The potential misidentification of Tsukamurella pulmonis as an atypical Mycobacterium species: a cautionary tale

Stanley, T. H.; Crothers, L.; McCalmont, Mark; Xu, Jianguo; Millar, B. Cherie; Goldsmith, Colin E.; Moore, John E.

doi:10.1099/jmm.0.46355-0

Cited by 25 publications

(13 citation statements)

References 2 publications

(3 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To ascertain the importance of Tsukamurella species as a cause of keratitis as well as whether the inflammation of most cases of Tsukamurella keratitis appear near the limbus, diphtheroidal grampositive rods recovered from corneal scrapings should be subjected to detailed phenotypic characterization and 16S rRNA gene sequencing. In fact, cases of Tsukamurella keratitis and conjunctivitis have probably been overlooked in the past because the diphtheroidal gram-positive rods recovered from corneal scrapings and eye swabs were either regarded as contaminants or misidentified as other bacteria, such as atypical mycobacteria (20).…”

mentioning

confidence: 99%

First Report of Tsukamurella Keratitis: Association between T. tyrosinosolvens and T. pulmonis and Ophthalmologic Infections

et al. 2009

View full text Add to dashboard Cite

We describe the first two cases of Tsukamurella keratitis, presented as eye pain with or without blurring of vision. One case was associated with trichiasis and the other with contact lens wear. The two isolates were identified as T. tyrosinosolvens and T. pulmonis, respectively, by phenotypic characterization and 16S rRNA sequencing. Case 2. A 25-year-old Chinese man with an unremarkable past medical history presented with left eye redness and pain in August 2008. He had a long history of contact lens wear with long daily duration of wear, usually more than 16 h per day. Examination of the left eye showed 360°vascular ingrowth at the corneal periphery and a 1.5-mm abscess at the inferonasal quadrant of the cornea near the limbus. There was mild anterior chamber reaction. No hypopyon was noted. Culture of corneal scrapings recovered a gram-positive bacillus and Serratia species. Cultures of swabs from the patient's contact lens case and of the contact lens solution recovered Serratia species and Pseudomonas species. The patient was treated with 0.5% levofloxacin ophthalmic drops and ofloxacin ointment for 3 weeks, and 0.3% gentamicin ophthalmic drops were added after 1 week in view of the contact lens case and solution culture results. The corneal abscess and anterior chamber reaction subsequently resolved, leaving a 1.5-mm corneal scar.Microbiological data. All clinical data were collected prospectively. Clinical specimens were collected and handled according to standard protocols (12). All suspect colonies were identified by standard conventional biochemical methods (12). Biochemical reactions in the API 20C AUX and API 50 CH systems (bioMérieux, Lyon, France) were also used for identifying the two strains of gram-positive bacilli, with Tsukamurella pulmonis and Tsukamurella tyrosinosolvens used as controls, as we previously described (24). On day 2 postincubation, a gram-positive aerobic nonsporulating bacillus was recovered from the cultures of the corneal scrapings from both patients. Both isolates were acid fast according to a modified acid-fast stain. Both isolates grew on blood agar as yellow, rough, irregular, dry, but easily emulsified, 2-mm diameter colonies after 48 h of incubation at 37°C in an aerobic environment with 5% CO 2 . For comparisons with those of other Tsukamurella species, the major phenotypic characteristics of the two isolates are summarized in Table 1. The phenotypic characteristics of the isolate recovered from patient 1 best fit the phenotypic profile of T. tyrosinosolvens, whereas those of the isolate recovered from patient 2 best fit that of T. pulmonis.16S rRNA gene sequencing. Bacterial DNA extraction, PCR amplification, and DNA sequencing of the 16S rRNA genes of the two isolates of gram-positive bacilli were performed according to our previous publication, using LPW3606 5Ј-TAC TTCGGGATAAGCCTG-3Ј and LPW3607 5Ј-ACGACTTCG TCCCAATCG-3Ј (Gibco BRL, Rockville, MD) as the PCR and sequencing primers (24). The sequences of the PCR products were compared with sequences of closely rela...

show abstract

mentioning

confidence: 99%

First Report of Tsukamurella Keratitis: Association between T. tyrosinosolvens and T. pulmonis and Ophthalmologic Infections

