MYCOLICIBACTERIUM FORTUITUM INFECTION IN EX SITU EMERALD TREE BOA (Corallus batesii).

Emerald tree boas (Corallus batesii) are boids that in situ occurs in forested habitats in the Amazon Basin. The mycobacterial species can infect reptiles but the species Mycolicibacterium fortuitum was identified only in feces samples of ex situ Python regius and was isolated from granulomatous lesions of an ex situ Iguana iguana when was still part of the genus Mycobacterium. This article aims to report a mycobacteria infection case in a female Corallus batesii kept under human care. The animal presented apathy and 2 months of anorexia, being found dead. The necropsy revealed presence of tracheal and pulmonary nodules besides multifocal, bacterial, granulomatous pneumonia. After Fite-Faraco histochemical staining, immunohistochemistry, semi-nested polymerase chain reaction (PCR) and genetic sequencing the Mycolicibacterium fortuitum complex was diagnosed with 99.54% of nucleotide similarity. This mycobacterial species was already pointed out as an important nosocomial pathogen and more studies are necessary to explore their zoonotic potential.

Odontogenic cutaneous sinus tracts due to infection with nontuberculous mycobacteria: a report of three cases.

BACKGROUND: Soft tissue or skin infections due to nontuberculous mycobacteria (NTM) have been reported frequently and are mostly associated with trauma or cosmetic interventions like plastic surgery. However, infection with NTM as a result of a dental procedure have rarely been described and the lack of clinical suspicion and a clear clinical manifestation makes diagnosis challenging. CASE PRESENTATION: We report on three patients with a facial cutaneous sinus tract of dental origin, due to an infection with respectively Mycobacterium fortuitum, M. abscessus and M. peregrinum. The infection source was the dental unit waterlines (DUWLs), which were colonized with NTM. CONCLUSIONS: Water of the DUWL can pose a health risk. This report emphasizes the need for quality control and certification of water flowing through DUWLs, including the absence of NTM. Our report also shows the need for a rapid recognition of NTM infections and accurate laboratory diagnosis in order to avoid long-term ineffective antibiotic treatment.

Cutaneous mycobacteriosis in a captive Amazonian manatee Trichechus inunguis.

An adult male Amazonian manatee Trichechus inunguis under human care presented with 3 circular cutaneous lesions on the dorsal aspect of the rostrum and between the nostrils (plenum). Initially these lesions were superficial, hypopigmented, without warmth and non-painful. Microbiological cultures of skin swabs isolated Candida sp. and Pseudomonas aeruginosa, and topical treatment with antiseptic, antifungal, anti-inflammatory and antibiotic medication was instituted. This treatment strategy did not lead to any clinical improvement, and after 6 mo, the lesions progressed to a confluent abscess (5.0 × 3.0 cm) with increased temperature and obvious discomfort on palpation. An impression smear of a cutaneous biopsy was submitted for Ziehl-Neelsen staining and after detection of acid-fast bacilli, the cutaneous biopsy and a swab from the lesion were sent for histopathology, culture and sensitivity testing. After 5 d of incubation and through PCR-restriction analysis of the isolates, Mycobacterium fortuitum and M. abscessus were identified. Sensitivity testing indicated that the isolates were susceptible to ciprofloxacin and clarithromycin, and after draining of the lesion and administration of systemic antibiotic treatment, there was rapid clinical improvement. This report describes non-healing lesions in an aquatic animal and illustrates the importance of evaluating the presence of non-tuberculous mycobacteria, opportunistic pathogens which are ubiquitous in the aquatic environment, in protracted, non-responsive cases. We also highlight the importance of a correct diagnosis and treatment approach, and we review concerns that these bacteria are zoonotic agents and are frequently resistant to conventional antibiotics.

