Extrapulmonary infections caused by a dominant strain of Mycobacterium massiliense (Mycobacterium abscessus subspecies bolletii)

A. Cheng, Y. C. Liu, M. L. Chen, C. C. Hung, Y. T. Tsai, W. H. Sheng, C. H. Liao, P. R. Hsueh, Y. C. Chen, S. C. Chang

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

A single strain of Mycobacterium massiliense (BRA 100), a subspecies of the Mycobacterium abscessus complex, has been responsible for an epidemic of post-surgical infections in Brazil. Outside Brazil, this is the first report to describe a single emerging strain of M. massiliense (TPE 101) associated with extrapulmonary infections. This phenomenon may be underestimated because sophisticated molecular typing of M. abscessus is not routinely performed. Our molecular epidemiology study was triggered by an outbreak investigation. Nine case isolates were grown from the surgical sites of nine mostly paediatric patients receiving operations from 2010 to 2011. All available non-duplicated isolates of M. abscessus during this period were obtained for comparison. Mycobacteria were characterized by multilocus sequence analysis (MLSA), repetitive sequence PCR (rep-PCR) and pulsed-field gel electrophoresis (PFGE). Of 58 isolates of M. abscessus overall, 56 were clinical isolates. MLSA identified 36 of the isolates as M. massiliense. All case isolates were indistinguishable by PFGE and named the TPE 101 pulsotype. Of the stored strains of M. abscessus, TPE 101 strains were over-represented among the control surgical wound (7/7, 100%) and subcutaneous tissue isolates (4/5, 80%) but rare among the respiratory isolates (1/16, 6%) and absent from external skin, ocular and environmental samples. In conclusion, a unique strain of M. massiliense has emerged as a distinctive pathogen causing soft tissue infections in Taiwan. Further study to identify whether this is due to an occult common source or to specific virulence factors dictating tissue tropism is warranted.

Original languageEnglish
JournalClinical Microbiology and Infection
Volume19
Issue number10
DOIs
Publication statusPublished - Oct 2013
Externally publishedYes

Fingerprint

Mycobacterium
Multilocus Sequence Typing
Pulsed Field Gel Electrophoresis
Brazil
Infection
Molecular Typing
Soft Tissue Infections
Tropism
Molecular Epidemiology
Nucleic Acid Repetitive Sequences
Subcutaneous Tissue
Virulence Factors
Taiwan
Disease Outbreaks
Pediatrics
Polymerase Chain Reaction
Skin

Keywords

  • DiversiLab
  • Mycobacterium abscessus
  • Mycobacterium bolletii
  • Mycobacterium massiliense
  • PFGE
  • Rep-PCR

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Extrapulmonary infections caused by a dominant strain of Mycobacterium massiliense (Mycobacterium abscessus subspecies bolletii). / Cheng, A.; Liu, Y. C.; Chen, M. L.; Hung, C. C.; Tsai, Y. T.; Sheng, W. H.; Liao, C. H.; Hsueh, P. R.; Chen, Y. C.; Chang, S. C.

In: Clinical Microbiology and Infection, Vol. 19, No. 10, 10.2013.

Research output: Contribution to journalArticle

Cheng, A. ; Liu, Y. C. ; Chen, M. L. ; Hung, C. C. ; Tsai, Y. T. ; Sheng, W. H. ; Liao, C. H. ; Hsueh, P. R. ; Chen, Y. C. ; Chang, S. C. / Extrapulmonary infections caused by a dominant strain of Mycobacterium massiliense (Mycobacterium abscessus subspecies bolletii). In: Clinical Microbiology and Infection. 2013 ; Vol. 19, No. 10.
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abstract = "A single strain of Mycobacterium massiliense (BRA 100), a subspecies of the Mycobacterium abscessus complex, has been responsible for an epidemic of post-surgical infections in Brazil. Outside Brazil, this is the first report to describe a single emerging strain of M. massiliense (TPE 101) associated with extrapulmonary infections. This phenomenon may be underestimated because sophisticated molecular typing of M. abscessus is not routinely performed. Our molecular epidemiology study was triggered by an outbreak investigation. Nine case isolates were grown from the surgical sites of nine mostly paediatric patients receiving operations from 2010 to 2011. All available non-duplicated isolates of M. abscessus during this period were obtained for comparison. Mycobacteria were characterized by multilocus sequence analysis (MLSA), repetitive sequence PCR (rep-PCR) and pulsed-field gel electrophoresis (PFGE). Of 58 isolates of M. abscessus overall, 56 were clinical isolates. MLSA identified 36 of the isolates as M. massiliense. All case isolates were indistinguishable by PFGE and named the TPE 101 pulsotype. Of the stored strains of M. abscessus, TPE 101 strains were over-represented among the control surgical wound (7/7, 100{\%}) and subcutaneous tissue isolates (4/5, 80{\%}) but rare among the respiratory isolates (1/16, 6{\%}) and absent from external skin, ocular and environmental samples. In conclusion, a unique strain of M. massiliense has emerged as a distinctive pathogen causing soft tissue infections in Taiwan. Further study to identify whether this is due to an occult common source or to specific virulence factors dictating tissue tropism is warranted.",
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