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Tsukamurella spp. have been isolated from activated sludge foams (12,31), arthropods (44), and soil (18) and more recently in opportunistic clinical infections (23,43). Although Tsukamurella spp.…”

mentioning

confidence: 99%

Genome Sequence and Characterization of the Tsukamurella Bacteriophage TPA2

Petrovski

Seviour

Tillett

2011

Appl Environ Microbiol

View full text Add to dashboard Cite

The formation of stable foam in activated sludge plants is a global problem for which control is difficult. These foams are often stabilized by hydrophobic mycolic acid-synthesizing Actinobacteria, among which are Tsukamurella spp. This paper describes the isolation from activated sludge of the novel double-stranded DNA phage TPA2. This polyvalent Siphoviridae family phage is lytic for most Tsukamurella species. Whole-genome sequencing reveals that the TPA2 genome is circularly permuted (61,440 bp) and that 70% of its sequence is novel. We have identified 78 putative open reading frames, 95 pairs of inverted repeats, and 6 palindromes. The TPA2 genome has a modular gene structure that shares some similarity to those of Mycobacterium phages. A number of the genes display a mosaic architecture, suggesting that the TPA2 genome has evolved at least in part from genetic recombination events. The genome sequence reveals many novel genes that should inform any future discussion on Tsukamurella phage evolution.A common problem in activated sludge systems is the formation of stable foams on the aerated reactor, leading to major environmental, operational, cosmetic, and health problems (12,41,42). These foams are typically stabilized by members of the mycolic acid-containing Actinobacteria (the Mycolata), although other hydrophobic filamentous bacteria, including "Candidatus Microthrix parvicella," are also important (12,24,39). One potentially attractive approach for controlling such foaming events is the use of lytic bacteriophages targeting the problematic foam-stabilizing populations (46, 48). Similar "phage therapy" strategies have been proposed to treat infectious diseases (6) and decrease bacterial contaminants in food (50). Furthermore, Thomas et al. (46) showed that Mycolata lytic bacteriophages could be isolated readily from activated sludge, making the development of a phage-based foam control approach an environmentally safe and attractive option for this worldwide operational problem.Tsukamurella is in the suborder Corynebacterineae, and on the basis of its mycolic acid-containing hydrophobic cell surface it has been categorized as a Mycolata (18). Tsukamurella spp. have been isolated from activated sludge foams (12, 31), arthropods (44), and soil (18) and more recently in opportunistic clinical infections (23, 43). Although Tsukamurella spp. are a problem in environmental and medical contexts, little attention has been directed toward the isolation and characterization of bacteriophages specific for members of this genus. To our knowledge, only one partially characterized Tsukamurella phage (TPA1, targeting T. paurometabola) has been reported in the literature (46). With the aim of developing a biocontrol approach to manage foaming within activated sludge systems, we have sought to isolate and characterize new lytic phages for members of this genus.More fundamentally, the ecological role of bacteriophages in activated sludge communities has received relatively little attention. This is surprising given the ...

show abstract

“…The underreporting of Tsukamurella spp. resulted from the similarity of this genus to other more common pathogens expected in immunocompromised patients, such as Mycobacterium (Stanley et al 2006). The culture-medium morphology, slow growth, and weak acid-alcohol-fastness characteristics of Tsukamurella , will cause misdiagnoses of Corynebacterium, Rhodococcus, Nocardia, Gordonia , or Mycobacterium species infections.…”

Section: Discussionmentioning

confidence: 99%

Tsukamurella tyrosinosolvens bacteremia with coinfection of Mycobacterium bovis pneumonia: case report and literature review

2016

View full text Add to dashboard Cite

IntroductionWe describe an immunocompromised patient with Tsukamurella tyrosinosolvens bacteremia and coinfection of Mycobacterium bovis pneumonia.Case DescriptionA 75-year-old male was admitted to our hospital complaining of persistent fever with general malaise. His medical history showed that he had diabetes mellitus (HbA1C 9.2%). A chest computed tomography (CT) showed left upper lung consolidation . Two sets of blood culture at admission finally showed Tsukamurella tyrosinosolvens. Moreover, three transbronchoscopy washing specimen cultures revealed Mycobacterium bovis.Discussion and EvaluationThe organism Tsukamurella tyrosinosolvens was identified using conventional biochemical identification methods, PCR-restriction DNA fragment analysis, and 16S rRNA gene sequencing. The clinical mycobacterial isolates were identified to the species level by combining Polymerase Chain Reaction (PCR) with an oligonucleotide microarray to detect the M. bovis amplicons.ConclusionAccording to our literature review, our patient’s case was the first of a coinfection with Tsukamurella tyrosinosolvens and Mycobacterium bovis. Prolonged antibiotic treatment and underlying disease control are necessary for this type of patient.

show abstract

The potential misidentification of Tsukamurella pulmonis as an atypical Mycobacterium species: a cautionary tale

Cited by 25 publications

References 2 publications

First Report of Tsukamurella Keratitis: Association between T. tyrosinosolvens and T. pulmonis and Ophthalmologic Infections

First Report of Tsukamurella Keratitis: Association between T. tyrosinosolvens and T. pulmonis and Ophthalmologic Infections

Genome Sequence and Characterization of the Tsukamurella Bacteriophage TPA2

Tsukamurella tyrosinosolvens bacteremia with coinfection of Mycobacterium bovis pneumonia: case report and literature review

Contact Info

Product

Resources

About