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a phylogenomic approach to bacterial subspecies classification: proof of concept in mycobacterium abscessus.mycobacterium abscessus is a rapidly growing mycobacterium that is often associated with human infections. the taxonomy of this species has undergone several revisions and is still being debated. in this study, we sequenced the genomes of 12 m. abscessus strains and used phylogenomic analysis to perform subspecies classification.201324330254
the genome sequence of 'mycobacterium massiliense' strain cip 108297 suggests the independent taxonomic status of the mycobacterium abscessus complex at the subspecies level.members of the mycobacterium abscessus complex are rapidly growing mycobacteria that are emerging as human pathogens. the m. abscessus complex was previously composed of three species, namely m. abscessus sensu stricto, 'm. massiliense', and 'm. bolletii'. in 2011, 'm. massiliense' and 'm. bolletii' were united and reclassified as a single subspecies within m. abscessus: m. abscessus subsp. bolletii. however, the placement of 'm. massiliense' within the boundary of m. abscessus subsp. bolletii r ...201324312320
[mycobacterium abscessus group lung disease: case reports and review of the literature].to analyze the clinical manifestations and efficacy of a combination antibiotic therapy including cefoxitin for mycobacterium abscessus (m.abscessus) group lung disease.201324423821
bronchopleural fistula following m. abscessus infection 11 years after lobectomy for lung cancer.bronchopleural fistula (bpf) is a potentially fatal complication of lung cancer resection surgery that occurs during the healing process of the bronchial stump. however, the vulnerability of the healed surgical wound to overlapping acquired airway destruction has not yet been determined in detail. we herein present a case of fatal bpf following mycobacterium abscessus (m. abscessus) infection, which occurred 11 years after right upper lobectomy for lung cancer. the findings of the present study ...201324255862
[drug sensitivity analysis of mycobacterium chelonae and mycobacterium abscessus and evaluation of etest for susceptibility testing].to study the drug resistance profile of mycobacterium(m.) chelonae and m.abscessus and to evaluate the clinical application of etest(epsilometer test) for susceptibility testing.201324252731
mycobacterium abscessus scleritis following intravitreous injection of bevacizumab. 201324151651
drug treatment of pulmonary nontuberculous mycobacterial disease in hiv-negative patients: the evidence.pulmonary disease (pd) caused by nontuberculous mycobacteria is an emerging infection mainly in countries where the incidence of tuberculosis is in decline. it affects an elderly population, often with underlying chronic lung diseases, but its epidemiology shows significant regional variation. guidelines and recommendations for treatment of these infections exist, but build strongly on expert opinion, as very few good quality clinical trials have been performed in this field. only for the most f ...201324124798
nontuberculous mycobacteria: the changing epidemiology and treatment challenges in cystic fibrosis.although patients with cystic fibrosis (cf) face numerous infectious pathogens over the course of their lifespan, increasing attention has recently been paid to nontuberculous mycobacteria (ntm). as reported prevalence rates rise across many countries such as the united states, the ability to recognize disease caused by ntm and subsequently treat such disease has become increasingly important. this review summarizes new observations on the epidemiology of ntm in cf as well as key elements to con ...201324048085
a case of erosive polyarthritis in a patient diagnosed with a suspicion of atypical mycobacteria.in this report, we introduce a case of erosive polyarthritis in a 55-year-old female diagnosed with mycobacterium abscessus pulmonary infection. her arthritis has been worsened after use of dmards. the patient demonstrated a significant response to the antimicrobial regimen that was administered. we call special attention to the possibility of mycobacterium abscessus being a cause of reactive polyarthritis, particularly if symptoms worsened after use of disease-modifying antirheumatic drugs (dma ...201324039641
insertion site and distribution of a genomic island conferring dna phosphorothioation in the mycobacterium abscessus complex.nearly half of us clinical isolates of the emerging pathogen mycobacterium abscessus were reported to exhibit smeared dna during pfge. this dna degradation (dnd) phenotype results from dna phosphorothioation, a sulfur modification found in other bacteria and conferred by dnd genes located on mobile elements. putative dnd genes are located on a 19.6 kbp genomic island (gi) in the m. abscessus type strain atcc 19977. we confirmed that atcc 19977(t) is dnd-positive by pfge and we developed a pcr as ...201324014661
whole-genome sequence of mycobacterium abscessus clinical strain v06705.infection caused by mycobacterium abscessus strains is a growing cause of concern in both community-acquired and health care-associated diseases, as these organisms naturally display multiple drug resistances. we report an annotated draft genome sequence of m. abscessus strain v06705 obtained from a patient in france.201324009121
post-operative sinus formation due to mycobacterium abscessus: a case report.mycobacterium abscessus is ubiquitously found rapidly growing mycobacteria. although it is an uncommon pathogen, it has been known to cause cutaneous infection following inoculation, minor trauma or surgery. this communication reports an immuno-competent patient developing multiple sinuses due to mycobacterium abscessus in the post- operative period.201324000496
identification and characterization of the genetic changes responsible for the characteristic smooth-to-rough morphotype alterations of clinically persistent mycobacterium abscessus.mycobacterium abscessus is an emerging pathogen that is increasingly recognized as a relevant cause of human lung infection in cystic fibrosis patients. this highly antibiotic-resistant mycobacterium is an exception within the rapidly growing mycobacteria, which are mainly saprophytic and non-pathogenic organisms. m. abscessus manifests as either a smooth (s) or a rough (r) colony morphotype, which is of clinical importance as r morphotypes are associated with more severe and persistent infectio ...201323998761
