Isolation and Identification of Mycobacterium chelonae from Human Sputum among Suspected Pulmonary Tuberculosis Infections in Basra-Iraq

Abdulameer A. Al-Mussawi^1,

¹Nursing College / Basra University

Cite this paper:
Abdulameer A. Al-Mussawi. Isolation and Identification of Mycobacterium chelonae from Human Sputum among Suspected Pulmonary Tuberculosis Infections in Basra-Iraq. American Journal of Infectious Diseases and Microbiology. 2014; 2(6):145-148. doi: 10.12691/ajidm-2-6-2

Abstract

Objective: The purpose of this study was to estimate the frequency of Mycobacterium Chelonae (M. chelonae) among tuberculosis suspected patients in Basra governorate and evaluate the antimicrobial susceptibility. Methods: Isolation of M. chelonae from 150 samples from patients attended to the Advisory Clinic for Chest Diseases and Respiratory (ACCDR) in Basra city, smears were stained with the Ziehl Neelsen technique. Specimens were inoculated on Lowenstein Jensen medium, Identification to species level was achieved on the basis of the growth characteristics. Drug susceptibility were tested to antibiotics (Rifampicin, Isoniazid, Ethambutol, Pyrazinamide and Streptomycin) using proportional method. Results: from 150 sputum samples among tuberculosis suspected patients, sixteen samples (10.6%) were Nontuberculosis mycobacterium (NTM), from 16 NTM samples, 4 (2.6%) were M. chelonae. Drug susceptibility results showed that all isolates resistance to rifampicin, while one isolate showed intermediate resistance to ethambutol. All isolates of M. chelonae were sensitive to pyrazinamide, isoniazid and streptomycin. Conclusion: The M. chelonae present a high frequency, especially among tuberculosis suspected patients, which requires confirmation on a follow-up, along with the examination of patterns of sensitivity, is an absolute necessity in health centers in Iraq.

Keywords:
mycobacterium chelonae Non tuberculosis mycobacterium Tuberculosis TB Antimicrobial Susceptibility Testing

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

Figures

References:

[1]	Al-Sulami A.A., Al-Taee A. M. and Widaa Q. 2012. Isolation and Identification of Mycobacterium avium complex and other non tuberculosis mycobacteria from drink water in Basra government, Iraq. East Mediter Health. J. 18 (3): 274-278.
[2]	Brown-Elliott BA, Wallace RJ Jr, Onyi GO. 1992. Activities of four macrolides, including clarithromycin, against Mycobacterium fortuitum, Mycobacterium chelonae, and M. chelonae-like organisms. Antimicrob Agents Chemother. 36: 180-184.
[3]	Brown-Elliott BA, Wallace RJ Jr. 2002. Clinical and taxonomic status of pathogenic nonpigmented or late-pigmenting rapidly growing mycobacteria. Clin Microbiol Rev. 15: 716-46.
[4]	Brown TH. 1985. The rapidly growing mycobacteria Mycobacterium fortuitum and Mycobacterium chelonei. Infect Control. 6: 283-288.
[5]	Canetti G, Froman S, Grosset J. 1963. Mycobacteria: Laboratory Methods for Testing Drug Sensitivity and Resistance. Bull Wld Hlth Org. 29: 565-578.
[6]	Conaglen PD, Laurenson IF, Sergeant A, Thorn SN, Rayner A, Stevenson J. 2013. Systematic review of tattoo-associated skin infection with rapidly growing mycobacteria and public health investigation of a cluster in Scotland, 2010. Euro Surveill. 18 (32): 1-13.
[7]	Cortesia C. , Lopez G. J. , de Waard J. H. , and Takiff H. E. . 2010. The use of quaternary ammonium disinfectants selects for persisters at high frequency from some species of non-tuberculous mycobacteria and may be associated with outbreaks of soft tissue infections. J Antimicrob Chemother. 65 (12): 2574-2581.
[8]	David E. Griffith, Timothy Aksamit, Barbara A. Brown-Elliott, Antonino Catanzaro, Charles Daley, Fred Gordin,Steven M. Holland, Robert Horsburgh, Gwen Huitt, Michael F. Iademarco, Michael Iseman, Kenneth Olivier, Stephen Ruoss, C. Fordham von Reyn, Richard J. Wallace, Jr., and Kevin Winthrop, 2007. An Official ATS/IDSA Statement: Diagnosis, Treatment, and Prevention of Nontuberculous Mycobacterial Diseases. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE. 175: 367: 415.
[9]	Falsey RR, Kinzer MH, Hurst S. 2013. Cutaneous inoculation of nontuberculous mycobacteria during professional tattooing: a case series and epidemiologic study. Clin Infect Dis. 57: 143-147.
[10]	García-Agudo L. and García-Martos P. 2011. Clinical significance and antimicrobial susceptibility of rapidly growing mycobacteria. Science against microbial pathogens: communicating current research and technological advances. A. Méndez-Vilas (Ed.): 363: 377.
[11]	Grange JM. 1981. Mycobaterium chelonei. Tubercle. 262: 273.
[12]	Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F.2007. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J RespirCrit Care Med. 175: 367-416.
[13]	Hazelton, T. R., Newell, J. D., Cook, J. L., Huitt, G. A. & Lynch, D. A. 2000. CT findings in 14 patients with Mycobacterium chelonae pulmonary infection. AJR Am J Roentgenol 175. 413-416.
[14]	Koh WJ, Lee JH, Kwon YS. 2007. Prevalence of gastroesophageal reflux disease in patients with nontuberculous mycobacterial lung disease. Chest. 131: 1825-1830.
[15]	Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC JR. 1997. Colour atlas and textbook of diagnostic Microbiology. 5 th ed. JB Lippincot Company.: 897-906.
[16]	Lalitha P, Rathinam SR, Srinivasan M. 2004. Ocular infections due to non-tuberculous Mycobacteria. Indian Journal of Medical Microbiology. 22: 231-237.
[17]	Mart´ın-Casabona, N.; Bahrmand,A.R.; Bennedsen, J. 2004. Non-tuberculous mycobacteria: Patterns of isolation. A multicountryretrospective survey. International Journal of Tuberculosisand Lung Disease. 8 (10: 1186-1193.
[18]	Mateo L, Rufí G, Nolla JM, Alcaide F. 2004. Mycobacterium chelonae tenosynovitis of the hand. Semin Arthritis Rheum. 34: 617.
[19]	Metta H., Corti M. and Brunzini R. 2008. Disseminated Infection Due to Mycobacterium chelonae with Scleritis, Spondylodiscitis and Spinal Epidural Abscess. The Brazilian Journal of Infectious Diseases. 12 (3): 260-262.
