Počet diagnostikovaných onemocnění vyvolaných netuberkulózními mykobakteriemi u predisponovaných jedinců zůstává v České republice každoročně konstantní. Jejich klinické uplatnění je variabilní a závisí na vlastnostech konkrétního druhu, jeho přítomnosti a kvantity v bezprostředním okolí člověka. Mezi nejčastější klinicky zaznamenávané druhy patří Mycobacterium avium, M. kansasii a M. xenopi. Nejvýznamnějším zdrojem M. avium je rašelina a z ní odvozené produkty. Sekundárně osídluje teplovodní systémy, které jsou velice rizikové z hlediska expozice (především vířivky). M. kansasii je stále přítomno ve vodách v oblastech ovlivněných průmyslovou a důlní činností. Jeho recentně vyčleněné genetické varianty jsou obvykle zcela bez klinického významu, nicméně mohou být přítomny jako kontaminace ve zdravotnických přípravcích. M. xenopi trvale osídluje většinu teplovodních systémů a jeho praktická všudypřítomnost ovlivňuje správné diagnostické závěry u nejasného nálezu při zobrazovacích metodách. Iniciace antibiotické léčby, která nemusí být vždy úspěšná, by měla probíhat na základě komplexního posouzení stavu pacienta, nálezu a jeho progrese. Ani výsledky laboratorních vyšetření nemusí být při rozhodování vždy směrodatné.
The annual number of diagnosed diseases caused by non-tuberculous mycobacteria in predisposed individuals remains constant in the Czech Republic. Their clinical characteristics vary depending on the properties of the causative species and its presence and quantity in the immediate environment of the patient. The most common clinically relevant species are Mycobacterium avium, M. kansasii, and M. xenopi. The most important source of M. avium is peat and products derived from it. M. avium may colonise warm water systems, posing a high risk of exposure to users (jacuzzi users in particular). M. kansasii is still present in waters of areas affected by industrial and mining activities. Its recently isolated genetic variants are mostly of no clinical significance but may be present as contaminants in medical preparations. M. xenopi permanently colonises most warm water systems, and its practical ubiquity makes difficult the interpretation of ambiguous findings on imaging. The antibiotic treatment, which may not always be successful, should be initiated after a comprehensive assessment of the patient’s condition, imaging data, and disease progression. Similarly, the results of laboratory tests may not always be authoritative in decision making.
- MeSH
- Humans MeSH
- Morbidity MeSH
- Mycobacterium avium Complex isolation & purification classification pathogenicity MeSH
- Mycobacterium kansasii isolation & purification pathogenicity MeSH
- Mycobacterium xenopi isolation & purification pathogenicity MeSH
- Mycobacterium classification pathogenicity MeSH
- Mycobacterium Infections * diagnosis etiology drug therapy classification microbiology transmission MeSH
- Nontuberculous Mycobacteria isolation & purification classification pathogenicity MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- Geographicals
- Czech Republic MeSH
OBJECTIVES: The aim of this study was to detect Mycobacterium tuberculosis complex, M. avium subsp. avium and M. intracellulare, Mycobacterium contamination and to explore the aerosol transmission of mycobacteria in public buildings in China. METHODS: A total of 552 environmental samples, namely 165 aerosol, 199 water, 70 air duct dust, and 118 soil samples, were collected from 39 public buildings and analysed using nested polymerase chain reaction. RESULTS: The positivity rate of Mycobacterium tuberculosis complex, M. avium subsp. avium and M. intracellulare in air samples were 0.6% and 1.8%, respectively. There was significant difference in the positivity rate of Mycobacterium aerosol among the three types of public building (χ2 = 6.108, p = 0.047). No positive results of Mycobacterium tuberculosis complex and M. avium and M. intracellulare were obtained from cooling, tap, shower, or fountain water. The positivity rate of Mycobacterium for water samples was 31.7% (63/199). The positivity rate of Mycobacterium tuberculosis complex, M. avium subsp. avium and M. intracellulare, Mycobacterium in soil samples were 1.1%, 34.6% and 43.6%, respectively. There was significant difference in the positivity rate of M. avium and M. intracellulare (χ2 = 47.219, p < 0.001) and Mycobacterium (χ2 = 33.535, p < 0.001) in the different origins of soil samples. CONCLUSIONS: Mycobacteria are widespread in public buildings. Mycobacterium tuberculosis complex, M. avium and M. intracellulare were simultaneously present in the air ducts of central air conditioning systems and indoor air in public buildings, which indicates that aerosol transmission is a potential route.