simultaneous detection of mycobacterium tuberculosis complex and nontuberculous mycobacteria in respiratory specimens.many nontuberculous mycobacteria (ntm) species have clinical significance, and the rapid and reliable identification of mycobacterium tuberculosis complex (mtbc) and ntm species is important. we evaluated the simultaneous detection of mtbc and ntm in respiratory specimens. mtbc and ntm were simultaneously detected and identified by laboratory-developed (ldt) real-time pcr, multiplex real-time pcr/melting curve analysis, rpob pcr restriction fragment length polymorphisms and the advansure mycobac ...201323988279
vertebral osteomyelitis caused by mycobacterium abscessus.mycobacterium infection caused by non-tuberculous mycobacterial (ntbm) organisms is becoming more common. although ntbm osteomyelitis is unusual, it can occur in otherwise healthy individuals, but it is also associated with immunocompromised states, such as steroidal therapy and aids, and may be observed following trauma. mycobacterium avium is reported to be the most common causative agent, and mycobacterium abscessus has only been described in two cases. we report the case of a 44-year-old man ...201323925676
standardization of multilocus sequence typing scheme for mycobacterium abscessus and mycobacterium massiliense.this study aims to develop a multilocus sequence typing (mlst) scheme for mycobacterium abscessus complex for the typing of stains within each species. a total of 89 clinical isolates of m. abscessus complex from 71 patients of 2 tertiary care hospitals in south korea were included. forty-two isolates were identified as m. abscessus, and 29, as mycobacterium massiliense through sequencing of 8 housekeeping genes and rpob. the mlst scheme identified 26 different sequence types(sts) and 13 differe ...201323891467
mycobacterium abscessus peritonitis associated with laparoscopic gastric banding.mycobacterium abscessus is a rapidly growing mycobacterium that is a common water contaminant in the environment. we report a case of m. abscessus infection with band erosion following laparoscopic gastric banding.201323855515
mab_3168c, a putative acetyltransferase, enhances adherence, intracellular survival and antimicrobial resistance of mycobacterium abscessus.mycobacterium abscessus is a non-tuberculous mycobacterium. it can cause diseases in both immunosuppressed and immunocompetent patients and is highly resistant to multiple antimicrobial agents. m. abscessus displays two different colony morphology types: smooth and rough morphotypes. cells with a rough morphotype are more virulent. the purpose of this study was to identify genes responsible for m. abscessus morphotype switching. with transposon mutagenesis, a mutant with a tn5 inserted into the ...201323840740
potentiation of high hydrostatic pressure inactivation of mycobacterium by combination with physical and chemical conditions.mycobacterium abscessus is an important hospital-acquired pathogen involved in infections associated with medical, surgical, and biopharmaceutical materials. in this work, we investigated the pressure-induced inactivation of two strains [2544 and american type culture collection (atcc) 19977] of m. abscessus in combination with different temperatures and ph conditions. for strain 2544, exposure to 250 mpa for 90 min did not significantly inactivate the bacteria at 20 °c, whereas at -15 °c, there ...201323836348
complete genome sequence of mycobacterium massiliense clinical strain asan 50594, belonging to the type ii genotype.we report the complete genome sequence of the mycobacterium massiliense clinical strain asan 50594, which was grouped into the m. massiliense type ii genotype, isolated from a korean patient. this genome sequence will serve as a valuable reference for understanding the disparity in virulence and epidemiological traits between strains belonging to the mycobacterium abscessus complex.201323833135
drosophila melanogaster model for mycobacterium abscessus infection.mycobacterium abscessus is a human pathogen that is responsible for a broad spectrum of tissue infections and disseminated infections in immunodeficient patients. this pathogen is one of the most resistant organisms to chemotherapeutic agents. therefore, we tested the hypothesis that the fruit fly, drosophila melanogaster, is a genetically tractable model host for m. abscessus. in this context, we infected d. melanogaster with m. abscessus. this m. abscessus infection results in dissemination in ...201323831804
thoracic empyema and bacteremia due to mycobacterium abscessus in a patient with liver cirrhosis.empyema thoracis with concomitant bacteremia caused by nontuberculous mycobacterium is rare. herein, we report a case of disseminated mycobacterium abscessus in a patient with liver cirrhosis and diabetes mellitus. m. abscessus was isolated from the specimen of pleural fluid and blood. the patients clinical condition gradually improved after antibiotic use and drainage.201323831159
nontuberculous mycobacteria in respiratory samples from patients with pulmonary tuberculosis in the state of rondônia, brazil.the main cause of pulmonary tuberculosis (tb) is infection with mycobacterium tuberculosis (mtb). we aimed to evaluate the contribution of nontuberculous mycobacteria (ntm) to pulmonary disease in patients from the state of rondônia using respiratory samples and epidemiological data from tb cases. mycobacterium isolates were identified using a combination of conventional tests, polymerase chain reaction-based restriction enzyme analysis of hsp65 gene and hsp65 gene sequencing. among the 1,812 ca ...201323827995
mycobacterium abscessus bacteremia after receipt of intravenous infusate of cytokine-induced killer cell therapy for body beautification and health boosting.we report the first series of mycobacterium abscessus bacteremia after cytokine-induced killer cell therapy for body beautification and health boosting.201323825355
lung transplantation for cystic fibrosis and bronchiectasis.lung transplantation has become an excellent treatment option for patients with cystic fibrosis (cf) and bronchiectasis with very advanced lung disease. despite the challenges that the cf patients present, survival is more favorable than that seen in patients with chronic obstructive pulmonary disease and pulmonary fibrosis. although those cf and bronchiectasis patients with severe respiratory disease are often infected with organisms that display in vitro resistance to the commonly used antibio ...201323821505