Micobacteriose em camarão branco do pacífico, Litopenaeus vannamei / Mycobacteriosis white shrimp pacific Litopenaeus vannamei

A infecção por Mycobacterium spp. tem sido constatada em diversos vertebrados, ocasionando doenças em humanos e animais. As espécies responsáveis pela ocorrência de micobacteriose em peixes, a saber, Mycobacterium marinum, M. fortuitum e M. chelonae, também são potencialmente infecciosas para os camarões peneídeos. A micobacteriose que afeta crustáceos corresponde a uma enfermidade sistêmica, granulomatosa, possuindo como agente etiológico bacilos Gram positivos ácido-álcool resistentes. Relata-se neste trabalho a ocorrência de micobacteriose em camarões da espécie Litopenaeus vannamei, sendo identificada a bactéria M. marinum nas amostras teciduais analisadas. Durante a manutenção de juvenis da espécie foram observadas lesões enegrecidas no sexto segmento abdominal de 20 espécimes. A partir das técnicas de Fite-Faraco e Fluorescence In Situ Hybridization (FISH) foi identificado o patógeno, representando uma doença bacteriana com potencial zootécnico que ocorre em ambientes aquáticos, acarretando riscos de contaminação tópica em pessoas envolvidas na manipulação de camarões.(AU)

The Mycobacterium spp. infection they have been documented in many vertebrates, causing known diseases in man and animals. The species responsible for the occurrence of mycobacteriosis in fish, Mycobacterium marinum, M. fortuitum and M. chelonae, are also potentially infectious for penaeid shrimp. The mycobacterial disease that affects shellfish corresponds to a systemic disease, granulomatous, having as an etiological agent Gram-positive bacilli resistant acid-alcohol. We report the occurrence of mycobacteriosis in shrimps of the species Litopenaeus vannamei, and identified the species M. marinum in tissue samples analyzed. During the maintenance of juvenile of the species, blackish lesions were observed in the sixth abdominal segment in 20 specimens. From techniques Fite-Faraco and hybridization in situ with fluorescence (FISH), has identified the pathogen in the analyzed tissue was observed, representing a bacterial disease of aquatic environments with zoonotic potential, causing risks of topical contamination on people involved in handling shrimp.(AU)

Micobacteriose em camarão branco do pacífico, Litopenaeus vannamei / Mycobacteriosis white shrimp pacific Litopenaeus vannamei

A infecção por Mycobacterium spp. tem sido constatada em diversos vertebrados, ocasionando doenças em humanos e animais. As espécies responsáveis pela ocorrência de micobacteriose em peixes, a saber, Mycobacterium marinum, M. fortuitum e M. chelonae, também são potencialmente infecciosas para os camarões peneídeos. A micobacteriose que afeta crustáceos corresponde a uma enfermidade sistêmica, granulomatosa, possuindo como agente etiológico bacilos Gram positivos ácido-álcool resistentes. Relata-se neste trabalho a ocorrência de micobacteriose em camarões da espécie Litopenaeus vannamei, sendo identificada a bactéria M. marinum nas amostras teciduais analisadas. Durante a manutenção de juvenis da espécie foram observadas lesões enegrecidas no sexto segmento abdominal de 20 espécimes. A partir das técnicas de Fite-Faraco e Fluorescence In Situ Hybridization (FISH) foi identificado o patógeno, representando uma doença bacteriana com potencial zootécnico que ocorre em ambientes aquáticos, acarretando riscos de contaminação tópica em pessoas envolvidas na manipulação de camarões.

The Mycobacterium spp. infection they have been documented in many vertebrates, causing known diseases in man and animals. The species responsible for the occurrence of mycobacteriosis in fish, Mycobacterium marinum, M. fortuitum and M. chelonae, are also potentially infectious for penaeid shrimp. The mycobacterial disease that affects shellfish corresponds to a systemic disease, granulomatous, having as an etiological agent Gram-positive bacilli resistant acid-alcohol. We report the occurrence of mycobacteriosis in shrimps of the species Litopenaeus vannamei, and identified the species M. marinum in tissue samples analyzed. During the maintenance of juvenile of the species, blackish lesions were observed in the sixth abdominal segment in 20 specimens. From techniques Fite-Faraco and hybridization in situ with fluorescence (FISH), has identified the pathogen in the analyzed tissue was observed, representing a bacterial disease of aquatic environments with zoonotic potential, causing risks of topical contamination on people involved in handling shrimp.