Introduction. Cystic fibrosis (CF) is a serious disease with multisystemic clinical signs that is easily and frequently complicated by bacterial infection. Recently, the prevalence of nontuberculous mycobacteria as secondary contaminants of CF has increased, with the Mycobacterium avium complex (MAC) and Mycobacterium abscessus complex (MABSC) being the most frequently identified. The MABSC includes subspecies of significant clinical importance, mainly due to their resistance to antibiotics.Gap statement. Sensitive method for early detection and differentiation of MABSC members and MAC complex for use in routine clinical laboratories is lacking. A method based on direct DNA isolation from sputum, using standard equipment in clinical laboratories and allowing uncovering of possible sample inhibition (false negative results) would be required. The availability of such a method would allow accurate and accelerated time detection of MABSC members and their timely and targeted treatment.Aim. To develop a real time multiplex assay for rapid and sensitive identification and discrimination of MABSC members and MAC complex.Methodology. The method of DNA isolation directly from the sputum of patients followed by quadruplex real-time quantitative PCR (qPCR) detection was developed and optimised. The sensitivity and limit of detection (LOD) of the qPCR was determined using human sputum samples artificially spiked with a known amount of M. abscessus subsp. massiliense (MAM).Results. The method can distinguish between MAC and MABSC members and, at the same time, to differentiate between M. abscessus subsp. abscessus/subsp. bolletii (MAAb/MAB) and MAM. The system was verified using 61 culture isolates and sputum samples from CF and non-CF patients showing 29.5 % MAAb/MAB, 14.7 % MAM and 26.2 % MAC. The LOD was determined to be 1 490 MAM cells in the sputum sample with the efficiency of DNA isolation being 95.4 %. Verification of the qPCR results with sequencing showed 100 % homology.Conclusions. The developed quadruplex qPCR assay, which is preceded by DNA extraction directly from patients' sputum without the need for culturing, significantly improves and speeds up the entire process of diagnosing CF patients and is therefore particularly suitable for use in routine laboratories.
- MeSH
- Mycobacterium Infections, Nontuberculous * diagnosis drug therapy MeSH
- Cystic Fibrosis * complications microbiology MeSH
- DNA therapeutic use MeSH
- Mycobacterium avium-intracellulare Infection * epidemiology MeSH
- Real-Time Polymerase Chain Reaction MeSH
- Humans MeSH
- Mycobacterium abscessus * genetics MeSH
- Mycobacterium avium Complex genetics MeSH
- Nontuberculous Mycobacteria MeSH
- Sputum microbiology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
AIM: Comparision of the incidence of cervical lymphadenitis caused by nontuberculous mycobacteria in two equal time periods before and after the ending of widespread calmetization (tuberculosis vaccination). Backgroung. From 2011 to 2018, 89 children were registered in the Tuberculosis Register with cervical lymphadenitis caused by nontuberculous mycobacteria, as confirmed by cultivation. In the majority of cases, the infection was caused by a mycobacterium belonging to the Mycobacterium avium complex. Only 7 cases of cervical lymphadenitis of the same etiology were registered during the same time interval between 2003 and 2010. The authors consider the ending of widespread calmetization (tuberculosis vaccination) in 2010 to be the main cause of the growing incidence. METHOD: A comparison of data for the period 2003-2018 about cases of the illness caused by atypical mycobacteria as reported in the Tuberculosis Register. RESULTS: The average incidence per year in the first interval was 0.04/100 000 children and in the second interval 0.53/100 000 children. During the second time interval, there was an increase from 0.14/100 000 children in 2011 to 1.40/100 000 children in 2018. While the incidence during the first time interval did not show any time trend (P=0.885), the year 2010 marks a significant turning point, with growth during the second interval being highly statistically significant (P<0.001).