recent advances in tuberculosis and nontuberculous mycobacteria lung disease.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 mass ...201323814596
new rapid scheme for distinguishing the subspecies of the mycobacterium abscessus group and identifying mycobacterium massiliense isolates with inducible clarithromycin resistance.mycobacterium abscessus (m. abscessus sensu lato, or the m. abscessus group) comprises three closely related taxa whose taxonomic statuses are under revision, i.e., m. abscessus sensu stricto, mycobacterium bolletii, and mycobacterium massiliense. we describe here a simple, robust, and cost-effective pcr-based method for distinguishing among m. abscessus, m. massiliense, and m. bolletii. based on the m. abscessus atcc 19977(t) genome, regions that discriminated between m. abscessus and m. massil ...201323804391
adherence and biofilm formation of mycobacterium avium, mycobacterium intracellulare and mycobacterium abscessus to household plumbing materials.measure adherence and biofilm formation by cells of mycobacterium avium, mycobacterium intracellulare and mycobacterium abscessus on common household plumbing materials namely stainless steel, glass, zinc-galvanized steel, copper and polyvinyl chloride (pvc).201323742161
serodiagnosis of mycobacterium avium complex and mycobacterium abscessus complex pulmonary disease by use of iga antibodies to glycopeptidolipid core antigen.an enzyme immunoassay kit that detects serum iga antibody reacting to glycopeptidolipid core antigen derived from mycobacterium avium complex (mac) was not useful for differentiating mac pulmonary disease (pd) from mycobacterium abscessus complex pd (mab-pd). however, this assay could be useful for differentiating mac- and mab-pd from pulmonary tuberculosis. (this study has been registered at clinicaltrials.gov under registration no. nct00970801.).201323740728
emergence of clinically relevant non-tuberculous mycobacterial infections in saudi arabia.non-tuberculous mycobacteria (ntm) are emerging around the world due to a higher prevalence of immunosuppressive illness and therapy. saudi arabia is not an exception as there have been novel mycobacterial species also identified. in addition, several published case reports from different parts of the country suggest a growing pathogenic potential of ntm. as the first nationwide study, we sought to gain an insight into the species diversity of ntm clinical isolates.201323738024
catheter related infection due to mycobacterium abscessus in a patient under peritoneal dialysis. 201323735153
extrapulmonary infections caused by a dominant strain of mycobacterium massiliense (mycobacterium abscessus subspecies bolletii).a single strain of mycobacterium massiliense (bra 100), a subspecies of the mycobacterium abscessus complex, has been responsible for an epidemic of post-surgical infections in brazil. outside brazil, this is the first report to describe a single emerging strain of m. massiliense (tpe 101) associated with extrapulmonary infections. this phenomenon may be underestimated because sophisticated molecular typing of m. abscessus is not routinely performed. our molecular epidemiology study was triggere ...201323718188
epidemiology and outcomes of deep surgical site infections following lung transplantation.we conducted a retrospective study of deep surgical site infections (ssis) among consecutive patients who underwent lung transplantation (ltx) at a single center from 2006 through 2010. thirty-one patients (5%) developed ssis at median 25 days after ltx. empyema was most common (42%), followed by surgical wound infections (29%), mediastinitis (16%), sternal osteomyelitis (6%), and pericarditis (6%). pathogens included gram-positive bacteria (41%), gram-negative bacteria (41%), fungi (10%) and my ...201323710593
lung transplant outcomes in cystic fibrosis patients with pre-operative mycobacterium abscessus respiratory infections.mycobacterium abscessus in cystic fibrosis (cf) patients is considered a contraindication to lung transplantation. we examine the post-transplant outcomes of cf patients with m. abscessus pre-transplant.201323710571
mycobacterium abscessus isolated from municipal water - a potential source of human infection.mycobacterium abscessus is a rapidly growing mycobacterium responsible for progressive pulmonary disease, soft tissue and wound infections. the incidence of disease due to m. abscessus has been increasing in queensland. in a study of brisbane drinking water, m. abscessus was isolated from ten different locations.the aim of this study was to compare genotypically the m. abscessus isolates obtained from water to those obtained from human clinical specimens.201323705674
cutaneous inoculation of nontuberculous mycobacteria during professional tattooing: a case series and epidemiologic study.the increase in popularity of tattoos has coincided with an increase in reports of cutaneous inoculation of nontuberculous (atypical) mycobacteria (ntm) during the tattooing process. we report 3 ntm infections in otherwise healthy persons who received tattoos, which prompted a multiagency epidemiologic investigation.201323704119
molecular longitudinal tracking of mycobacterium abscessus spp. during chronic infection of the human lung.the mycobacterium abscessus complex is an emerging cause of chronic pulmonary infection in patients with underlying lung disease. the m. abscessus complex is regarded as an environmental pathogen but its molecular adaptation to the human lung during long-term infection is poorly understood. here we carried out a longitudinal molecular epidemiological analysis of 178 m. abscessus spp. isolates obtained from 10 cystic fibrosis (cf) and 2 non cf patients over a 13 year period. multi-locus sequence ...201323696800
clinical isolates of mycobacterium abscessus in guangzhou area most possibly from the environmental infection showed variable susceptibility.mycobacterium abscessus (m. abscessus) can cause a variety of human infections, involving the lung, skin and soft tissues, and is generally believed to be acquired from environmental sources. the aim of this study was to investigate the molecular diversity and antibiotic susceptibility of m. abscessus isolates as the basis for strategies to improve control and management of infection.201323673103
