Mycobacterium neoaurum and Mycobacterium bacteremicum sp. nov. as causes of mycobacteremia.

Reference isolates of Mycobacterium neoaurum, Mycobacterium aurum, and the nonvalidated species "Mycobacterium lacticola" were the focus of two recent molecular taxonomic studies. On the basis of this grouping, we identified 46 clinical pigmented, rapidly growing mycobacterial isolates. By 16S rRNA gene sequencing, only two major taxa were identified: M. neoaurum and a previously uncharacterized "M. neoaurum-like" group. The M. neoaurum-like group exhibited only 99.7% identity to M. neoaurum by 16S rRNA gene sequencing and 96.5% identity to M. neoaurum by rpoB sequencing and was named M. bacteremicum. No clinical isolates of M. aurum or M. lacticola were identified. Of isolates with known sources, 4/8 (50%) of M. bacteremicum isolates and 22/34 (65%) of M. neoaurum isolates were recovered from blood, and 35% of these were known to be from patients with catheter-related sepsis. MIC and clinical data on these 46 isolates of M. neoaurum and M. bacteremicum along with a review of 16 previously reported cases of infection with the M. neoaurum-M. lacticola group demonstrated that the isolates were highly susceptible to all drugs tested except clarithromycin, and most clinical cases were successfully treated. The clarithromycin resistance suggested the presence of an inducible erm gene reported in other species of rapidly growing mycobacteria. Sequencing studies are currently required to identify these two species. Strain ATCC 25791 (originally submitted as an example of Mycobacterium aurum) is proposed to be the type strain of M. bacteremicum.

Exercise following organ transplantation: A critical part of the routine post transplant care.

There are many reasons for recommendation of regular physical activity for organ transplant recipients, including 1) Restoration of physical functioning following deconditioning experienced prior to transplant; 2) Most patients are physically inactivity, 3) The high prevalence of cardiovascular risk factors that may be modified by regular physical activity; 4) Physical activity will optimize physical functioning following transplant; and 5) p; hysical activity may reduce or attenuate side effects of immunosuppression. There are many recommendations for regular physical activity as an integral part of treatment of conditions that are common to transplant recipients, including: hypertension management; hyperlipidemia; Diabetes; and elevated cardiovascular disease risk. Transplant recipients tolerate progressive exercise training well and can achieve levels of functioning similar or higher than normal individuals. In order to optimize functioning and overall health in organ transplant recipients, regular physical activity should be prescribed and encouraged as a part of the routine post transplant care.