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Molecular analysis of clinical isolates previously diagnosed as Mycobacterium intracellulare reveals incidental findings of "Mycobacterium indicus pranii" genotypes in human lung infection

 Su-Young Kim  ;  Hye Yun Park  ;  Byeong-Ho Jeong  ;  Kyeongman Jeon  ;  Hee Jae Huh  ;  Chang-Seok Ki  ;  Nam Yong Lee  ;  Seung-Jung Han  ;  Sung Jae Shin  ;  Won-Jung Koh 
 BMC INFECTIOUS DISEASES, Vol.15 : 406, 2015 
Journal Title
Issue Date
Aged ; Bacterial Proteins/chemistry ; Bacterial Proteins/classification ; Bacterial Proteins/genetics ; Base Sequence ; DNA Transposable Elements ; Female ; Genotype ; Humans ; Lung Diseases/diagnosis* ; Lung Diseases/microbiology ; Male ; Middle Aged ; Mycobacterium/genetics ; Mycobacterium/isolation & purification* ; Mycobacterium/metabolism ; Mycobacterium avium Complex/genetics ; Mycobacterium avium Complex/isolation & purification ; Mycobacterium avium Complex/metabolism ; Mycobacterium avium-intracellulare Infection/diagnosis* ; Mycobacterium avium-intracellulare Infection/microbiology ; Phylogeny ; Polymorphism, Single Nucleotide ; RNA, Ribosomal, 16S/genetics ; Tomography, X-Ray Computed
Mycobacterium intracellulare ; Mycobacterium indicus pranii ; Multigene sequence-based typing ; Insertion elements
BACKGROUND: Mycobacterium intracellulare is a major cause of Mycobacterium avium complex lung disease in many countries. Molecular studies have revealed several new Mycobacteria species that are closely related to M. intracellulare. The aim of this study was to re-identify and characterize clinical isolates from patients previously diagnosed with M. intracellulare lung disease at the molecular level. METHODS: Mycobacterial isolates from 77 patients, initially diagnosed with M. intracellulare lung disease were re-analyzed by multi-locus sequencing and pattern of insertion sequences. RESULTS: Among the 77 isolates, 74 (96 %) isolates were designated as M. intracellulare based on multigene sequence-based analysis. Interestingly, the three remaining strains (4 %) were re-identified as "Mycobacterium indicus pranii" according to distinct molecular phylogenetic positions in rpoB and hsp65 sequence-based typing. In hsp65 sequevar analysis, code 13 was found in the majority of cases and three unreported codes were identified. In 16S-23S rRNA internal transcribed spacer (ITS) sequevar analysis, all isolates of both species were classified within the Min-A ITS sequevar. Interestingly, four of the M. intracellulare isolates harbored IS1311, a M. avium-specific element. Two of three patients infected with "M. indicus pranii" had persistent positive sputum cultures after antibiotic therapy, indicating the clinical relevance of this study. CONCLUSIONS: This analysis highlights the importance of precise identification of clinical isolates genetically close to Mycobacterium species, and suggests that greater attention should be paid to nontuberculous mycobacteria lung disease caused by "M. indicus pranii".
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1. College of Medicine (의과대학) > Dept. of Microbiology (미생물학교실) > 1. Journal Papers
Yonsei Authors
Shin, Sung Jae(신성재) ORCID logo https://orcid.org/0000-0003-0854-4582
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