[new light on the contagiousness of mycobacterium abscessus]. 201323659159
mabsbase: a mycobacterium abscessus genome and annotation database.mycobacterium abscessus is a rapidly growing non-tuberculous mycobacterial species that has been associated with a wide spectrum of human infections. as the classification and biology of this organism is still not well understood, comparative genomic analysis on members of this species may provide further insights on their taxonomy, phylogeny, pathogenicity and other information that may contribute to better management of infections. the mabsbase described in this paper is a user-friendly databa ...201323658631
transition metal-α-amino acid complexes with antibiotic activity against mycobacterium spp.synthetic iridium-, rhodium-, and ruthenium-amino acid complexes with hydrophobic l-amino acids have antibiotic activity against mycobacterium spp., including mycobacterium bovis bcg and the rapidly growing species mycobacterium abscessus and mycobacterium chelonae. concentrations of transition metal-amino acid complexes demonstrating hemolysis or cytotoxicity were 10- to 25-fold higher than were the mics.201323650159
paediatric lung transplant outcomes vary with mycobacterium abscessus complex species. 201323633613
nontuberculous mycobacterial infection after fractionated co(2) laser resurfacing.nontuberculous mycobacteria are increasingly associated with cutaneous infections after cosmetic procedures. fractionated co2 resurfacing, a widely used technique for photorejuvenation, has been associated with a more favorable side effect profile than alternative procedures. we describe 2 cases of nontuberculous mycobacterial infection after treatment with a fractionated co2 laser at a private clinic. densely distributed erythematous papules and pustules developed within the treated area within ...201323628077
advantages of using matrix-assisted laser desorption ionization-time of flight mass spectrometry as a rapid diagnostic tool for identification of yeasts and mycobacteria in the clinical microbiological laboratory.yeast and mycobacteria can cause infections in immunocompromised patients and normal hosts. the rapid identification of these organisms can significantly improve patient care. there has been an increasing number of studies on using matrix-assisted laser desorption ionization-time of flight mass spectrometry (maldi-tof ms) for rapid yeast and mycobacterial identifications. however, studies on direct comparisons between the bruker biotyper and biomérieux vitek ms systems for the identification of ...201324048537
the first structure of a mycobacteriophage, the mycobacterium abscessus subsp. bolletii phage araucaria.the unique characteristics of the waxy mycobacterial cell wall raise questions about specific structural features of their bacteriophages. no structure of any mycobacteriophage is available, although ∼3,500 have been described to date. to fill this gap, we embarked in a genomic and structural study of a bacteriophage from mycobacterium abscessus subsp. bolletii, a member of the mycobacterium abscessus group. this opportunistic pathogen is responsible for respiratory tract infections in patients ...201323678183
selected insights from application of whole-genome sequencing for outbreak investigations.the advent of high-throughput whole-genome sequencing has the potential to revolutionize the conduct of outbreak investigation. because of its ultimate resolution power for differentiating between closely related pathogen strains, whole-genome sequencing could augment the traditional epidemiologic investigations of infectious disease outbreaks.201323856896
patients with inhibitory and neutralizing auto-antibodies to interferon-γ resemble the sporadic adult-onset phenotype of mendelian susceptibility to mycobacterial disease (msmd) lacking bacille calmette-guerin (bcg)-induced diseases.to recognize patients with inhibitory and neutralizing auto-antibodies to interferon-γ (autoabs-ifn-γ) presenting with the sporadic phenotype of mendelian susceptibility to mycobacterial disease (msmd) mainly characterized by recurrent intracellular mycobacterium or/and salmonella infections, we comprehensively investigated il12/23-ifn-γ signaling, candidate genetic sequencings or/and protein expressions of il12rb1, ifnrg1, il12p40, ifnrg2, stat1, ikka, nemo, cybb and irf8 in four patients. thei ...201323083630
b-cell lymphoma in a patient with complete interferon gamma receptor 1 deficiency.immunosuppression-associated lymphoproliferative disorders can be related to primary as well as acquired immune disorders. interferon gamma receptor (ifn-γr) deficiency is a rare primary immune disorder, characterized by increased susceptibility to mycobacterial infections. here we report the first case of an epstein barr virus (ebv) related b-cell lymphoma in a patient with complete ifn-γr1 deficiency. the patient was a 20-year-old man with homozygous 22cdel in ifngr1 resulting in complete abse ...201323800860
heterologous expression of mycobacterial esx complexes in escherichia coli for structural studies is facilitated by the use of maltose binding protein fusions.the expression of heteroligomeric protein complexes for structural studies often requires a special coexpression strategy. the reason is that the solubility and proper folding of each subunit of the complex requires physical association with other subunits of the complex. the genomes of pathogenic mycobacteria encode many small protein complexes, implicated in bacterial fitness and pathogenicity, whose characterization may be further complicated by insolubility upon expression in escherichia col ...201324312350
the detection and sequencing of a broad-host-range conjugative incp-1β plasmid in an epidemic strain of mycobacterium abscessus subsp. bolletii.an extended outbreak of mycobacterial surgical infections occurred in brazil during 2004-2008. most infections were caused by a single strain of mycobacterium abscessus subsp. bolletii, which was characterized by a specific rpob sequevar and two highly similar pulsed-field gel electrophoresis (pfge) patterns differentiated by the presence of a ∼50 kb band. the nature of this band was investigated.201323565273
