Clinical relevance of Mycobacterium chelonae-abscessus group isolation in 95 patients.
OBJECTIVE
To determine the clinical relevance of Mycobacterium chelonae-abscessus group isolation from clinical samples.


METHODS
We retrospectively reviewed medical files of all patients from whom these mycobacteria were isolated between January 1999 and January 2005 and re-identified the isolates by rpoB sequencing. We applied the American Thoracic Society (ATS) diagnostic criteria to establish clinical relevance.


RESULTS
Ninety-five patients were traced (56 M. chelonae, 25 Mycobacterium abscessus, 8 Mycobacterium massiliense, 6 Mycobacterium bolletii). Most isolates were cultured from pulmonary samples in patients with pre-existing pulmonary disease. Among patients with pulmonary isolates, 27% (20/74) meets ATS criteria; M. abscessus is most relevant (50%; 9/18), followed by M. massiliense (29%; 2/7), M. bolletii (20%; 1/5) and M. chelonae (18%; 8/44). Extrapulmonary disease presented as disseminated skin disease, eye disease specific for M. chelonae and otomastoiditis for M. abscessus. Treatment, especially for pulmonary M. abscessus disease, yielded limited results.


CONCLUSIONS
One-fourth of the patients with pulmonary M. chelonae-abscessus group isolates met the ATS criteria; this percentage differs by species. Species distribution and clinical relevance differ from other regions. M. abscessus isolation in cystic fibrosis patients warrants special attention. Current ATS criteria might be too lenient to diagnose M. chelonae-abscessus group disease.
van Ingen
Jakko
J
Department of Pulmonary Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. jakko.van.ingen@rivm.nl
de Zwaan
Rina
R
Dekhuijzen
Richard P N
RP
Boeree
Martin J
MJ
van Soolingen
Dick
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000382:microbiology; D003710:Demography; D015818:Eye Infections, Bacterial / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008168:Lung / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000453:epidemiology; D016926:Mycobacterium chelonae / Q000235:genetics / Q000302:isolation & purification*; D055815:Young Adult
D001426:Bacterial Proteins