title: [Molecular epidemiological analysis by IS1245-based restriction fragment length polymorphism typing on cases with pulmonary Mycobacterium avium disease observed in the same family].
abstract: BACKGROUND
  Mycobacterium avium-intracellulare complex (MAC) has become one of major human pathogens, however, its routes of transmission and environmental reservoirs causing human infection were not yet elucidated. We reported three families affected by pulmonary Mycobacterium avium (M. avium) disease. Previous reports on MAC diseases observed in the same family were very rare. The purposes of this study were to investigate whether the infected M. avium was the same strain among cases in the same family and to examine the possibility of human-to-human transmission, or infection from exposure to a common environmental reservoir.
  
  
  METHODS
  M. avium isolates from nine cases of three families were examined by DNA polymorphism based typing technique, restriction fragment length polymorphism (RFLP) analysis using insertion sequence IS1245 as a probe, to type the strains. Some isolates were subcultured to a single clone.
  
  
  RESULTS
  All strains isolated from cases in the same family showed different patterns by the RFLP analysis. And not only simultaneous polyclonal infection but also repeated polyclonal infections were observed in some patients.
  
  
  CONCLUSIONS
  The results suggest importance of underlying anti-mycobacterial immunological impairment and defects of local defense rather than virulence of infected strains as the pathogenesis of pulmonary M. avium disease.
authors.affiliation: Department of Respiratory Diseases, National Hospital Organization, Nishi-Niigata Chuo National Hospital, Japan. kuwabara@masa.go.jp
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Kuwabara
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Koichi
authors.initials: K
authors.lastname: Wada
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Tsuchiya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015373:Bacterial Typing Techniques; D004251:DNA Transposable Elements / Q000235:genetics*; D004269:DNA, Bacterial / Q000235:genetics; D005190:Family; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D015269:Mycobacterium avium Complex / Q000145:classification* / Q000235:genetics* / Q000276:immunology / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000453:epidemiology / Q000235:genetics / Q000382:microbiology* / Q000635:transmission; D011110:Polymorphism, Genetic; D012150:Polymorphism, Restriction Fragment Length; D012137:Respiratory System / Q000276:immunology
chemical_list: D004251:DNA Transposable Elements; D004269:DNA, Bacterial