the significance of mycobacterium abscessus subspecies abscessus isolation during mycobacterium avium complex lung disease therapy.isolation of mycobacterium abscessus subspecies abscessus (maa) is common during mycobacterium avium complex (mac) lung disease therapy, but there is limited information about the clinical significance of the maa isolates.201425357074
genome analysis reveals three genomospecies in mycobacterium abscessus.mycobacterium abscessus complex, the third most frequent mycobacterial complex responsible for community- and health care-associated infections in developed countries, comprises of m. abscessus subsp. abscessus and m. abscessus subsp. bolletii reviously referred as mycobacterium bolletii and mycobacterium massiliense. the diversity of this group of opportunistic pathogens is poorly described.201424886480
mycobacterium abscessus phospholipase c expression is induced during coculture within amoebae and enhances m. abscessus virulence in mice.mycobacterium abscessus is a pathogenic, rapidly growing mycobacterium involved in pulmonary and cutaneo-mucous infections worldwide, to which cystic fibrosis patients are exquisitely susceptible. the analysis of the genome sequence of m. abscessus showed that this bacterium is endowed with the metabolic pathways typically found in environmental microorganisms that come into contact with soil, plants, and aquatic environments, where free-living amoebae are frequently present. m. abscessus also c ...201425486995
nontuberculous mycobacterial pulmonary infections.pulmonary infections due to nontuberculous mycobacteria (ntm) are increasingly recognized worldwide. although over 150 different species of ntm have been described, pulmonary infections are most commonly due to mycobacterium avium complex (mac), mycobacterium kansasii, and mycobacterium abscessus. the identification of these organisms in pulmonary specimens does not always equate with active infection; supportive radiographic and clinical findings are needed to establish the diagnosis. it is dif ...201424624285
inhaled amikacin for treatment of refractory pulmonary nontuberculous mycobacterial disease.treatment of pulmonary nontuberculous mycobacteria, especially mycobacterium abscessus, requires prolonged, multidrug regimens with high toxicity and suboptimal efficacy. options for refractory disease are limited.201424460437
contamination of hypertonic saline solutions in use by cystic fibrosis patients in israel.treatment of cystic fibrosis (cf) patients with inhaled hypertonic saline (hs) solutions is safe, beneficial and reduces exacerbation rates. we studied contamination of solutions used by israeli cf patients for prolonged periods.201424484849
respiratory infections in patients with cystic fibrosis undergoing lung transplantation.cystic fibrosis is an inherited disease characterised by chronic respiratory infections associated with bronchiectasis. lung transplantation has helped to extend the lives of patients with cystic fibrosis who have advanced lung disease. however, persistent, recurrent, and newly acquired infections can be problematic. classic cystic fibrosis-associated organisms, such as staphylococcus aureus and pseudomonas aeruginosa, are generally manageable post-transplantation, and are associated with favour ...201424461904
antibiotic management of lung infections in cystic fibrosis. ii. nontuberculous mycobacteria, anaerobic bacteria, and fungi.airway infections are a key component of cystic fibrosis (cf) lung disease. whereas the approach to common pathogens such as pseudomonas aeruginosa is guided by a significant body of evidence, other infections often pose a considerable challenge to treating physicians. in part i of this series on the antibiotic management of difficult lung infections, we discussed bacterial organisms including methicillin-resistant staphylococcus aureus, gram-negative bacterial infections, and treatment of multi ...201425167882
mycobacterium abscessus infection in a burn intensive care unit patient.infection is the leading cause of death in burn patients. historically, this was due to burn wound sepsis but pneumonia has now emerged as the most common source. in light of the increasing incidence of multi-drug-resistant organisms, the description of rare infections is paramount in continuing the fight against deadly pathogens. we aim to describe the second case of non-tuberculous mycobacterium (ntm) reported in a burn patient. difficulties in diagnosis and management will also be highlighted ...201425493353
lung transplantation in patients with cystic fibrosis: special focus to infection and comorbidities.despite advances in medical care, patients with cystic fibrosis still face limited life expectancy. the most common cause of death remains respiratory failure. end-stage cystic fibrosis can be treated with lung transplantation and is the third most common reason for which the procedure is performed. outcomes for cystic fibrosis are better than most other lung diseases, but remain limited (5-year survival 60%). for patients with advanced disease lung transplantation appears to improve survival. o ...201424655065
lack of antimicrobial bactericidal activity in mycobacterium abscessus.antibiotic therapy of infections caused by the emerging pathogen mycobacterium abscessus is challenging due to the organism's natural resistance toward most clinically available antimicrobials. we investigated the bactericidal activity of antibiotics commonly administered in m. abscessus infections in order to better understand the poor therapeutic outcome. time-kill curves were generated for clinical m. abscessus isolates, mycobacterium smegmatis, and escherichia coli by using antibiotics commo ...201424752273
characterization of broad-spectrum mycobacterium abscessus class a β-lactamase.imipenem and cefoxitin are used to treat mycobacterium abscessus infections and have moderate activity against this fast-growing mycobacterium (mic₅₀ of 16 and 32 mg/l, respectively). m. abscessus is highly resistant to most other β-lactams, although the underlying mechanisms have not been explored. here, we characterized m. abscessus class a β-lactamase (bla(mab)) and investigated its role in β-lactam resistance.201424132992
high recurrence rate of lymphadenitis due to nontuberculous mycobacteria and its association with concurrent salmonella infection in taiwan.the objective of this study is to investigate the clinical characteristics of lymphadenitis due to nontuberculous mycobacteria (ntm) in taiwan.201423615164