Determinación de la concentración de Mycobacterium por espectrofotometría / Determination of Mycobacterium fortuitum concentration by spectrophotometry / Determinação da concentração de Mycobacterium fortuitum através da espectrofotometria

Mycobacterium fortuitum es agente causante de enfermidad oportunista en humanos y animales. Es un agente biológico modelo para estudios experimentales que sustituy Mycobacterium bovis, que es más patógeno. Este estudio presenta una metodología alternativa para el recuento de unidades formadoras de colonias por mililitro de inóculo para determinar la concentración de Mycobacterium fortuitum usando espectrofotometría. Catorce muestras se utilizaron Mycobacterium fortuitum, cultivadas en Lowesntein-Jensen, ocho de ellos de siete días de cultivo, y la otra entre 8 y 14 días en la cultura. Todas las muestras se colocaron en placas y se incubaron a 37o.C durante 7 días en un invernadero. De cada muestra se hicieron lecturas las variables de absorbancia (Abs) y transmitancia (T%) en un espectrofotómetro, a una longitud de onda de 560 nm y 600 nm. La comparación de los valores de UFC, ABS y T% por análisis de regresión lineal simple, el estadístico SAS versión 8.2 del software, hubo una fuerte evidencia estadística de que el aumento del valor de transmitancia se asocia con la disminución en el valor de UFC chapado, siguiendo el modelo matemático: LOG10 (UFC) = 21,012 - 0,1936 * transmitancia, con p = 0,0025 y una repetibilidad de más de 80%.

Mycobacterium fortuitum is an opportunistic agent which causes disease in human and animals. It is also a biological model for experimental studies instead of using Mycobacterium bovis, which is more pathogenic. This work presents an alternative methodology using spectrophotometry to count colony forming units (CFU) per milliliter of inoculum, in order to determinate Mycobacterium fortuitum concentration. Fourteen Mycobacterium fortuitum samples were cultivated in Lowenstein-Jensen culture media, considering that eight of them were seven days old cultures and the others were between eight and 14 days old. All samples were seeded and incubated at 37o.C for 7 days in an incubator. For each sample, the variables absorbance (Abs) and transmitance (T%) were read with an spectrophotometer and wave length of 560nm and 600nm. When the values of CFU, Abs and T% were compared through simple linear regression analysis and using the statistic software SAS Version 8.2., it was observed strong statistical evidence that the increase of transmitance value is associated to the decrease of CFU plate values, according to the mathematic model: LOG10 (CFU) = 21.012 - 0.1936*Transmitance, and p value = 0.0025 and a repeatability over 80%.

O Mycobacterium fortuitum é um agente oportunista causador de doença em humanos e animais. Além disso, é um modelo biológico para estudos experimentais em substituição ao Mycobacterium bovis, que é mais patogênico. Este estudo apresenta metodologia alternativa à contagem de unidades formadoras de colônia por mililitro de inóculo, para determinar a concentração do Mycobacterium fortuitum utilizando espectrofotometria. Utilizaram-se 14 amostras de Mycobacterium fortuitum, cultivadas em meio Lowesntein-Jensen, sendo oito delas com sete dias de cultivo e as demais entre oito e 14 dias de cultivo. Todas as amostras foram semeadas e incubadas a 37o.C por 7 dias em estufa. Fizeram-se, de cada amostra, leituras das variáveis absorbância (Abs) e transmitância (T%) em espectrofotômetro, nos comprimentos de onda de 560nm e 600nm. Comparando-se os valores obtidos de UFC, Abs e T% por meio da análise de regressão linear simples, pelo programa estatístico SAS versão 8.2, observou-se forte evidência estatística que o aumento do valor da transmitância está associado com o decréscimo do valor de UFC em placas, seguindo o modelo matemático: LOG10 (UFC) = 21.012 - 0.1936*Transmitância, com valor de p = 0,0025 e uma repetibilidade de mais de 80%.

Determinación de la concentración de Mycobacterium por espectrofotometría / Determination of Mycobacterium fortuitum concentration by spectrophotometry / Determinação da concentração de Mycobacterium fortuitum através da espectrofotometria