- MeSH
- Child MeSH
- Incidence MeSH
- Humans MeSH
- Lymphadenitis * MeSH
- Mycobacterium avium Complex MeSH
- Tuberculosis * epidemiology MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
Mycobacterial infections in pigs are caused particularly by the Mycobacterium avium complex (MAC) and these infections lead to great economic losses mainly within the countries with high pork meat production. The importance of the MAC infections in humans is rising because of its higher prevalence and also higher mortality rates particularly in advanced countries. In addition, treatment of the MAC infections in humans tends to be complicated because of its increasing resistance to antimicrobial agents. Several studies across Europe have documented the MAC occurrence in the slaughtered pigs - not only in their lymph nodes and tonsils, which are the most frequent, but also in the diaphragmas, other organs and not least in meat. This is why we need both more specific and more sensitive methods for the MAC infection detection. Different PCR assays were established as well as advanced intravital testing by the gamma interferon release test. On the other hand, tuberculin skin test is still one of the cheapest methods of mycobacterial infections detection.
- MeSH
- DNA, Bacterial genetics MeSH
- Mycobacterium avium-intracellulare Infection diagnosis epidemiology microbiology veterinary MeSH
- Humans MeSH
- Mycobacterium avium Complex classification genetics immunology isolation & purification MeSH
- Swine Diseases diagnosis epidemiology microbiology MeSH
- Polymerase Chain Reaction methods MeSH
- Swine MeSH
- Interferon-gamma Release Tests methods MeSH
- Tuberculin Test MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Geographicals
- Europe epidemiology MeSH
- MeSH
- Mycobacterium Infections, Nontuberculous diagnosis therapy MeSH
- Diagnostic Imaging methods MeSH
- Ethambutol therapeutic use MeSH
- Immunosuppression Therapy adverse effects MeSH
- Cough * etiology therapy MeSH
- Clarithromycin therapeutic use MeSH
- Drug Therapy, Combination MeSH
- Middle Aged MeSH
- Humans MeSH
- Mycobacterium avium Complex MeSH
- Myelodysplastic Syndromes MeSH
- Mycobacterium Infections diagnosis therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Autori popisujú problémy diagnostiky oligosymptomatického nodulárneho pľúcneho procesu s regionálnou lymfadenomegáliou, pôvodne považovaného za respiračnú tuberkulózu. Prostredníctvom kazuistiky mladej pacientky dokumentujú úskalia etiologickej diferenciálnej diagnostiky takýchto chorôb. Poukazujú na nutnosť opakovaných odberov biologického materiálu so snahou o mikrobiologické potvrdenie etiologického agens.
The authors describe diagnostic problems of oligosymptomatic nodular lung disease associated with regional lymphadenomegaly, originally considered as respiratory tuberculosis. The difficulties of etiologic differential diagnosis of such diseases are documented through the case report of a young patient. They point out the need of repeated sample taking with effort of microbiologic confirmation of etiologic agent.
- MeSH
- Antitubercular Agents therapeutic use MeSH
- Bronchoalveolar Lavage MeSH
- Bronchoalveolar Lavage Fluid microbiology MeSH
- Diagnosis, Differential MeSH
- Adult MeSH
- Ethambutol therapeutic use MeSH
- Fluoroquinolones therapeutic use MeSH
- Mycobacterium avium-intracellulare Infection * diagnostic imaging diagnosis drug therapy MeSH
- Clarithromycin therapeutic use MeSH
- Drug Therapy, Combination MeSH
- Humans MeSH
- Mycobacterium avium Complex isolation & purification MeSH
- Treatment Failure MeSH
- Sarcoidosis, Pulmonary diagnosis MeSH
- Tuberculosis, Pulmonary diagnosis drug therapy MeSH
- Tomography, X-Ray Computed MeSH
- Disease Progression MeSH
- Radiography, Thoracic MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Reflecting the known biological activity of isoniazid-based hydrazones, seventeen hydrazones of 4-(trifluoromethyl)benzohydrazide as their bioisosters were synthesized from various benzaldehydes and aliphatic ketones. The compounds were screened for their in vitro activity against Mycobacterium tuberculosis, nontuberculous mycobacteria (M. avium, M. kansasii), bacterial and fungal strains. The most antimicrobial potent derivatives were also investigated for their cytostatic and cytotoxic properties against three cell lines. Camphor-based molecule, 4-(trifluoromethyl)-N'-(1,7,7-trimethylbicyclo[2.2.1]heptan-2-ylidene)benzohydrazide, exhibited the highest and selective inhibition of M. tuberculosis with the minimum inhibitory concentration (MIC) of 4 µM, while N'-(4-chlorobenzylidene)-4-(trifluoromethyl)benzohydrazide was found to be superior against M. kansasii (MIC = 16 µM). N'-(5-Chloro-2-hydroxybenzylidene)-4-(trifluoromethyl)benzohydrazide showed the lowest MIC values for gram-positive bacteria including methicillin-resistant Staphylococcus aureus as well as against two fungal strains of Candida glabrata and Trichophyton mentagrophytes within the range of ≤0.49-3.9 µM. The convenient substitution of benzylidene moiety at the position 4 or the presence of 5-chloro-2-hydroxybenzylidene scaffold concomitantly with a sufficient lipophilicity are essential for the noticeable antimicrobial activity. This 5-chlorosalicylidene derivative avoided any cytotoxicity on two mammalian cell cultures (HepG2, BMMΦ) up to the concentration of 100 µM, but it affected the growth of MonoMac6 cells.
