|Year : 2017 | Volume
| Issue : 1 | Page : 14-18
Recent methods for diagnosis of nontuberculous mycobacteria infections: Relevance in clinical practice
Anand Kumar Maurya1, Vijaya Lakshmi Nag1, Surya Kant2, Anuradha Sharma1, Ravi Shekhar Gadepalli1, Ram Awadh Singh Kushwaha2
1 Department of Microbiology, All Institute of Medical Sciences, Jodhpur, Rajasthan, India
2 Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
|Date of Web Publication||24-Jul-2017|
Anand Kumar Maurya
Department of Microbiology, All India Institute of Medical Sciences, Jodhpur - 342 005, Rajasthan
Source of Support: None, Conflict of Interest: None
Nontuberculous mycobacteria (NTM) infections are ever more important in recent years for leading causes of morbidity and mortality worldwide. Clinical appearance of Mycobacterium tuberculosis (TB) complex and NTM is same, but the treatment regimen is always different. NTM is challenging for both diagnostic and therapeutic with reason that it mimic pathological, microbiological, immunological, and radiological findings of TB. Newer molecular diagnostic methods allow for a better identification of NTM infections in patients not responding to antitubercular treatment and falsely categorized as drug-resistant TB. This article will explore the recent methods for the diagnosis and identification of NTM infections in clinical practice. In the future, the molecular-based diagnosis will significantly reduce the turnaround time of the diagnosis and thereby improving patient outcome.
Keywords: Biomarkers, Mycobacterium tuberculosis complex, nontuberculous mycobacteria, tuberculosis
|How to cite this article:|
Maurya AK, Nag VL, Kant S, Sharma A, Gadepalli RS, Kushwaha RA. Recent methods for diagnosis of nontuberculous mycobacteria infections: Relevance in clinical practice. Biomed Biotechnol Res J 2017;1:14-8
|How to cite this URL:|
Maurya AK, Nag VL, Kant S, Sharma A, Gadepalli RS, Kushwaha RA. Recent methods for diagnosis of nontuberculous mycobacteria infections: Relevance in clinical practice. Biomed Biotechnol Res J [serial online] 2017 [cited 2019 Jul 16];1:14-8. Available from: http://www.bmbtrj.org/text.asp?2017/1/1/14/211406
| Introduction|| |
Tuberculosis (TB) is most important infectious diseases cause of death worldwide. Nontuberculous mycobacteria (NTM) another name as mycobacteria other than TB are acid-fast bacilli, but they are also differ from Mycobacterium TB complex (MTBC). These mycobacteria are widely present in our environment, and they are found in natural recourses of water, biofilm, damp walls, and also found in tap water. NTM is lacking the evidence of human to human transmission, but it infects to human from environmental sources.
Mycobacterium avium complex was reported as the most frequently isolates in all these countries, including India as per the International Union against TB and Lung Diseases reports. Mycobacterium fortuitum was the most frequently reported in Belgium (2.1%), Italy (2.5%), Denmark (5.3%), United Kingdom (6.0%), France (6.5%), Finland (6.7%), Spain (10.8%), Germany (12.2%), Portugal (16.5%), Czech Republic (17.5%), Switzerland (17.5%), and Turkey (33.9%). The study suggested that environment is the main source of NTM infection, and reported prevalence in worldwide with varying frequencies,,,,, isolation rates were between 0.7% and 34% in India.,
NTM treatment are different according to the species involvement, disease site, and susceptibility pattern. Clinical appearance and progresses are often slow in NTM infection. Population-based studies data showed that NTM disease is increasing in the United States., American Thoracic Society and Infectious Diseases Society of America were working together to develop recommended guidelines for NTM disease., Studies reported from USA region showed that NTM lung disease is most commonly due to M. avium complex and Mycobacterium kansasii being second. M. kansasii is the pathogen most commonly seen in in England and Wales, whereas M. malmoense is the most commonly in Scotland. Mycobacterium xenopi is common in Southeast England. M. avium complex and M. kansasii are also most common in Japan. NTM prevalence reported from India, 17.4% of fibrocavitary disease and 7.4% of other clinical specimens among M. fortuitum. The most frequently NTM species isolated from Delhi and Kasauli was M. avium intracellulare (8.6%) from sputum specimens.,,,,
| Laboratory Diagnostics of Nontuberculous Mycobacteria|| |
Laboratory methods are important role in the NTM diagnosis as well as monitoring of treatment and prevention.
Various staining methods are available for staining as Ziehl-Neelsen (ZN) stain and modified Kinyoun stain are indicate the presence of mycobacteria. Corbol fuschin is generally used in modified Kinyoun and ZN stain and is directly visible by light microscopy. Fluorescence microscopy uses auramine and rhodamine which both fluoresces at short wavelength. Studies reported that sensitivity rates of the ZN and auramine stain are higher than Kinyoun stain,, but when compared to culture, it is only 60% and 90%.,, In histopathological examinations, the sensitivity of fluorescence microscopy and ZN staining is low due to negatively influence by formalin fixation., On the basis of staining, it is not very easy to discriminate between MTBC and NTM. Smear sensitivity is lower in extra-pulmonary TB patients, and persons with the disease due to NTM Infection. However, it is very clear that ZN microscopy is an important method to the detection of mycobacteria, but it unable to help in identification of NTM, and should be pursued by culture.
