Mycobacterium celatum infection in two HIV-infected patients treated prophylactically with rifabutin

Gholizadeh, Y.; Varnerot, A.; Maslo, Caroline; Salauze, B.; Badaoui, H.; Vincent, Véronique; Buré-Rossier, Anne

doi:10.1007/bf01699987

Cited by 17 publications

(10 citation statements)

References 14 publications

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“…Numerous clinically significant isolations have been reported in AIDS patients, presenting as disseminated infection in 10 patients (7,37,48,105,151,178), limited to the lungs in 5 cases (48), and exclusively extrapulmonary in one case of penile infection (29). In contrast, in nonimmunocompromised patients, only one case of fatal pulmonary disease in an elderly woman (21) and one of childhood lymphadenopathy (G. Haase, H. Skopnik, S. Bätge, and E. C. Böttger, Letter, Lancet 344:1020-1021, 1994) have been reported.…”

Section: Abscessusmentioning

confidence: 99%

Impact of Genotypic Studies on Mycobacterial Taxonomy: the New Mycobacteria of the 1990s

2003

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The advancement of genetic techniques has greatly boosted taxonomic studies in recent years. Within the genus Mycobacterium, 42 new species have been detected since 1990, most of which were grown from clinical samples. Along with species for which relatively large numbers of strains have been reported, some of the new species of mycobacteria have been detected rarely or even only once. From the phenotypic point of view, among the new taxa, chromogens exceed nonchromogens while the numbers of slowly and rapidly growing species are equivalent. Whereas conventional identification tests were usually inconclusive, an important role was played by lipid analyses and in particular by high-performance liquid chromatography. Genotypic investigations based on sequencing of 16S rRNA gene have certainly made the most important contribution. The investigation of genetic relatedness led to the redistribution of the species previously included in the classically known categories of slow and rapid growers into new groupings. Within slow growers, the intermediate branch related to Mycobacterium simiae and the cluster of organisms related to Mycobacterium terrae have been differentiated; among rapid growers, the group of thermotolerant mycobacteria has emerged. The majority of species are resistant to isoniazid and, to a lesser extent, to rifampin. Many of the new species of mycobacteria are potentially pathogenic, and there are numerous reports of their involvement in diseases. Apart from disseminated and localized diseases in immunocompromised patients, the most frequent infections in immunocompetent people involve the lungs, skin, and, in children, cervical lymph nodes. The awareness of such new mycobacteria, far from being a merely speculative exercise, is therefore important for clinicians and microbiologists

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Section: Abscessusmentioning

confidence: 99%

Impact of Genotypic Studies on Mycobacterial Taxonomy: the New Mycobacteria of the 1990s

2003

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confidence: 99%

“…The complete resistance to rifampin and the full susceptibility to rifabutin are typical. However, the resistance to ciprofloxacin is unusual (1,3,6,8,11).…”

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confidence: 99%

Misidentification and Diagnostic Delay Caused by a False-Positive Amplified Mycobacterium tuberculosis Direct Test in an Immunocompetent Patient with a Mycobacterium celatum Infection

Tjhie¹,

Belle

Dessens-Kroon

et al. 2001

J Clin Microbiol

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The Gen-Probe amplified Mycobacterium tuberculosis direct test can give discrepant results directly in respiratory or cultured samples from patients infected with Mycobacterium celatum, leading to inappropriate therapy for, in our case, an immunocompetent patient.Mycobacterium celatum was first described in 1993 (3), and since then, sporadic reports have been published on the isolation of this mycobacterium from immunocompromised patients (1,5,6,8,11,12 1994), and a fatal pulmonary infection in an apparently healthy adult (4). Biochemically, the organism is indistinguishable from the Mycobacterium avium complex, and mycolic acid high-pressure liquid chromatography analysis or genetic analysis is required for proper identification (3). For identification, cross-reactivity with nontuberculous mycobacteria has been described with the AccuProbe culture confirmation test (Gen-Probe, San Diego, Calif.) for the M. tuberculosis complex (2, 10). This note describes the initial misidentification and interpretation of a positive amplified M. tuberculosis direct (AMTD) test (GenProbe) result for a respiratory sample derived from an immunocompetent patient with an M. celatum infection.A 61-year-old man was referred on 5 March 1999 by a general practitioner to the outpatient respiratory disease clinic because of general malaise, a productive cough, and an unexplained 16-kg weight loss in the past 3 years. The chest radiograph showed a pulmonary infiltrate in the right upper lobe, with extensive cavities identified by computed tomography. A bronchial lavage was performed and showed on average more than one acid-fast rod per high-power field (magnification, ϫ1,000. The AMTD test was positive with a value of 1,000,000 relative light units (RLU). Tuberculostatic drug therapy was started with 300 mg of isoniazid, 600 mg of rifampin, and 2,000 mg of pyrazinamide. Liquid culture (MB/BacT; Organon Teknika, Boxtel, The Netherlands) was positive on 25 March 1999 and was subcultured on Löwenstein Jensen agar. The subculture grew very small smooth colonies with a pale yellow pigment and was sent to the Mycobacterium section of the National Institute of Public Health and the Environment (RIVM, Bilthoven, The Netherlands) for drug susceptibility testing by the agar proportion method and species identification. The AccuProbe culture confirmation tests for M. tuberculosis, M. avium complex, Mycobacterium kansasii, and Mycobacterium gordonae were negative. Because of the discrepancy between the AMTD test as performed by the Medical Microbiology department at the University Hospital Maastricht and the AccuProbe results of the RIVM, a culture was sent again to the RIVM. This material again yielded a positive result (509,094 RLU) in the AMTD test in Maastricht and again yielded a negative result in the AccuProbe test at the RIVM. Therefore, it was concluded that the AMTD result was probably a false positive. Drug susceptibility data were only obtained on 26 June 1999 (Table 1) because of the slow growth and the initial suspicion that we were de...

