• Tuberculosis and Respiratory Diseases
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• v.74 no.6
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• pp.251-255
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• 2013

Tuberculosis (TB) is one of the largest health problems in the world today. And the incidence of nontuberculous mycobacteria (NTM) lung disease appears to be increasing worldwide. Recently, an automated, nucleic acid amplification assay for the rapid detection of both Mycobacterium tuberculosis and rifampin resistance was developed (Xpert MTB/RIF). And fixed-dose combinations of anti-TB drugs and linezolid have been introduced in the treatment of TB. And new NTM species, named Mycobacterium massiliense, which is very closely related to Mycobacterium abscessus was reported. In this review, these recent advances in the diagnosis and treatment of TB and clinical characteristics of M. massiliense lung disease are discussed.

• Korean Journal of Clinical Laboratory Science
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• v.47 no.1
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• pp.1-5
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• 2015

The nontuberculous mycobacteria (NTM) have been found in different environmental sources. They tend to colonize different body surfaces and secretions. The purpose of this study is to evaluate the presence of NTM in the theater environment. Fifty of Theater environment sample were examined using acid-fast stain, Lowenstein-Jensen medium culture, PCR and DNA-Sequencing. 4 of 50 samples were detected as NFB in AFB stain, L-J medium culture, PCR. and then, All of 4 NTM stains identified as Mycobacterium fortitum type in DNA-sequencing result.

• Tuberculosis and Respiratory Diseases
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• v.74 no.5
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• pp.215-221
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• 2013

Background: Nontuberculous mycobacteria (NTM) are considered opportunistic pathogens, and several species of NTM are associated with human diseases that typically involve the pulmonary, skin/soft tissue, or lymphatic systems; such infection may also cause disseminated diseases. Recent studies have reported increasing rates of NTM-induced disease worldwide. Methods: Respiratory samples are being analyzed for acid-fast bacilli (AFB) culture and NTM identification at Dankook University Hospital in Cheonan, Korea, from September 2005 to September 2011. Identification is performed by using polymerase chain reaction-restriction fragment length polymorphism analysis targeting a novel region of the rpoB gene. Results: A total of 25,133 specimens were received for AFB culture, of which 1,014 (4.0%) were NTM-positive. A total of 267 samples from 186 patients were tested for NTM identifications, and 232 samples from 157 patients were positive for NTM species. Among the patients who tested positive for NTM, 65.6% were men and the average age was 63.3 years. Mycobacterium avium complex, the most commonly detected NTM pathogen, was found in 65.9% of the 232 samples. The annual average percentage of NTM isolates from AFB culture-positive specimens was 31.3%: the highest rate was seen in 2011 (44.3%), followed by 2009 (37.4%) and 2010 (37.2%). An upward trend in NTM incidence was found during the study period. Conclusion: The prevalence of pulmonary NTM isolates continues to increase in Cheonan, suggesting that pulmonary NTM disease is becoming increasingly common.

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

• Tuberculosis and Respiratory Diseases
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• v.77 no.1
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• pp.1-5
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• 2014

The recovery of nontuberculous mycobacteria (NTM) from respiratory specimens and the number of patients with NTM lung disease have been rapidly increasing in Korea. An early differential diagnosis of NTM lung disease from pulmonary tuberculosis (TB) is important, as the therapeutic regimen differs from that of pulmonary TB, and it is not necessary to track the contacts of patients with NTM lung disease. However, differentiating NTM lung disease from pulmonary TB remains difficult, because the clinical presentations of the two diseases are similar and a definite diagnosis of NTM lung disease based on sputum culture takes time. This review focuses on the changing epidemiology, clinical and radiographic manifestation, and laboratory diagnosis of pulmonary TB and NTM lung disease in Korea.

• Tuberculosis and Respiratory Diseases
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• v.66 no.4
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• pp.309-313
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• 2009

There are several respiratory diseases that show chronic granulomatous inflammation for the histologic finding. Among them, sarcoidosis and tuberculosis are not easy to differentiate when the clinical and radiological features present similar patterns. The increasing incidence of nontuberculous mycobacteria pulmonary disease is making it more difficult for clinicians to arrive at a proper diagnosis. A 69 year old male patient visited our hospital with chronic cough as his chief compliant. His radiologic findings were multiple enlarged mediastinal lymphadenpathies with innumerable micronodules and multiple patch infiltrations. The spleen biopsy finding showed chronic granulomatous inflammation, and Mycobacterium avium was identified on the bronchoscopic culture. Because of these findings, we treated him with drugs for nontuberculous mycobacteria disease other than sarcoidosis. However, during the treatment, his symptoms and radiological features became aggravated. Thus, we reviewed the radiologic and pathologic findings and decided to treat him with steroid, which relieved his symptoms and improved the radiologic findings. We report here on a case of sarcoidosis that was initially misdiagnosed as nontuberculous mycobacteria pulmonary disease.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.2
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• pp.171-176
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• 2019

