title: Mycobacterium arupense, Mycobacterium heraklionense, and a Newly Proposed Species, "Mycobacterium virginiense" sp. nov., but Not Mycobacterium nonchromogenicum, as Species of the Mycobacterium terrae Complex Causing Tenosynovitis and Osteomyelitis.
abstract: Mycobacterium terrae complex has been recognized as a cause of tenosynovitis, with M. terrae and Mycobacterium nonchromogenicum reported as the primary etiologic pathogens. The molecular taxonomy of the M. terrae complex causing tenosynovitis has not been established despite approximately 50 previously reported cases. We evaluated 26 isolates of the M. terrae complex associated with tenosynovitis or osteomyelitis recovered between 1984 and 2014 from 13 states, including 5 isolates reported in 1991 as M. nonchromogenicum by nonmolecular methods. The isolates belonged to three validated species, one new proposed species, and two novel related strains. The majority of isolates (20/26, or 77%) belonged to two recently described species: Mycobacterium arupense (10 isolates, or 38%) and Mycobacterium heraklionense (10 isolates, or 38%). Three isolates (12%) had 100% sequence identity to each other by 16S rRNA and 99.3 to 100% identity by rpoB gene region V sequencing and represent a previously undescribed species within the M. terrae complex. There were no isolates of M. terrae or M. nonchromogenicum, including among the five isolates reported in 1991. The 26 isolates were susceptible to clarithromycin (100%), rifabutin (100%), ethambutol (92%), and sulfamethoxazole or trimethoprim-sulfamethoxazole (70%). The current study suggests that M. arupense, M. heraklionense, and a newly proposed species ("M. virginiense" sp. nov.; proposed type strain MO-233 [DSM 100883, CIP 110918]) within the M. terrae complex are the major causes of tenosynovitis and osteomyelitis in the United States, with little change over 20 years. Species identification within this complex requires sequencing methods.
authors.affiliation: Mycobacteria/Nocardia Research Laboratory, Department of Microbiology, The University of Texas Health Science Center at Tyler, Tyler, Texas, USA ravikiran.vasireddy@uthct.edu.
authors.forename: Ravikiran
authors.initials: R
authors.lastname: Vasireddy
authors.affiliation: Mycobacteria/Nocardia Research Laboratory, Department of Microbiology, The University of Texas Health Science Center at Tyler, Tyler, Texas, USA.
authors.forename: Sruthi
authors.initials: S
authors.lastname: Vasireddy
authors.affiliation: Mycobacteria/Nocardia Research Laboratory, Department of Microbiology, The University of Texas Health Science Center at Tyler, Tyler, Texas, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Brown-Elliott
authors.affiliation: Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Wengenack
authors.affiliation: Division of Infectious Disease, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.
authors.forename: Uzoamaka A
authors.initials: UA
authors.lastname: Eke
authors.affiliation: Mycobacteria/Nocardia Research Laboratory, Department of Microbiology, The University of Texas Health Science Center at Tyler, Tyler, Texas, USA.
authors.forename: Jeana L
authors.initials: JL
authors.lastname: Benwill
authors.affiliation: Saskatchewan Disease Control Laboratory, Regina, Saskatchewan, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Turenne
authors.affiliation: Mycobacteria/Nocardia Research Laboratory, Department of Microbiology, The University of Texas Health Science Center at Tyler, Tyler, Texas, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wallace
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D012321:DNA-Directed RNA Polymerases; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009161:Mycobacterium / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D009165:Mycobacterium Infections, Nontuberculous / Q000382:microbiology*; D010019:Osteomyelitis / Q000382:microbiology*; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA; D013717:Tenosynovitis / Q000382:microbiology*; D014481:United States; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S; D012321:DNA-Directed RNA Polymerases; C105078:RNA polymerase beta subunit