non-tuberculous mycobacteria: a retrospective review of scottish isolates from 2000 to 2010.there is growing recognition of the clinical importance of non-tuberculous mycobacteria (ntm), a group of versatile opportunistic bacterial pathogens. we describe the characteristics of ntm isolates in scotland over an 11-year period using data held by the scottish mycobacteria reference laboratory. american thoracic society microbiological criteria were used to evaluate the clinical significance of isolates. data presented include analysis of trends across time, species/body site associations, ...201423986391
an outbreak of mycobacterium abscessus infection in a pediatric intensive care unit in kuwait.mycobacterium abscessus has been associated with respiratory tract infections, localized skin and soft tissue infections and sepsis. however, outbreaks of m. abscessus are rare.201424042493
in vitro activity of cefoxitin and imipenem against mycobacterium abscessus complex.the in vitro activity of cefoxitin and imipenem was compared for 43 strains of the mycobacterium abscessus complex, mostly isolated from cystic fibrosis patients. the mics of imipenem were lower than those of cefoxitin, although the number of imipenem-resistant strains was higher according to the clsi breakpoints. strain comparisons indicated that the mics of cefoxitin were significantly higher for mycobacterium bolletii than for m. abscessus. the mics of both β-lactams were higher for the rough ...201424112243
gm-csf knockout mice for preclinical testing of agents with antimicrobial activity against mycobacterium abscessus.of the non-tuberculous mycobacteria, mycobacterium abscessus is particularly refractory to antimicrobial therapy and new agents with activity against these pathogens are urgently needed. the screening of candidate antimicrobial agents against m. abscessus requires a relevant and reproducible animal model of chronic infection. granulocyte-macrophage colony-stimulating factor knockout (gm-csf ko) mice were used to develop a new animal model of chronic pulmonary m. abscessus infection that can be u ...201424222613
characterization of rough and smooth morphotypes of mycobacterium abscessus isolates from clinical specimens.mycobacterium abscessus, which consists of the two subspecies m. abscessus subspecies abscessus and m. abscessus subspecies bolletii, can produce rough or smooth colony morphologies. here we analyzed 50 m. abscessus isolates cultured from the respiratory specimens of 34 patients, 28 (82%) of whom had cystic fibrosis (cf), with respect to their colony morphologies and antibiotic susceptibilities. the overall proportions of occurrences of the two morphotypes were similar, with specimens from 50% o ...201424197890
discrimination of mycobacterium abscessus subsp. massiliense from mycobacterium abscessus subsp. abscessus in clinical isolates by multiplex pcr.the rapidly growing mycobacterium m. abscessus sensu lato is the causative agent of emerging pulmonary and skin diseases and of infections following cosmetic surgery and postsurgical procedures. m. abscessus sensu lato can be divided into at least three subspecies: m. abscessus subsp. abscessus, m. abscessus subsp. massiliense, and m. abscessus subsp. bolletii. clinical isolates of rapidly growing mycobacteria were previously identified as m. abscessus by dna-dna hybridization. more than 30% of ...201424197885
in vivo evaluation of antibiotic activity against mycobacterium abscessus.the prognosis of mycobacterium abscessus infections is poor due to the lack of effective drug treatment. the objective of this study was to set up an animal model suitable to test antibiotic activity against m. abscessus.201424253289
the drug resistance profile of mycobacterium abscessus group strains from korea.bacteria of the mycobacterium abscessus group are the second most common pathogens responsible for lung disease caused by nontuberculous mycobacteria in korea. there is still a lack of studies investigating the genetic mechanisms involved in m. abscessus resistance to antibiotics other than clarithromycin. this study investigated the characteristics of drug resistance exhibited by m. abscessus clinical isolates from korea.201424422193
bacterial adherence to different meshes used in abdominal surgery.we studied the influence of morphology and type of material of abdominal wall prostheses in the avoidance of bacterial adhesion in acute and chronic mesh infections.201424283764
sporotrichoid cutaneous infection by mycobacterium abscessus. 201424261556
multilocus sequence typing scheme for the mycobacterium abscessus complex.we developed a multilocus sequence typing (mlst) scheme for mycobacterium abscessus sensu lato, based on the partial sequencing of seven housekeeping genes: argh, cya, glpk, gnd, murc, pta and purh. this scheme was used to characterize a collection of 227 isolates recovered between 1994 and 2010 in france, germany, switzerland and brazil. we identified 100 different sequence types (sts), which were distributed into three groups on the tree obtained by concatenating the sequences of the seven hou ...201424384536
risk factors for nontuberculous mycobacterial infections in solid organ transplant recipients: a case-control study.the epidemiology of nontuberculous mycobacteria (ntm) disease in solid organ transplant recipients is poorly defined.201424350627
sacroiliitis secondary to catheter-related bacteremia due to mycobacterium abscessus (sensu stricto).we describe a case of sacroiliitis secondary to catheter-related bacteremia due to mycobacterium abscessus (sensu stricto). this case confirms that multilocus sequence typing and variable-number tandem-repeat methods are very robust techniques to identify the pathogen species and to validate molecular epidemiological links among complex m. abscessus isolates.201424479655
managing pulmonary nontuberculous mycobacterial infection. time for a patient-centered approach.the incidence of nontuberculous mycobacteria is increasing worldwide. however, the evidence base for clinical management comprises mostly expert opinion, case series, and few randomized clinical trials. most currently recommended treatment regimens entail prolonged use of multiple antimicrobial agents associated with multiple self-limited and persistent potential adverse effects, including irreversible impairments of hearing, vision, and kidney function. yet, little is known about how treatment ...201424460445
