous mycobacteria (NTM). The aim of the study was to analyze longitudinal trends of NTM identification and pattern of antimicrobial susceptibility testing. Methods: NTM recovery rates, distribution of NTM species identification, and antimicrobial susceptibility pattern of NTM at Pusan National University Yangsan Hospital between January 2016 and December 2020 were retrospectively analyzed. Results: A total of 52,456 specimens from 21,264 patients were submitted for mycobacterial culture, of which 2,521 from 1,410 patients were NTM positive over five years (January 2016 to December 2020). NTM isolation showed an increasing trend from 2016 to 2020 (p<0.001, test for trend) mainly caused by Mycobacterium avium complex. The vast majority of M. avium complex were susceptible to key agents clarithromycin and amikacin. For Mycobacterium kansasii, resistance to rifampin and clarithromycin is rare. Amikacin was the most effective drug against Mycobacterium abscessus subspecies abscessus and Mycobacterium subspecies massiliense. Most of M. subspecies massiliense were susceptible to clarithromycin, while the majority of M. abscessus subspecies abscessus were resistant to clarithromycin (p<0.001). Conclusion: There was an increasing trend of NTM isolation in our hospital. Resistance to key drugs was uncommon for most NTM species except for M. abscessus subspecies abscessus against clarithromycin.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.4
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• pp.435-438
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• 2017

Nontuberculous mycobacteria (NTM) contains M. avium-intracellular complex (MAC), M. fortuitum, M. chelonae, M. abscessus, M. kansasii, etc., which causes infections in swine, poultry, and other animals. These bacteria are opportunistic pathogens that can contaminate people, and in doing so, cause various social economic problems. This study proved that NTM are also present in air conditioners of multiuse facilities in frequently visited populated areas. The results of this study are meaningful because they showed that pathogenic microbes can live in the surroundings and cause diseases to people with impaired immunity. This study used the AFB stain, L-J medium culture, and PCR method for the detection of MTB and NTM in air conditioner dust. MTB was not detected in any of the collected samples, while NTM was detected in 2 out of 40 samples (5%). Most people living in the modern environment cannot avoid being exposed to air conditioners so special attention is needed for sanitary inspections and the management of air conditioners. Moreover, it is important to study NTM through various individuals, accumulate the related data and establish the methods and standards of hygiene management system to reduce NTM infections in public areas. Moreover, it would be necessary to identify the precise species of NTM through DNA sequencing and evaluate the effects of NTM on the pulmonary tuberculosis in immunodeficiency patients.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.4
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• pp.349-355
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• 2020

Recently, the detection of Mycobacterium tuberculosis complex (MTBC) in respiratory specimens has decreased, and nontuberculous mycobacteria (NTM) has increased. This study examined the increase in NTM lung disease patients and their age and sex distribution compared to the increase in NTM detection in 132,359 respiratory specimens examined in a Gwangju Secondary Hospital from 2010 to 2019. Furthermore, the prevalence of pulmonary tuberculosis infection in NTM positive patients was investigated. The positive rates of the mycobacterial culture were 21.9% (1,624/7,403) in 2010 and 17.4% (1,937/11,161) in 2019. The NTM recovery rate increased from 38.0% (617/1,624) in 2010 to 72.4% (1,403/1,937) in 2019. The average diagnosis rate of NTM lung disease in the NTM positive patients was 27.1%. Among them, cases of current pulmonary tuberculosis infection decreased from 44.9% in 2010 to 23.4% in 2019, and cases of previous diagnosis or treatment decreased from 15.8% to 10.7%. Of all NTM lung diseases, 69.0% were in their 60s or older, with more females than males. In the future, according to aging and tuberculosis management policies, NTM detection is expected to increase while MTBC decreases and laboratories must pay close attention to this phenomenon and constantly monitor the test results.

