Rapid identification of cutaneous infections by nontubercular mycobacteria by polymerase chain reaction-restriction analysis length polymorphism of the hsp65 gene.
BACKGROUND
Nontubercular mycobacteria (NTM) may cause cutaneous infections which are difficult to interpret due to the variability of the clinical manifestations. This study involved eight patients (four men and four women) with primary cutaneous infections caused by NTM; the skin lesions included dermo-hypodermal abscesses, suppurative granulomas, and papulonodules localized on the legs, arms, hands, and face. The general condition of the patients was relatively good and they were not immunosuppressed.


METHODS
All samples were processed with standard methods and the isolates were identified by pattern restriction analysis after polymerase chain reaction (PCR-PCA) amplification of the heat shock protein of 65 kDa.


RESULTS
In this way, we were able to identify three Mycobacterium chelonae strains, two Mycobacterium marinum, two Mycobacterium fortuitum, and one Mycobacterium avium. The lesions disappeared in 3 or 4 weeks after treatment with two or more antimicrobials.


CONCLUSIONS
For a correct diagnosis of cutaneous infection by NTM, demonstrating the presence of mycobacteria is essential; routinely available techniques lack sensitivity and are extremely tedious; often mycobacteria are not seen after acid-fast stain. We used PCR-PCA to identify mycobacteria grown in liquid media; the time of identification of mycobacteria was shortened relative to conventional methods.
Ena
P
P
Dermatology Institute, Division of Experimental and Clinical Microbiology, University of Sassari, Viale San Pietro 43b, I-07100 Sassari, Italy. sechila@ssmain.uniss.it
Sechi
L A
LA
Saccabusi
S
S
Molicotti
P
P
Lorrai
M P
MP
Siddi
M
M
Zanetti
S
S
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins; D018834:Chaperonin 60; D018833:Chaperonins / Q000235:genetics*; D017291:Clarithromycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy; D009170:Nontuberculous Mycobacteria / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods; D012293:Rifampin / Q000627:therapeutic use; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D018834:Chaperonin 60; C074119:heat-shock protein 65, Mycobacterium; D018833:Chaperonins; D017291:Clarithromycin; D007538:Isoniazid; D012293:Rifampin