Mycobacterium fortuitum es agente causante de enfermidad oportunista en humanos y animales. Es un agente biológico modelo para estudios experimentales que sustituy Mycobacterium bovis, que es más patógeno. Este estudio presenta una metodología alternativa para el recuento de unidades formadoras de colonias por mililitro de inóculo para determinar la concentración de Mycobacterium fortuitum usando espectrofotometría. Catorce muestras se utilizaron Mycobacterium fortuitum, cultivadas en Lowesntein-Jensen, ocho de ellos de siete días de cultivo, y la otra entre 8 y 14 días en la cultura. Todas las muestras se colocaron en placas y se incubaron a 37o.C durante 7 días en un invernadero. De cada muestra se hicieron lecturas las variables de absorbancia (Abs) y transmitancia (T%) en un espectrofotómetro, a una longitud de onda de 560 nm y 600 nm. La comparación de los valores de UFC, ABS y T% por análisis de regresión lineal simple, el estadístico SAS versión 8.2 del software, hubo una fuerte evidencia estadística de que el aumento del valor de transmitancia se asocia con la disminución en el valor de UFC chapado, siguiendo el modelo matemático: LOG10 (UFC) = 21,012 - 0,1936 * transmitancia, con p = 0,0025 y una repetibilidad de más de 80%.(AU)

Mycobacterium fortuitum is an opportunistic agent which causes disease in human and animals. It is also a biological model for experimental studies instead of using Mycobacterium bovis, which is more pathogenic. This work presents an alternative methodology using spectrophotometry to count colony forming units (CFU) per milliliter of inoculum, in order to determinate Mycobacterium fortuitum concentration. Fourteen Mycobacterium fortuitum samples were cultivated in Lowenstein-Jensen culture media, considering that eight of them were seven days old cultures and the others were between eight and 14 days old. All samples were seeded and incubated at 37o.C for 7 days in an incubator. For each sample, the variables absorbance (Abs) and transmitance (T%) were read with an spectrophotometer and wave length of 560nm and 600nm. When the values of CFU, Abs and T% were compared through simple linear regression analysis and using the statistic software SAS Version 8.2., it was observed strong statistical evidence that the increase of transmitance value is associated to the decrease of CFU plate values, according to the mathematic model: LOG10 (CFU) = 21.012 - 0.1936*Transmitance, and p value = 0.0025 and a repeatability over 80%.(AU)

O Mycobacterium fortuitum é um agente oportunista causador de doença em humanos e animais. Além disso, é um modelo biológico para estudos experimentais em substituição ao Mycobacterium bovis, que é mais patogênico. Este estudo apresenta metodologia alternativa à contagem de unidades formadoras de colônia por mililitro de inóculo, para determinar a concentração do Mycobacterium fortuitum utilizando espectrofotometria. Utilizaram-se 14 amostras de Mycobacterium fortuitum, cultivadas em meio Lowesntein-Jensen, sendo oito delas com sete dias de cultivo e as demais entre oito e 14 dias de cultivo. Todas as amostras foram semeadas e incubadas a 37o.C por 7 dias em estufa. Fizeram-se, de cada amostra, leituras das variáveis absorbância (Abs) e transmitância (T%) em espectrofotômetro, nos comprimentos de onda de 560nm e 600nm. Comparando-se os valores obtidos de UFC, Abs e T% por meio da análise de regressão linear simples, pelo programa estatístico SAS versão 8.2, observou-se forte evidência estatística que o aumento do valor da transmitância está associado com o decréscimo do valor de UFC em placas, seguindo o modelo matemático: LOG10 (UFC) = 21.012 - 0.1936*Transmitância, com valor de p = 0,0025 e uma repetibilidade de mais de 80%.(AU)

Mycobacterium fortuitum-related lymphadenitis associated with the varicella-zoster virus.

Lymphadenitis caused by non-tuberculous mycobacteria is an uncommon manifestation in immunocompetent individuals. Here, we report a case of Mycobacterium fortuitum infection in a previously healthy 9-year-old patient who developed cervical lymphadenitis evolving to a suppurative ulcer associated with a varicella-zoster virus infection. We discuss the relationship between the varicella-zoster virus and the immune response of the host as an explanation for the unusual progression of the case.

Mycobacterium fortuitum-related lymphadenitis associated with the varicella-zoster virus

Lymphadenitis caused by non-tuberculous mycobacteria is an uncommon manifestation in immunocompetent individuals. Here, we report a case of Mycobacterium fortuitum infection in a previously healthy 9-year-old patient who developed cervical lymphadenitis evolving to a suppurative ulcer associated with a varicella-zoster virus infection. We discuss the relationship between the varicella-zoster virus and the immune response of the host as an explanation for the unusual progression of the case.

Disseminated folliculitis by Mycobacterium fortuitum in an immunocompetent woman.