A comparative study between commercially available mycobacteria growth indicator tubes (MGIT) in the BACTEC MGIT 960 System and the conventional Ogawa media was carried out to assess the effectiveness of the re-decontaminating process for the recovery of mycobacteria. Processed specimens with 5% sodium hydroxide and 0.5% N-acetyl-L-cysteine were inoculated into MGIT and Ogawa media. The acid fast bacilli (AFB) recovered from the cultures were identified using a mycobacterium tuberculosis (TB) antigen kit. If contaminants were observed in the MGIT tubes within five days, a decontaminating process was repeated. A total of 1,190 out of 4,790 (24.8%) specimens showed positive results using the BACTEC MGIT 960 system. Among them, 278 specimens were reprocessed. When the MGIT and Ogawa results were compared, it showed discordant results (weighted kappa value: 0.283). One TB and 10 nontuberculous mycobacteria (NTM) were newly detected in MGIT only. The likely benefit of the re-decontaminating process is the detection of additional mycobacteria that could not be detected without a re-decontaminating process despite being small in number. In addition to the combination of MGIT and Ogawa, the re-decontaminating process is recommended in the case of contaminations to recover mycobacteria.

• Journal of Microbiology and Biotechnology
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• v.19 no.10
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• pp.1259-1264
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• 2009

We assessed the capacity of two liquid-medium culture methods with automated incubation and reading systems (MB/BacT ALERT 3D System and BACTEC MGIT 960 System) and one solid-medium culture method ($L\ddot{o}wenstein$-Jensen) to detect mycobacteria in different types of clinical samples. Out of 1,770 cultured clinical samples (1,519 of respiratory origin and 251 of non respiratory origin), mycobacteria were isolated in 156 samples (135 M. tuberculosis complex, 8 M. chelonae, 6 M. kansasii, 4 M. fortuitum, 2 M. gordonae, and 1 M. marinum) by at least one of the methods used. The BACTEC MGIT 960 System proved to be the most sensitive method (86.5%), especially in the detection of M. tuberculosis complex (89.1%). However, $L\ddot{o}wenstein$-Jensen culture was the most sensitive (76.2%) to detect nontuberculous mycobacteria. The BACTEC MGIT 960 System showed the lowest mean detection time for mycobacterial growth (15.3 days), significantly shorter than the other two methods. Highest sensitivity (95.5%) and specificity (99.6%) values were obtained using the BACTEC MGIT 960 System with the $L\ddot{o}wenstein$-Jensen culture method, which was also the only combination capable of detecting 100% of the nontuberculous mycobacteria.

• Tuberculosis and Respiratory Diseases
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• v.79 no.2
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• pp.74-84
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• 2016

Nontuberculous mycobacteria (NTM) are emerging pathogens that affect both immunocompromised and immunocompetent patients. The incidence and prevalence of NTM lung disease are increasing worldwide and rapidly becoming a major public health problem. For the diagnosis of NTM lung disease, patients suspected to have NTM lung disease are required to meet all clinical and microbiologic criteria. The development of molecular methods allows the characterization of new species and NTM identification at a subspecies level. Even after the identification of NTM species from respiratory specimens, clinicians should consider the clinical significance of such findings. Besides the limited options, treatment is lengthy and varies by species, and therefore a challenge. Treatment may be complicated by potential toxicity with discouraging outcomes. The decision to start treatment for NTM lung disease is not easy and requires careful individualized analysis of risks and benefits. Clinicians should be alert to those unique aspects of NTM lung disease concerning diagnosis with advanced molecular methods and treatment with limited options. Current recommendations and recent advances for diagnosis and treatment of NTM lung disease are summarized in this article.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.416-418
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• 2015

Mycobacterium shinjukuense is a novel species of nontuberculous mycobacteria (NTM) that was first reported in Japan in 2011. It is a slow-growing NTM pathogen that can cause chronic pulmonary infections. There are only a few reported cases of M. shinjukuense infections, all of which are from Japan. We reported a case of chronic lung disease caused by M. shinjukuense. The organism was identified by 16S rRNA, rpoB, and hsp65 gene sequencing. To the best of our knowledge, this was the first confirmed case of lung disease caused by M. shinjukuense outside of Japan.