the cystic fibrosis lung microbiome.the chronic colonization of the lower airways by bacterial pathogens is the leading cause of morbidity and mortality in patients with cystic fibrosis (cf). pseudomonas aeruginosa is the most common cf pathogen, followed by staphylococcus aureus. improvements in airway clearance and more effective treatment of the conventional cf pathogens has led to the emergence of new airway pathogens such as stenotrophomonas maltophilia, mycobacterium abscessus, and achromobacter. more recently, it has become ...201424437409
genome sequencing of mycobacterium abscessus isolates from patients in the united states and comparisons to globally diverse clinical strains.nontuberculous mycobacterial infections caused by mycobacterium abscessus are responsible for a range of disease manifestations from pulmonary to skin infections and are notoriously difficult to treat, due to innate resistance to many antibiotics. previous population studies of clinical m. abscessus isolates utilized multilocus sequence typing or pulsed-field gel electrophoresis, but high-resolution examinations of genetic diversity at the whole-genome level have not been well characterized, par ...201425056330
looking in amoebae as a source of mycobacteria.mycobacteria exhibit various relationships with amoebae, ranging from the killing of one partner by the other one, to amoebae hosting mycobacteria in trophozoites and cysts. this observation indicates that poorly described biological factors affect the relationships, including mycobacterial cell-wall glycolipids and the size of the mycobacteria. experimental observations indicate that a majority of environmental, opportunistic mycobacteria but also obligate pathogens including mycobacterium tube ...201425017516
classification algorithm for subspecies identification within the mycobacterium abscessus species, based on matrix-assisted laser desorption ionization-time of flight mass spectrometry.mycobacterium abscessus, as a species, has been increasingly implicated in respiratory infections, notably in cystic fibrosis patients. the species comprises 3 subspecies, which can be difficult to identify. since they differ in antibiotic susceptibility and clinical relevance, developing a routine diagnostic tool discriminating mycobacterium abscessus at the subspecies level is a real challenge. forty-three mycobacterium abscessus species isolates, previously identified by multilocus sequence t ...201425009048
direct identification of mycobacterium abscessus through 16s rdna sequence analysis and a citrate utilization test: a case report.a growing number of nontuberculous mycobacteria infection cases, especially those caused by rapidly growing mycobacteria (rgm), have been reported in the past decade. conventional methods for mycobacteria diagnosis are inefficient and easily lead to misdiagnosis. new detection methods, such as gene sequencing, have been reported but are not widely used. the aim of the present case report was to provide a quick and exact method of identifying myobacterium abscessus (m. abscessus) infections. the ...201424944608
analysis of species and intra-species associations between the mycobacterium abscessus complex strains using pulsed-field gel electrophoresis (pfge) and multi-locus sequence typing (mlst).pfge and mlst showed that the strains of m. massiliense hsp65 ii-1 were clearly separated from the strains of m. massiliense hsp65 i or ii-2 as well as the strains of m. abscessus or m. bolletii; thus, m. massiliense hsp6 5ii-1 might represent an additional subspecies of m. massiliense.201424918987
mycobacterium abscessus: a rare cause of vascular graft infection.prosthetic vascular graft infection (pvgi) following vascular reconstructive surgery is an uncommon but serious complication and is associated with high morbidity as well as mortality rate. staphylococcal species are the most common organisms causing pvgi. mycobacterium abscessus is a very rare cause of pvgi and poses a significant diagnostic and management dilemma. to the best of our knowledge, we report the third documented case of m. abscessus vascular graft infection that was diagnosed with ...201425134652
prevalence and drug resistance of mycobacteria in turkish cystic fibrosis patients.isolation of mycobacteria in cystic fibrosis (cf) patients is increasingly being reported. because of having long term antimicrobial treatment, cf patients are at risk of pulmonary infection with especially resistant nontuberculous mycobacteria (ntm) strains. the aim of the present study is to determine the prevalence of mycobacterium spp. and antimicrobial susceptibility in turkish cf patients.201425123237
mycobacteria entry and trafficking into endothelial cells.endothelial cells are susceptible to infection by mycobacteria, but the endocytic mechanisms that mycobacteria exploit to enter host cells and their mechanisms of intracellular transport are completely unknown. using pharmacological inhibitors, we determined that the internalization of mycobacterium tuberculosis (mtb), mycobacterium smegmatis (msm), and mycobacterium abscessus (mab) is dependent on the cytoskeleton and is differentially inhibited by cytochalasin d, nocodazole, cycloheximide, wor ...201425113069
mycobacterium abscessus infection in cystic fibrosis: molecular typing and clinical outcomes.mycobacterium abscessus is a significant pathogen in the cystic fibrosis patient population. pcr amplification and sequencing can provide accurate subspecies identification, and can predict macrolide susceptibility, which is becoming increasingly important for patient management. molecular techniques for further typing of isolates provide tools for the ongoing investigations into the clinical impact of particular m. abscessus strains. whole-genome sequencing is likely to be the only technique th ...201425106861
analysis of a panel of rapidly growing mycobacteria for resistance to aldehyde-based disinfectants.after several accounts across the globe of mycobacteria outbreaks associated with medical procedures and aldehyde disinfectants resistance, we undertook an analysis of mycobacteria isolated from patients seen in a hospital in the united states between 1994 and 2008 to determine prevalence of resistance to aldehyde-based disinfectants. out of the 117 clinical isolates screened, 6 isolates belonging to the emerging mycobacterium abscessus group were found to display significant levels of resistanc ...201425087149
