A novel duplex PCR method based on variable-number tandem-repeat targets to discriminate among Mycobacterium abscessus complex isolates was developed and evaluated in 85 clinical isolates. The assay accuracy was confirmed by a multiple-target sequence analysis. The duplex PCR assay is a one-step, reliable, and accurate assay for discriminating M. abscessus species.Mycobacterium abscessus belongs to a group of rapidly growing mycobacteria (RGM) that cause a wide spectrum of infections in humans (6,17). Recently, M. abscessus complex was divided into three closely related Mycobacterium species: M. abscessus (sensu stricto) (hereafter referred to as M. abscessus), M. massiliense, and M. bolletii (1, 4).M. abscessus is the most drug-resistant mycobacterial species known and exhibits unsatisfactory treatment response rates, especially for patients with pulmonary disease (6, 17). Inducible resistance of M. abscessus to clarithromycin has been suggested as an explanation for the lack of efficacy of clarithromycin-based treatments against the bacterium (14). In contrast, M. massiliense shows marked susceptibility to clarithromycin due to the absence of inducible resistance to macrolides (8). Therefore, treatment response rates to clarithromycin-based antibiotic therapy are higher in patients with M. massiliense than in those with M. abscessus lung disease (10). M. bolletii, a rare pathogen at present, has also been shown to be highly resistant to clarithromycin (3, 9, 11).Since recent studies suggest that antibiotic susceptibility and treatment outcomes differ significantly among these species, the species-level identification of M. abscessus complex isolates has been strongly recommended in order to determine the clinical significance and to assist in managing patients (8,10).Despite progress in our ability to identify mycobacterial species using molecular methods, M. abscessus complex isolates cannot be reliably identified at the species level by sequencing a single genetic locus such as rpoB or hsp65 (13). Currently, the species-level identification of M. abscessus complex solely depends on multiple sequencing analysis targeting several genes, including rpoB, hsp65, gnd, glpK, secA, and sodA (2, 13, 15). This process requires a number of additional, laborious steps (e.g., cloning) to obtain the sequences of the products, leading to expensive and complicated procedures that must be done in reference laboratories.Increasingly, variable-number tandem-repeat (VNTR) analyses have been used for the molecular typing of isolated mycobacterial strains as well as for mycobacterial species identification (7, 16). In this study, a novel duplex PCR method based on variable-number tandem-repeat targets to discriminate among Mycobacterium abscessus complex isolates was developed and evaluated in 85 clinical isolates.A total of 85 clinical isolates were collected between