Identification of non-tuberculosis mycobacteria species of clinical isolates from patients clinically diagnosed with tuberculosis in Fujian Province, China
LIU Hai-can1, HUANG Ming-xiang2, JIANG Yi1, LIAN Lu-lu1, 3, ZHAO Xiu-qin1, ZHANG Li-shui2, WU Yi-mou3, WAN Kang-lin1, 3
1. State Key Laboratory for Infectious Diseases Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention, Beijing 102206, China; 2. Fuzhou Pulmonary Hospital,Fuzhou 350008, China; 3. Pathogenic Biology Institute, University of South China, Hengyang 421001, China
Abstract:Some species of non-tuberculosis mycobacteria (NTM) are important causes of human disease and infections. The purpose of this study was to describe the NTM species of clinical isolates from patients with tuberculosis in Fujian, China. The clinical NTM strains isolated from the patients clinically diagnosed with tuberculosis collected from 2005 to 2011 in Fuzhou Pulmonary Hospital, Fujian Province, and were identified to species level using conventional and molecular methods including multi-loci PCR, PRA-hsp65 and PRA-rpoB and sequencing for hsp65, rpoB, 16S rRNA and ITS. A total of 450 pre-identified NTM isolates were identified as 45 (10.00%) Mycobacterium tuberculosis strains and 405 (90.00%) NTM strains, which including 23 different NTM species and a Gordonia bronchialis isolates. There were at least 23 NTM species as potential pathogens were found to cause pulmonary infections in human beings, and 6 NTM species and Gordonia bronchialis were firstly identified in patients with a clinical diagnosis of tuberculosis (TB) in Fujian Province. NTM species identification is very important for distinguishing between TB and NTM pulmonary diseases. And combination of several methods can increase identification accuracy and efficacy.
刘海灿, 黄明翔, 蒋毅, 连璐璐, 赵秀芹, 张丽水, 吴移谋, 万康林. 福建省肺非结核分枝杆菌临床分离株的菌种鉴定[J]. 中国人兽共患病学报, 2017, 33(5): 389-397.
LIU Hai-can, HUANG Ming-xiang, JIANG Yi, LIAN Lu-lu, ZHAO Xiu-qin, ZHANG Li-shui, WU Yi-mou, WAN Kang-lin. Identification of non-tuberculosis mycobacteria species of clinical isolates from patients clinically diagnosed with tuberculosis in Fujian Province, China. Chinese Journal of Zoonoses, 2017, 33(5): 389-397.
[1] Daniel MT. The history of tuberculosis[J]. Respiratory Med, 2006. 100(1): 1862-1870. doi:10.1016/j.rmed.2006.08.006 [2] Heyderman RS, Clark J. Clinical manifestations of nontuberculous Mycobacteria [M]. New York: Springer, 2006: 167. [3] Griffith DE, Aksamit T, Brown-Elliott BA, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases[J]. Am J Respir Crit Care Med, 2007, 175(4): 367-416. doi:10.1164/rccm.200604-571ST [4] Jarzembowski JA, Young MB. Nontuberculous mycobacterial infections[J]. Arch Pathol Lab Med, 2008, 132: 1333-1341. doi:10.1043/1543-2165(2008)132 [5] Lee H, Park HJ, Cho SN, et al. Species identification of Mycobacteria by PCR-restriction fragment length polymorphism of the rpoB gene[J]. J Clin Microbiol, 2000, 38(8): 2966-2971. [6] Shinners D, Yeager H, Nontuberculous mycobacterial infection: clinical syndromes and diagnosis: overview[M]. 4 ed. Tuberculosis and nontuberculous mycobacterial infections, ed. D. Schlossberg, Philadelphia: W. B. Saunders Co., 1999 [7] Jing H, Wang H, Wang Y, et al, Prevalence of nontuberculous Mycobacteria infection, China, 2004-2009[J]. Emerg Infect Dis, 2012, 18(3): 527-528. doi:10.3201/eid1803.110175 [8] Standards NCFCL. Susceptibility testing of mycobacteria, Nocardia, and other aerobic actinomycetes[S]. National Committee for Clinical Laboratory Standards, 2003. [9] Senna SG, Marsico AG, Vieira G, et al. Identification of nontuberculous mycobacteria isolated from clinical sterile sites in patients at