Mycobacterium fortuitum is a non-tuberculous fast-growing mycobacterium which is frequently acquired from environmental sources such as soil and water. Since it is an opportunist pathogen, it is associated with trauma, surgery or immunodeficiency. The current report describes a case of Mycobacterium fortuitum-caused disseminated lesions on the skin of an immunocompetent patient.

Detection of mycobacteria in ornamental fish in Iran by culture and Ziehl-Neelsen staining methods

Background: Mycobacterial infections in fish is largely chronic to subacute in nature and affects fishes in fresh water, brackish water and salt water. In addition to their known infectivity to fishes, aquatic mycobacteria pose significant zoonotic concerns. Due to the zoonotic character of the disease, increasing importance of aquariology, and lack of any clinical signs in early steps of mycobacteriosis, present study was undertaken to analyze the distribution of mycobacteria in diseased and apparently healthy ornamental fish from some local aquarium fish shops in four different cities in Iran by culture and Ziehl-Neelsen staining. Materials, Methods & Results: One hundred and one fresh water aquarium fish of 22 species from some local shops in four cities in Iran were examined. Before decontamination, smears of homogenized samples stained with Ziehl-Neelsen. For bacterial culture, samples were inoculated on Lowenstein-Jensen medium. Culture plates were examined daily for four weeks. The rate of growth at different temperature, colony morphology and pigmentation were evaluated for species identification. Among 79 moribund fish examined, 16 individuals were positive for acid fast rods at microscopic examination. Seven fish out of 22 apparently healthy individuals also gave positive microscopic results. Using the culture method, 29 and 10 Mycobacterium isolates were obtained from moribund and healthy fish. The following Mycobacterium species were isolated from unhealthy fish: Mycobacterium fortuitum, M. marinum, and M. smegmatis. The number of different species of Mycobacterium from apparently healthy fish was: M. fortuitum (one fish), M. marinum (one fish), M. terrae (one fish) and M. flavescens (one fish). Discussion: Based on the results in both moribund and apparently healthy fish examined, culture examination showed more mycobacteria than Ziehl-Neelsen staining detection. Lower proportion of Ziehl-Neelsen positive results compared with culture method was reported in aquarium fish in Slovania. Using positive microscopic results, 13 isolates were obtained where as 29 samples gave positive culture results for mycobacteria. Similar result was also observed in clinically healthy ornamental fish and their aquarium environment. The identification of mycobacteria by Ziehl-Neelsen staining is a traditional method. However, acid-fast bacilli may not always be found through direct microscopy because the destruction of mycobacteria or their low number may sometimes happen. Culture examination is a more sensitive method than direct microscopy. However, killing of mycobacteria caused by host defense mechanisms, a low number of viable mycobacteria in the tissue, or by destruction of the mycobacteria during the preparation of the sample could result in negative cultivation results. Species of Mycobacterium identified in unhealthy fish were M. fortuitum, M. marinum and M. smegmatis. High frequency of identifying M. fortuitum and M. marinum (6 out of 7) in the samples provide more evidence that these species are common Mycobacterium species to be found in diseased aquarium fish. Numerous studies showed the common isolation of these two species from aquarium fish. M. marinum infection may be an occupational hazard for certain professionals such as pet shop workers. Many infections may also occur in fish fanciers who keep an aquarium at home. Less common than M. marinum, M. fortuitum is also capable of infecting human. In this study, the occurrence of M. marinum and M. fortuitum in both unhealthy and apparently healthy aquarium fish shows the importance of recognizing fish mycobacteriosis in order to prevent their transmission to human.

Properties of catechol 1, 2 dioxygenase in the cell free extract and immobilized extract of Mycobacterium fortuitum