• Tuberculosis and Respiratory Diseases
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• v.74 no.4
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• pp.187-190
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• 2013

We report a rare case of lung disease caused by Mycobacterium lentiflavum in a previously healthy woman. A 54-year-old woman was referred to our hospital due to chronic cough and sputum. A computed tomography scan of the chest revealed bilateral bronchiectasis with bronchiolitis in the right middle lobe and the lingular division of the left upper lobe. Nontuberculous mycobacteria were isolated twice from three expectorated sputum specimens. All isolates were identified as M. lentiflavum by multilocus sequence analysis based on rpoB, hsp65, and 16S rRNA fragments. To the best of our knowledge, this is the first documented case of M. lentiflavum lung disease in an immunocompetent adult in Korea.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.23 no.3
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• pp.169-176
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• 2013

Objectives: The aim of this study is to critically review the health effects of not only direct exposure to biocide, but also indirect exposure to by-product hazardous agents generated through the use of biocide in metalworking operations. Methods: An extensive literature review was conducted of studies reporting on respiratory disease cases, particularly hypersensitivity pneumonitis (HP), in environments using water-soluble metalworking fluids (MWFs). Keyword search terms included 'metalworking fluids', 'machining fluids', 'metalworking operation' 'machining operation' and 'biocide', which were also used in combination. Additional articles were identified in references cited in the articles reviewed. Results: Several of the field, epidemiological and experimental studies reviewed assumed that the symptoms and signs typical of HP developed in machinists who handled water-soluble MWF could be caused by inhalation exposure to nontuberculous mycobacteria (NTM). Most NTM are known to be not only resistant to both biocide and disinfectant, but also to have acid-fast cell walls that are highly antigenic. The presence or persistence of the Mycobacterium species, referred to as NTM, in metalworking fluid-using operations may be caused by NTM contamination in either the natural water or tap water that is used to dilute the base oil and additives for water-soluble MWFs. This hypothesis that NTM contamination in water-soluble MWFs is a causative agent of HP has high biologic plausibility, such as antigenic property, hydrophobicity and small diameter (< 5 um). Conclusions: Aerosolized mycobacteria colonized from MWF are likely to be causing the HP. Inhalation exposure to mycobacteria should be considered as a possible cause for the development of HP.

• Archives of Plastic Surgery
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• v.39 no.1
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• pp.18-24
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• 2012

Background : Infection caused by rapidly growing mycobacteria (RGM) is not uncommon, and the prevalence of RGM infection has been increasing. Clinical diagnosis is difficult because there are no characteristic clinical features. There is also no standard antibiotic regimen for treating RGM infection. A small series of patients with RGM infections was studied to examine their treatments and outcomes. Methods : A total of 5 patients who had developed postoperative infections from January 2009 to December 2010 were retrospectively reviewed. Patients were initially screened using a mycobacteria rapid screening test (polymerase chain reaction [PCR]-reverse blot hybridization assay). To confirm mycobacterial infection, specimens were cultured for nontuberculous mycobacteria and analyzed by 16 S ribosomal RNA and rpoB gene PCR. Results : The patients were treated with intravenous antibiotics during hospitalization, and oral antibiotics were administered after discharge. The mean duration of follow-up was 9 months, and all patients were completely cured of infection with a regimen of a combination of antibiotics plus surgical treatment. Although none of the patients developed recurrence, there were complications at the site of infection, including hypertrophic scarring, pigmentation, and disfigurement. Conclusions : Combination antibiotic therapy plus drainage of surgical abscesses appeared to be effective for the RGM infections seen in our patients. Although neither the exact dosage nor a standardized regimen has been firmly established, we propose that our treatment can provide an option for the management of rapidly growing mycobacterial infection.

• Tuberculosis and Respiratory Diseases
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• v.72 no.2
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• pp.173-176
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• 2012

We report a rare case of lung disease caused by Mycobacterium terrae in a previously healthy woman. A 45-year-old woman was referred to our hospital due to a chronic cough with sputum. A computed tomography scan of the chest revealed bronchiolitis in conjuction with bronchiectasis in both lungs. Nontuberculous mycobacteria were identified and isolated from the bronchoalveolar lavage fluid collected from each lung. All isolates were identified as M. terrae by various molecular methods that characterized the rpoB and hsp65 gene sequences. Antibiotic therapy using clarithromycin, rifampin, and ethambutol improved the patient's condition and successfully resulted in sputum conversion.

• Tuberculosis and Respiratory Diseases
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• v.82 no.1
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• pp.88-89
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• 2019