title: Clinical relevance of Mycobacterium chelonae-abscessus group isolation in 95 patients.
abstract: 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.
authors.affiliation: Department of Pulmonary Diseases, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. jakko.van.ingen@rivm.nl
authors.forename: Jakko
authors.initials: J
authors.lastname: van Ingen
authors.forename: Rina
authors.initials: R
authors.lastname: de Zwaan
authors.forename: Richard P N
authors.initials: RP
authors.lastname: Dekhuijzen
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Boeree
authors.forename: Dick
authors.initials: D
authors.lastname: van Soolingen
mesh_terms: 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
chemical_list: D001426:Bacterial Proteins