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“…The infections caused by this organism were reported to occur mostly in persons with suppressed cell-mediated immunity, such as AIDS patients (Piersimoni et al, 1994(Piersimoni et al, , 1997Gholizadeh et al, 1998 ;Bonomo et al, 1998 ;Bull et al, 1995 ;Zurawski et al, 1997), but infections also occurred in apparently immunocompetent hosts (BuxGewehr et al, 1998). Drug susceptibility testing showed that this organism was resistant to rifampicin (RMP), isoniazid (INH) and pyrazinamide (Butler et al, 1993), so that regimens similar to those administered in MAC- Abbreviations : AMI, amikacin ; AZI, azithromycin ; CIP, ciprofloxacin ; CLA, clarithromycin ; CLO, clofazimine ; EMB, ethambutol ; INH, isoniazid ; i.p., intraperitoneally ; MAC, Mycobacterium avium-intracellulare complex ; RFB, rifabutin ; RMP, rifampicin ; SO, smooth opaque ; SPA, sparfloxacin ; ST, smooth transparent.…”

Section: Introductionmentioning

confidence: 99%

“…Drug susceptibility testing showed that this organism was resistant to rifampicin (RMP), isoniazid (INH) and pyrazinamide (Butler et al, 1993), so that regimens similar to those administered in MAC- Abbreviations : AMI, amikacin ; AZI, azithromycin ; CIP, ciprofloxacin ; CLA, clarithromycin ; CLO, clofazimine ; EMB, ethambutol ; INH, isoniazid ; i.p., intraperitoneally ; MAC, Mycobacterium avium-intracellulare complex ; RFB, rifabutin ; RMP, rifampicin ; SO, smooth opaque ; SPA, sparfloxacin ; ST, smooth transparent. infected patients were usually used for the treatment of M. celatum infections (Piersimoni et al, 1997 ;Gholizadeh et al, 1998 ;Bonomo et al, 1998 ;Bull et al, 1995 ;Tortoli et al, 1995 ;Zurawski et al, 1997). …”

Section: Introductionmentioning

confidence: 99%

Virulence and drug susceptibility of Mycobacterium celatum

Fattorini

Baldassarri

et al. 2000

Microbiology

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The virulence and drug susceptibility of a clinical isolate of Mycobacterium celatum which showed smooth transparent (ST) and smooth opaque (SO) colonies were studied. While ST cells multiplied intracellularly and maintained their coccobacillary form in a human macrophage model of infection, SO cells formed long filaments and completely destroyed the phagocytes. In BALB/c mice, the ST variant, but not the SO variant, grew efficiently in the spleen, liver and lung. The ST variant was usually more resistant in vitro than the SO variant to drugs, with MIC values for clarithromycin (CLA), azithromycin (AZI), ciprofloxacin, sparfloxacin, amikacin, clofazimine, ethambutol and isoniazid being higher than those of the SO variant. In beige mice infected with the more highly virulent variant ST, CLA and AZI were the most active drugs in terms of viable count reduction in organs and mutant selection. Together, these observations indicate that the ST variant of M. celatum is a virulent form that can be efficiently inhibited in vivo by CLA and AZI.

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Mycobacterium celatum infection in two HIV-infected patients treated prophylactically with rifabutin

Cited by 17 publications

References 14 publications

Impact of Genotypic Studies on Mycobacterial Taxonomy: the New Mycobacteria of the 1990s

Impact of Genotypic Studies on Mycobacterial Taxonomy: the New Mycobacteria of the 1990s

Misidentification and Diagnostic Delay Caused by a False-Positive Amplified Mycobacterium tuberculosis Direct Test in an Immunocompetent Patient with a Mycobacterium celatum Infection

Virulence and drug susceptibility of Mycobacterium celatum

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