- MeSH
- Anti-Infective Agents chemical synthesis pharmacology toxicity MeSH
- Cell Line MeSH
- Hep G2 Cells MeSH
- Candida glabrata drug effects MeSH
- Hydrazones chemistry pharmacology toxicity MeSH
- Humans MeSH
- Microbial Sensitivity Tests MeSH
- Mycobacterium avium Complex drug effects MeSH
- Mycobacterium kansasii drug effects MeSH
- Mycobacterium tuberculosis drug effects MeSH
- Mice MeSH
- Cell Survival drug effects MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Mice MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
V Praze bylo v letech 2000–2015 notifikováno celkem 185 případů infekcí vyvolaných netuberkulózními mykobakterii, tj. 0,96 na 100 000 obyvatel a rok a 12,1 % z celkového počtu 1 527 případů registrovaných v tomto období v České republice. Relativně nejvyšší počet 111 případů vyvolaných komplexem Mycobacterium avium představoval v Praze podíl 60 % všech infekcí vyvolaných netuberkulózními mykobakterii a 0,57 případů na 100 000 obyvatel a rok. V souboru 111 těchto nemocných bylo 44 mužů a 67 žen (39,6, resp. 60,4 % z celkového počtu s věkovým průměrem 64,1, resp. 64,9 let). Postižení dýchacího ústrojí bylo zaznamenáno u 105 (94,6 %) nemocných, u jedné nemocné šlo o postižení zažívacího ústrojí a u zbývajících 5 případů šlo o krční lymfadenitidy u dětí. Plošné rozložení netuberkulózních mykobakteriálních infekcí vyvolaných komplexem M. avium vykazovalo nápadné rozdíly mezi jednotlivými městskými částmi pražské aglomerace, které se pohybovaly mezi 2 až 49 případy, tj. 0,17 až 1,07 na 100 000 obyvatel příslušných městských částí. Nejvyšší hodnoty byly registrovány ve dvou geograficky odlehlých obvodech Praha 6 a Praha 4, kde bylo notifikováno 0,72 a 1,07 případu na 100 000 obyvatel a rok. Výsledky naší studie by měly být využity při hlubším rozboru příčin nerovnoměrného rozložení a přetrvávání endemických lokalit netuberkulózních mykobakteriálních infekcí vyvolaných v Praze komplexem M. avium. Další studie budou vyžadovat především molekulárně-genetickou identifikaci etiologických agens, která by měla prokázat jejich identitu, nebo naopak odlišnost a dokázat jejich přítomnost v environmentálních rezervoárech a v okolí nemocných a exponovaných jedinců.
x
- MeSH
- Epidemiologic Factors MeSH
- Epidemiologic Studies MeSH
- Humans MeSH
- Mycobacterium avium Complex MeSH
- Mycobacterium Infections * epidemiology MeSH
- Check Tag
- Humans MeSH
- Geographicals
- Czech Republic MeSH
The nontuberculous mycobacteria are typically environmental organisms residing in soil and water. These microorganisms can cause a wide range of clinical diseases; pulmonary disease is most frequent, followed by lymphadenitis in children, skin and soft tissue disease, and rare extra pulmonary or disseminated infections. Mycobacterium avium complex is the second most common cause of pulmonary mycobacterioses after M. tuberculosis. This review covers the clinical and laboratory diagnosis of infection caused by the members of this complex and particularities for the treatment of different disease types and patient populations.
- MeSH
- Mycobacterium avium-intracellulare Infection diagnosis etiology therapy MeSH
- Humans MeSH
- Environmental Microbiology MeSH
- Mycobacterium avium Complex classification drug effects genetics MeSH
- Risk Factors MeSH
- Disease Reservoirs microbiology MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