Polycyclic aromatic hydrocarbons (PAH) are carcinogenic compounds which contaminate water and soil, and the enzymes can be used for bioremediation of these environments. This study aimed to evaluate some environmental conditions that affect the production and activity of the catechol 1,2-dioxygenase (C12O) by Mycobacterium fortuitum in the cell free and immobilized extract in sodium alginate. The bacterium was grown in mineral medium and LB broth containing 250 mg L-1 of anthracene (PAH). The optimum conditions of pH (4.0-9.0), temperature (5-70 ºC), reaction time (10-90 min) and the effect of ions in the enzyme activity were determined. The Mycobacterium cultivated in LB shown higher growth and the C12O activity was two-fold higher to that in the mineral medium. To both extracts the highest enzyme activity was at pH 8.0, however, the immobilized extract promoted the increase in the C12O activity in a pH range between 4.0 and 8.5. The immobilized extract increased the enzymatic activity time and showed the highest C12O activity at 45 ºC, 20 ºC higher than the greatest temperature in the cell free extract. The enzyme activity in both extracts was stimulated by Fe3+, Hg2+ and Mn2+ and inhibited by NH4+ and Cu2+, but the immobilization protected the enzyme against the deleterious effects of K+ and Mg2+ in tested concentrations. The catechol 1,2-dioxygenase of Mycobacterium fortuitum in the immobilized extract has greater stability to the variations of pH, temperature and reaction time, and show higher activity in presence of ions, comparing to the cell free extract

[Mycobacterium fortuitum: two patients and the same surgeon]. / Mycobacterium fortuitum: dos pacientes y un mismo cirujano.

We describe two cases of surgical site infections due to Mycobacterium fortuitum after plastic surgery. Both patients were assisted by the same surgeon on differents hospitals. Both patients received combined antibiotic treatment and surgical debridement or multiple aspirative punctures. The final evolutions were satisfactory.

[Breast implant infection by Mycobacterium fortuitum in a patient with systemic lupus erythematosus]. / Infección protésica mamaria por Mycobacterium fortuitum en una paciente con lupus eritematoso sistémico.

In recent decades there has been an increase in the number of breast implants for reconstruction and cosmetic purposes. Infection is a severe complication mostly caused by Staphylococcus aureus or coagulase-negative staphylococci. Mycobacteria are an infrequent cause of infection in this type of surgery. We describe a case of Mycobacterium fortuitum infection in a patient with lupus, subjected to a prosthetic replacement. These patients are more prone to unusual opportunistic infections. Treatment always requires both removal of prosthetic material and antibiotic therapy.

Infección protésica mamaria por Mycobacteriumfortuitum en una paciente con lupus eritematoso sistémico / Breast implant infection by Mycobacterium fortuitum in a patient with systemic lupus erythematosus

In recent decades there has been an increase in the number of breast implants for reconstruction and cosmetic purposes. Infection is a severe complication mostly caused by Staphylococcus aureus or coagulase-negative staphylococci. Mycobacteria are an infrequent cause of infection in this type of surgery. We describe a case of Mycobacterium fortuitum infection in a patient with lupus, subjected to a prosthetic replacement. These patients are more prone to unusual opportunistic infections. Treatment always requires both removal of prosthetic material and antibiotic therapy.

En las últimas décadas se ha producido un incremento en el número de colocaciones de implantes mamarios para reconstrucciones y fines estéticos. La infección es una complicación seria y en su mayoría es producida por Staphylococcus aureus o Staphylococcus coagulasa-negativa. Las micobacterias son una causa infrecuente de infección en este tipo de cirugías. Describimos el caso de una infección de un implante mamario por Mycobacterium fortuitum en una paciente lúpica sometida a un recambio protésico. Este tipo de pacientes es más propenso a padecer infecciones oportunistas. El tratamiento siempre requiere retiro del material asociado a antibioterapia.

Soft tissue infection due to Mycobacterium fortuitum following acupuncture: a case report and review of the literature.

We report the first case of a post-acupuncture soft tissue infection due to Mycobacterium fortuitum. Two months after finishing an acupuncture treatment session, an immunocompetent 23-year-old woman developed cellulitis at the side of the needle insertions and the acid-fast bacillus was isolated from a closed abscess. The patient was successfully treated with a proper drug combination. We review the literature concerning the infection source and the risks for skin and soft tissue infection due to mycobacteria after acupuncture. The infection source in most cases is unknown but is probably associated with the inadequate sterilization of the needles or the puncture site. We show that these infections are not rare but difficult to diagnose. To avoid delays in the definitive diagnosis, infection with mycobacteria should be considered for skin and soft tissue infections, in particular late-onset infections, which are negative for routine bacterial cultures and without a clinical response to antibiotics used for acute pyogenic infections. Bacterial cultures from this lesion should be maintained for at least six weeks before discharged as negative.