a university hospital in the city of Rio de Janeiro, Brazil[J]. J Bras Pneumol, 2011, 37(4): 521-526. doi:10.1590/S1806-37132011000400015 [10] Silva C, Ueki S, Geiger D, et al. hsp 65 PCR-restriction enzyme analysis (PRA) for identification of Mycobacteria in the clinical laboratory [J]. Rev Inst Med Trop Sao Paulo, 2001, 43(1): 25-28. doi:10.1590/S0036-46652001000100005 [11] Plikaytis BB, Plikaytis BD, Yakrus MA, et al. Differentiation of slowly growing Mycobacterium species, including Mycobacterium tuberculosis , by gene amplification and restriction fragment length polymorphism analysis[J]. J Clin Microbiol, 1992, 30(7): 1815-1822. [12] Telenti A, Marchesi F, Balz M, et al. Rapid identification of Mycobacteria to the species level by polymerase chain reaction and restriction enzyme analysis[J]. J Clin Microbiol, 1993, 31(2): 175-178. [13] Kent PT, Kubica GP. Public health mycobacteriology: a guide for the level III laboratory[M]. Atlanta: US Department of Health and Human Services, Public Health Service, Centers for Disease Control. 1985: 31-46. [14] Soolingen DV, Hermans P, Haas P, et al., Occurrence and stability of insertion sequences in Mycobacterium tuberculosis complex strains: evaluation of an insertion sequence-dependent DNA polymorphism as a tool in the epidemiology of tuberculosis[J]. J Clin Microbiol, 1991, 29(11): 2578-2586. [15] Huard RC, de Oliveira Lazzarini LC, Butler WR, et al. PCR-based method to differentiate the subspecies of the Mycobacterium tuberculosis complex on the basis of genomic deletions[J]. J Clin Microbiol, 2003, 41(4): 1637-1650. doi:10.1128/JCM.41.4.1637-1650.2003 [16] Whang J, Lee BS, Choi GE, et al. Polymerase chain reaction-restriction fragment length polymorphism of the rpoB gene for identification of Mycobacterium avium subsp. paratuberculosis and differentiation of Mycobacterium avium subspecies[J]. Diagn Microbiol Infect Dis, 2011, 70(1): 65-71. doi:10.1016/j.diagmicrobio.2011.01.014 [17] Kim BJ, Lee KH, Park BN, et al., Differentiation of mycobacterial species by PCR-restriction analysis of DNA (342 base pairs) of the RNA polymerase gene (rpoB)[J]. J Clin Microbiol, 2001, 39(6): 2102-2109. doi:10.1128/JCM.39.6.2102-2109.2001 [18] Telenti A, Marchesi F, Balz M, et al. Rapid identification of mycobacteria to the species level by polymerase chain reaction and restriction enzyme analysis[J]. J Clin Microbiol, 1993, 31(2): 175-178. [19] Chimara E, Ferrazoli L, Ueky SY, et al. Reliable identification of mycobacterial species by PCR-restriction enzyme analysis (PRA)- hsp 65 in a reference laboratory and elaboration of a sequence-based extended algorithm of PRA-hsp65 patterns[J]. BMC Microbiol, 2008, 8: 48. doi:10.1186/1471-2180-8-48 [20] Bodle EE, Cunningham JA, Della-Latta P, et al. Epidemiology of nontuberculous Mycobacteria in atients without HIV Infection, New York City[J]. Emerg Infect Dis, 2008, 14(3): 390-396. doi:10.3201/eid1403.061143. [21] Brunello F, Ligozzi M, Cristelli E, et al. Identification of 54 mycobacterial species by PCR-restriction fragment length polymorphism analysis of the hsp65 gene[J]. J Clin Microbiol, 2001, 39(8): 2799-2806. doi:10.1128/JCM.39.8.2799-2806.2001 [22] da Silva Rocha A, Werneck Barreto AM, Dias Campos CE, et al. Novel allelic variants of Mycobacteria isolated in Brazil as determined by PCR-restriction enzyme analysis of hsp65[J]. J Clin Microbiol, 2002, 40(11): 4191-4196. doi:10.1128/JCM.40.11.4191-4196.2002 [23] Cheunoy W, Prammananan T, Chaiprasert A, et al. Comparative evaluation of polymerase chain reaction and restriction enzyme analysis: two amplified targets, hsp 65 and rpoB , for identification of cultured Mycobacteria [J]. Diagn Microbiol