Familial cluster of cutaneous Mycobacterium avium infection resulting from use of a circulating, constantly heated bath water system

Sugita, Yasuyuki; Ishii, Norihisa; Katsuno, Masako; Yamada, Roppei; Nakajima, Hiroshi

doi:10.1046/j.1365-2133.2000.03428.x

Cited by 44 publications

(30 citation statements)

References 26 publications

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“…MAC has been shown to present as pulmonary infections in immunocompetent patients including elderly women and smokers, as well as immunocompromised individuals who have undergone organ transplantation or with inheritable defects in IFN-␥ (10,14). Cutaneous manifestations of MAC in immunocompetent individuals also occur, especially in children (15,16). All of these manifestations of MAC have in common infiltration by mononuclear cells and granuloma formation.…”

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confidence: 99%

Mycobacterium aviumInfection and Modulation of Human Macrophage Gene Expression

Greenwell-Wild

Vázquez

Sim

et al. 2002

The Journal of Immunology

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Mycobacterium avium is a facultative intracellular pathogen cleared rapidly via intact host defense mechanisms. In the absence of adequate T cell function, as occurs in HIV-1-induced immunodeficiency, M. avium becomes an opportunistic infection with uncontrolled replication and reinfection of macrophage hosts. How M. avium infects, survives, and replicates in macrophages without signaling an effective microbicidal counterattack is unresolved. To address whether M. avium signals the expression of molecules, which influence mycobacterial survival or clearance, human monocyte-derived macrophage cultures were exposed to M. avium. Within minutes, M. avium, or its cell wall lipoarabinomannan, binds to the adherent macrophages and induces a spectrum of gene expression. In this innate response, the most abundant genes detected within 2 h by cDNA expression array involved proinflammatory chemokines, cytokines including TNF-α and IL-1, and adhesion molecules. Associated with this rapid initial up-regulation of recruitment and amplification molecules was enhanced expression of transcription factors and signaling molecules. By 24 h, this proinflammatory response subsided, and after 4 days, when some bacteria were being degraded, others escaped destruction to replicate within intracellular vacuoles. Under these conditions, inducible NO synthase was not up-regulated and increased transferrin receptors may facilitate iron-dependent mycobacterial growth. Sustained adhesion molecule and chemokine expression along with the formation of multinucleated giant cells appeared consistent with in vivo events. Thus, in the absence of T lymphocyte mediators, macrophages are insufficiently microbicidal and provide a nonhostile environment in which mycobacteria not only survive and replicate, but continue to promote recruitment of new macrophages to perpetuate the infection.

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confidence: 99%

Mycobacterium aviumInfection and Modulation of Human Macrophage Gene Expression

Greenwell-Wild

Vázquez

Sim

et al. 2002

The Journal of Immunology

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“…M. avium is an ubiquitous organism found in drinking water systems worldwide (2,6,12,43,58), and it has been detected in biofilms (12). Different warm water systems, such as hot tubs, circulating bath systems, and hospital water systems, have been recognized as potential sources of diseases caused by M. avium (32,33,51,57). There are few reports on the association between M. avium and drinking water (2).…”

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confidence: 99%

Survival of Mycobacterium avium in Drinking Water Biofilms as Affected by Water Flow Velocity, Availability of Phosphorus, and Temperature

Torvinen¹,

Lehtola²,

Martikainen

et al. 2007

Appl Environ Microbiol

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Mycobacterium avium is a potential pathogen occurring in drinking water systems. It is a slowly growing bacterium producing a thick cell wall containing mycolic acids, and it is known to resist chlorine better than many other microbes. Several studies have shown that pathogenic bacteria survive better in biofilms than in water. By using Propella biofilm reactors, we studied how factors generally influencing the growth of biofilms (flow rate, phosphorus concentration, and temperature) influence the survival of M. avium in drinking water biofilms. The growth of biofilms was followed by culture and DAPI (4,6-diamidino-2-phenylindole) staining, and concentrations of M. avium were determined by culture and fluorescence in situ hybridization methods. The spiked M. avium survived in biofilms for the 4-week study period without a dramatic decline in concentration. The addition of phosphorus (10 g/liter) increased the number of heterotrophic bacteria in biofilms but decreased the culturability of M. avium. The reason for this result is probably that phosphorus increased competition with other microbes. An increase in flow velocity had no effect on the survival of M. avium, although it increased the growth of biofilms. A higher temperature (20°C versus 7°C) increased both the number of heterotrophic bacteria and the survival of M. avium in biofilms. In conclusion, the results show that in terms of affecting the survival of slowly growing M. avium in biofilms, temperature is a more important factor than the availability of nutrients like phosphorus.

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“…(17,18). Infections cause by nontuberculous mycobacteria associated with bath water have also been reported (11,12,19,20). In the present study, we investigated the presence or inhabitation of Legionella spp.…”

Section: Introductionmentioning

confidence: 99%

“…have been documented worldwide to date (3)(4)(5)(6)(7)(8). In Japan, several outbreaks caused by L. pneumophila associated with bath water in hot springs or public bathhouses (9,10), as well as nontuberculous mycobacteria associated with bath water in 24-hour home baths and public bathhouses (11,12), have been documented.…”

Section: Introductionmentioning

confidence: 99%