[20]	Miyamoto, Y., Mukai, T., Nakata, N., Maeda, Y., Kai, M., Naka, T., Yano, I. & Makino, M. 2006. Identification and characterization of the genes involved in glycosylation pathways of mycobacterial glycopeptidolipid biosynthesis. J Bacteriol. 188: 86-95.
[21]	Nash KA, Brown-Elliott BA, Wallace RJ Jr. 2009. A novel gene, erm (41), confers inducible macrolide resistance to clinical isolates of Mycobacterium abscessus but is absent from Mycobacterium chelonae. Antimicrob Agents Chemother. 53: 1367-1376.
[22]	Pan America health organization regional systems for vaccines (SIREVA). Streptococcus pneumoniae and Haemophilus influenzae identification and susceptibility testing. Proceedings of the Insituto Nacional de Saluda; Nov 23-Dec 1; Santa Fe de Bogota, 1998.
[23]	Pappas SA, Schaaf DM, DiCostanzo MB, King FW, Sharp JT. 1983. Contamination of flexible fiberoptic bronchoscopes. Am Rev Respir Dis. 127: 391-392.
[24]	Regnier S, Cambau E, Meningaud JP, Guihot A, Deforges L, Carbonne A, Bricaire F and Caumes E. 2009. Clinical management of rapidly growing mycobacterial cutaneous infections in patients after mesotherapy. Clinical Infectious Diseases. 49: 1358-1364.
[25]	Sethi NK, Aggarwal PK, Duggal L and Sachar VP. 2003. Mycobaterium chelonei infection following laparoscopic inguinal herniorrhaphy. JAPI. 51: 81.
[26]	Shaaban H. S, Bishop S. L, Menon L., Slim J. 2012. Mycobacterium chelonae infection of the parotid gland: 4 (1): 79-81.
[27]	Simons S., Ingen J. v., Hsueh P., Hung N. V., P.N., Dekhuijzen R.,Boeree M. J., and Soolingen D. 2011. Nontuberculous Mycobacteria in Respiratory Tract Infections, Eastern Asia. Emerging Infectious Diseases. 17 (3): 343-349.
[28]	Sungkanuparph S, Sathapatayavongs B, Pracharktam R.2003. Infections with rapidly growing mycobacteria: report of 20 cases. International Journal of Infectious Diseases.7: 198-205.
[29]	Talip B. A., Sleator R. D. , Lowery C. J., Dooley J. S.G., and Snelling W. J. 2013. An Update on Global Tuberculosis (TB). Infect Dis. 6: 39-50.
[30]	Todd R. Hazelton1, John D. Newell, Jr., James L. Cook3, Gwen A. Huitt and David A. 2000. Lynch1CT Findings in 14 Patients with Mycobacterium chelonae Pulmonary Infection. American Journal of Roentgenology. 175 (2): 413-416.
[31]	Tschiedel E. Grasemann H. Ratjen F. 2006. Mycobacterium chelonae in a CF patient with anaplastic large cell lymphoma. Journal of Cystic Fibrosis. 5 (2): 133-136.
[32]	[Vestal, A. L. 1975. Procedures for the isolation and identification of mycobacteria. U.S. Department of Health, Education and Welfare publication no. (CDC) 76-8230; 97-115. Center for Disease Control, Atlanta.
[33]	Wali S. 2009. Mycobacterium chelonae empyema with bronchopleuralfistula in an immunocompetent patient. Annals of Thoracic Medicine. 4 (4): 213-215.
[34]	Wallace RJ Jr, Brown BA, Onyi GO. 1992. Skin, soft tissue, and bone infections due to Mycobacterium chelonae: importance of prior corticosteroid therapy, frequency of disseminated infections, and resistance to oral antimicrobials other than clarithromycin. J Infect Dis. 166: 405-12.
[35]	Wallace RJ Jr., Dukart G., Brown-Elliott B. A., Griffith D. E. , Scerpella E. G. and Marshall B. 2014. Clinical experience in 52 patients with tigecycline-containing regimens for salvage treatment of Mycobacterium abscessus and Mycobacterium chelonae infections. J Antimicrob Chemother. 69 (7): 1-9.
[36]	Wallace, R. J., Jr, Tanner, D., Brennan, P. J. & Brown, B. A.1993. Clinical trial of clarithromycin for cutaneous (disseminated) infection due to Mycobacterium chelonae. Ann Intern Med 119, 482-486.
[37]	Wallace RJ Jr, Brown-Elliott BA, Ward SC. 2001. Activities of linezolid against rapidly growing mycobacteria. Antimicrob Agents Chemother. 45: 764-767.
[38]	Wang H.C., Liaw Y.S, Yang P.C., Kuo S.H. and Luh K.T. 1995. A pseudoepidemic of Mycobacterium chelonae infection caused by contamination of a fibreoptic bronchoscope suction channel. Eur. Respir. J. 8: 1259-1262.
[39]	Xiang Y. Han, MD, PhD, Indra DE, MD, PhD, Kalen L and Jacobson, MD. 2007. Rapidly Growing Mycobacteria: Clinical and Microbiologic Studies of 115 Cases. Am J ClinPathol. 128 (4): 612-621.