Infect Dis, 2005, 51(3): 165-171. doi:10.1016/j.diagmicrobio.2004.09.006 [24] Hafner B, Haag H, Geiss HK, et al. Different molecular methods for the identification of rarely isolated non-tuberculous Mycobacteria and description of new hsp 65 restriction fragment length polymorphism patterns[J]. Mol Cell Probes, 2004, 18(1): 59-65. doi:10.1016/j.mcp.2003.09.003 [25] Devallois A, Goh Ks, Rastogi N. Rapid identification of mycobacteria to species level by PCR restriction fragment length polymorphism analysis of the hsp 65 gene and proposition of an algorithm to differentiate 34 mycobacterial[J]. J Clin Microbiol, 1997, 35(11): 2969-2973. [26] Lee H, Park HJ, Cho SN, et al. Species identification of Mycobacteria by PCR-restriction fragment length polymorphism of the rpoB gene[J]. J Clin Microbiol, 2000, 38(8): 2956-2971. [27] Reuss AM, Wiese-Posselt M, Weissmann B, et al. Incidence rate of nontuberculous mycobacterial disease in immunocompetent children: a prospective nationwide surveillance study in Germany[J]. Pediatr Infect Dis J, 2009, 28(7): 642-644. doi:10.1097/INF.0b013e3181978e8e [28] Adékambi T, Drancourt M. Isolation of Mycobacterium septicum from the sputum of a patient suffering from hemoptoic pneumonia[J]. Res Microbiol, 2006, 157(5): 466-470. doi:10.1016/j.resmic.2005.10.006 [29] Leao SC, Martin A, Mejia GI, et al. Practical handbook for the phenotypic and genotypic identification of Mycobacteria [M]. 1 ed. 2004, Belgium: Bruges. [30] Shin S, Kim EC, Yoon J-H. Identification of nontuberculous Mycobacteria by sequence analysis of the 16S ribosomal RNA, the heat-shock protein 65 and the RNA polymerase-subunit genes[J]. Korean J Lab Med, 2006, 26(3): 153-160. doi:10.3343/kjlm.2006.26.3.153 [31] Imperiale B, Zumárraga M, Gioffré A, et al. Disease caused by non-tuberculous mycobacteria diagnostic procedures and treatment evaluation in the North of Buenos Aires Province[J]. Revista Argentina de Microbiología, 2012, 44: 3-9. doi:10.1590/S0325-75412012000100002 [32] Jacobson K, Garcia R, Libshitz H, et al. Clinical and radiological features of pulmonary disease caused by rapidly growing Mycobacteria in cancer patients[J]. Eur J Clin Microbiol Infect Dis, 1998, 17(9): 615-621. [33] Euzeby JP. List of Prokaryotic names with Standing in Nomenclature-Genus Mycobacterium[EB/OL]. (2013-1-14)[2016-12-01]. http://www.bacterio.cict.fr/m/-mycobacterium.html. [34] Zamarioli LA, Coelho AGV, Pereira CM, et al. Descriptive study of the frequency of nontuberculous Mycobacteria in the Baixada Santista region of the state of São Paulo, Brazil[J]. J Bras Pneumol, 2008, 34(8): 590-594. doi:10.1590/S1806-37132008000800008 [35] Chen M, Wan K. Tuberculosis laboratory technical munual[M]. 1 ed. Beijing: Science Press, 2011. (in Chinese) [36] Arnow PM, Bakir M, Thompson K, et al. Endemic contamination of clinical specimens by Mycobacterium gordonae [J]. Clin Infect Dis, 2000, 31(2): 472-476. doi:10.1086/313940 [37] Gangadharam PR, Lockhart JA, Awe RJ, et al. Mycobacterial contamination through tap water[J]. Am Rev Respir Dis, 1976, 113: 894. doi:10.1164/arrd.1976.113.6.894 [38] Fujita K, Ito Y, Hirai T, et al. Genetic relatedness of Mycobacterium avium -intracellulare complex isolates from patients with pulmonary MAC disease and their residential soils[J]. Clin Microbiol Infect, 2013, 19(6): 537-541. doi:10.1111/j.1469-0691.2012.03929.x [39] Pourahmad F, Thompson KD, Adams A, et al. Comparative evaluation of polymerase chain reaction-restriction enzyme analysis (PRA) and sequencing of heat shock protein 65 (hsp65) gene for identification of aquatic mycobacteria[J]. J Microbiol Methods, 2009, 76(2): 128-135. doi:10.1016/j.mimet.2008.09.021