title: Simultaneous detection of Mycobacterium tuberculosis complex and nontuberculous mycobacteria in respiratory specimens.
abstract: Many nontuberculous mycobacteria (NTM) species have clinical significance, and the rapid and reliable identification of Mycobacterium tuberculosis complex (MTBC) and NTM species is important. We evaluated the simultaneous detection of MTBC and NTM in respiratory specimens. MTBC and NTM were simultaneously detected and identified by laboratory-developed (LDT) real-time PCR, multiplex real-time PCR/melting curve analysis, rpoB PCR restriction fragment length polymorphisms and the AdvanSure Mycobacteria GenoBlot assay (LG Life Sciences). Eighty-five respiratory specimens from 69 patients showed simultaneous detection of MTBC and NTM. A line probe assay showed 70.6% concordance with LDT. Ten patients (14.5%) had a history of tuberculosis, and eight patients (11.6%) had been previously diagnosed with bronchiectasis. Mixed cultures were present one time in 57 patients (82.6%) and repeatedly in 12 patients (17.4%). MTBC was more frequent in 44 patients (63.8%), and NTM was isolated in seven patients (10.1%). The commonly detected NTM species in the mixed cultures were Mycobacterium intracellulare (29.0%) and Mycobacterium abscessus (29.0%). Co-isolation caused a failure of antitubercular drug susceptibility testing in 2 patients (2.9%). Molecular methods allow MTBC and NTM species to be simultaneously identified in respiratory specimens. NTM isolated with MTBC has clinical significance in some patients and should not be ignored.
authors.affiliation: Department of Laboratory Medicine, Seoul National University Bundang Hospital, 82, Gumiro, 173 Beongil, Bundanggu, Seongnam, Gyeonggido 463-707, Republic of Korea; Department of Laboratory Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongnogu, Seoul 110-744, Republic of Korea. Electronic address: smilemee@gmail.com.
authors.forename: Sang Mee
authors.initials: SM
authors.lastname: Hwang
authors.forename: Mi Suk
authors.initials: MS
authors.lastname: Lim
authors.forename: Yun Ji
authors.initials: YJ
authors.lastname: Hong
authors.forename: Taek Soo
authors.initials: TS
authors.lastname: Kim
authors.forename: Kyoung Un
authors.initials: KU
authors.lastname: Park
authors.forename: Junghan
authors.initials: J
authors.lastname: Song
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Eui Chong
authors.initials: EC
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015373:Bacterial Typing Techniques / Q000379:methods; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D060085:Coinfection / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000175:diagnosis; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000302:isolation & purification*; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000302:isolation & purification*; D012150:Polymorphism, Restriction Fragment Length; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D012137:Respiratory System / Q000382:microbiology*; D012189:Retrospective Studies; D013048:Specimen Handling / Q000379:methods; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis; D055815:Young Adult
keywords: Co-isolation; Mycobacterium tuberculosis complex; Nontuberculous mycobacteria