detection and assessment of clarithromycin inducible resistant strains among korean mycobacterium abscessus clinical strains: pcr methods.mycobacterium abscessus group belongs to a group of rapidly growing mycobacteria (rgm) and, following mycobacterium avium complex, is the second most common pathogen responsible for lung disease caused by nontuberculous mycobacteria (ntm). clarithromycin is known to be the key drug in the treatment of m. abscessus group disease, but a high failure rate of treatment response is reported due to clarithromycin inducible resistance.201424652818
clinical experience in 52 patients with tigecycline-containing regimens for salvage treatment of mycobacterium abscessus and mycobacterium chelonae infections.we report the largest clinical experience using tigecycline-containing regimens for salvage treatment of patients with mycobacterium abscessus and mycobacterium chelonae.201424633206
a case of mycobacterium abscessus infection presenting as a cystic lesion in an insulin injection site in a diabetic patient. 201424628302
notes from the field: rapidly growing nontuberculous mycobacterium wound infections among medical tourists undergoing cosmetic surgeries in the dominican republic--multiple states, march 2013-february 2014.in august 2013, the maryland department of health and mental hygiene (mdhmh) was notified of two persons with rapidly growing nontuberculous mycobacterial (rg-ntm) surgical-site infections. both patients had undergone surgical procedures as medical tourists at the same private surgical clinic (clinic a) in the dominican republic the previous month. within 7 days of returning to the united states, both sought care for symptoms that included surgical wound abscesses, clear fluid drainage, pain, an ...201424598597
acetic acid, the active component of vinegar, is an effective tuberculocidal disinfectant.effective and economical mycobactericidal disinfectants are needed to kill both mycobacterium tuberculosis and non-m. tuberculosis mycobacteria. we found that acetic acid (vinegar) efficiently kills m. tuberculosis after 30 min of exposure to a 6% acetic acid solution. the activity is not due to ph alone, and propionic acid also appears to be bactericidal. m. bolletii and m. massiliense nontuberculous mycobacteria were more resistant, although a 30-min exposure to 10% acetic acid resulted in at ...201424570366
mycobacterium abscessus cording prevents phagocytosis and promotes abscess formation.mycobacterium abscessus is a rapidly growing mycobacterium causing a wide spectrum of clinical syndromes. it now is recognized as a pulmonary pathogen to which cystic fibrosis patients have a particular susceptibility. the m. abscessus rough (r) variant, devoid of cell-surface glycopeptidolipids (gpls), causes more severe clinical disease than the smooth (s) variant, but the underlying mechanisms of r-variant virulence remain obscure. exploiting the optical transparency of zebrafish embryos, we ...201424567393
high-level relatedness among mycobacterium abscessus subsp. massiliense strains from widely separated outbreaks.three recently sequenced strains isolated from patients during an outbreak of mycobacterium abscessus subsp. massiliense infections at a cystic fibrosis center in the united states were compared with 6 strains from an outbreak at a cystic fibrosis center in the united kingdom and worldwide strains. strains from the 2 cystic fibrosis outbreaks showed high-level relatedness with each other and major-level relatedness with strains that caused soft tissue infections during an epidemic in brazil. we ...201424565502
rapid molecular detection of inducible macrolide resistance in mycobacterium chelonae and m. abscessus strains: a replacement for 14-day susceptibility testing?the erm(41) gene causes inducible macrolide resistance in mycobacterium abscessus but not mycobacterium chelonae. erm(41) sequencing of 285 m. abscessus and 45 m. chelonae isolates was compared to 14-day susceptibility; agreement percentages were 98.9% and 100%, respectively. extended incubation may not be necessary for m. chelonae, and the erm(41) genotype is a useful adjunct for m. abscessus.201424554745
novel drug combination for mycobacterium abscessus disease therapy identified in a drosophila infection model.mycobacterium abscessus is known to be the most drug-resistant mycobacterium and accounts for ∼80% of pulmonary infections caused by rapidly growing mycobacteria. this study reports a new drosophila melanogaster-m. abscessus infection model that can be used as an in vivo efficacy model for anti-m. abscessus drug potency assessment.201424519481
the clinical management of cesarean section-acquired mycobacterium abscessus surgical site infections.rapidly growing mycobacteria (rgm) can cause a broad spectrum of both community and healthcare-associated infections in humans. the aim of this study was to report the clinical management and outcomes of successive patients following cesarean delivery with healthcare-associated surgical site infections (ssis) caused by rgm.201424518628
genomic reconnaissance of clinical isolates of emerging human pathogen mycobacterium abscessus reveals high evolutionary potential.mycobacterium abscessus (ma) is an emerging human pathogen that causes both soft tissue infections and systemic disease. we present the first comparative whole-genome study of ma strains isolated from patients of wide geographical origin. we found a high proportion of accessory strain-specific genes indicating an open, non-conservative pan-genome structure, and clear evidence of rapid phage-mediated evolution. although we found fewer virulence factors in ma compared to m. tuberculosis, our data ...201424515248
erm(41)-dependent inducible resistance to azithromycin and clarithromycin in clinical isolates of mycobacterium abscessus.the ribosomal methylase erm(41) confers inducible resistance to macrolides in mycobacterium abscessus. the aim of this work was to systematically study and compare drug susceptibility to clarithromycin and azithromycin in m. abscessus and mycobacterium chelonae clinical isolates with a particular focus on inducible drug resistance.201424500188
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