Lowenstein-Jensen (LJ) is conventional and an excellent medium for the growth of Mycobacterium tuberculosis, but are generally inferior to Middlebrook agar as an all-purpose medium for both M. tuberculosis and NTM. Guidelines and Recommendation for culture of NTM as per ATS (American Thoracic Society) include two types of medium, one solid medium (LJ or Middlebrook medium) and one liquid medium culture system BACTEC (Becton-Dickenson Diagnostics), MB Redox (Heipha Diagnostika), BacT/ALERT® MP (bioMerieux, France), MGIT (BD Diagnostics), and Septi-check (BD Diagnostics).,,, Most media require additives OADC enrichment (mixture of Bovine albumin, Dextrose, Catalase, and Oleic acid) to increase the growth rate and PANTA antibiotic (mixture of polymyxin B, amphotericin B, nalidixic acid, trimethoprim, and azlocillin) are often added to inhibit the growth of contaminants.,,, A conventional method for the growth of mycobacteria is time-consuming (6–8 weeks), but they are considered “gold standard.” Liquid-based culture is high sensitivity because the growth of M. tuberculosis can be detected within 1–2 weeks. However, they always use in combination with the conventional LJ method for NTM culture. Moreover, the final report can be sent after 6 weeks if no growth detected in the liquid-based culture and 8 weeks of incubation on the LJ slants.
Biochemical identification of nontuberculous mycobacteria species identification
Various biochemical test for NTM species differentiation includes reduction of nitrate, niacin secretion, tween eighty hydrolysis, growth on MacConkey agar, reduction of tellurite, urease activity, without crystal violet, catalase activity, caratogenesis, at 68°C, semi-quantitative catalase activity, growth activity with arylsulfatase, pyrazinamidase, and ß-glucocidase. Data from various paper showed that specific growth inhibitors as nitrobenzoic acid (PNB), and nitro-alpha-acetylamino-beta-hydroxypropiophenone inhibit to the M. tuberculosis- complex and it may be useful for the differentiation of NTM. The rate of growth, pigmentation of colonies, and various biochemical reactions are used for phenotypic identification of NTM species.
| Molecular Methods|| |
Traditional methods are available for identification of NTM by solid media, biochemical tests, and antimicrobial sensitivity testing, but they need more time to detection and less sensitive to molecular testing. Mycobacterium identification by molecular testing continues transforming the diagnosis of TB worldwide. Molecular testing is based on the principle of nucleic acid amplification which allows a speedy and precise identification of the Mycobacterium species <24 h., DNA hybridization and DNA sequencing are very common and essential in nowadays laboratory setup for identification and differentiation of mycobacteria., Various molecular methods are commercially available like DNA probes are Gen-Probe Amplified M. tuberculosis Direct Test (Gen-Probe, San Diego, California, USA) and AMPLICOR nucleic acid amplification test (USA) and its application are used for identification and differentiation of mycobacterial species, including M. tuberculosis complex, M. intracellulare, M. Avium, M. kansasii, M. avium complex, M chelonae, M fortutium, and M. gordonae., Molecular studies reported the sensitivity of nucleic acid amplification testing to detect more greater than 95% M. tuberculosis nucleic acid in positive acid-fast bacillus sputum smears cases, and negative results show strong association of an NTM species.,
Line probe assays
Line probe assays are based on nucleic acid amplification and reverse hybridization to detect NTM and its speciation of NTM to various species from clinical and culture isolates by DNA hybridization based GenoType® Mycobacterium common mycobacteria/additional species (CM/AS) assay (Hain Lifescience, Nehren Germany). This is commercial kit detect to the identification and differentiates different species of NTM from cultures. This method based on nucleic acid amplification targeting the 23S ribosomal RNA gene region, followed by reverse hybridization on nitrocellulose membrane strips. There are two kits available-the CM, recognize 15 Mycobacterium species, including M. tuberculosis complex whereas the AS denotes 16 additional less common NTM species available. The GenoType® Mycobacterium CM/AS assay is very precise, rapid, and consistent test for the identification of mycobacterial species, which dedicate set up and qualified laboratory staff. Polymerase chain reaction (PCR)-based sequencing, genes coding for the 32 kDa protein,, 16S ribosomal RNA, 65 kDa heat shock protein, and 16S-23S ribosomal RNA internal transcribed spacer are other molecular methods available in laboratories.
| Immunodiagnostic Test|| |
Interferon-gamma based determinations
Various studies revealed that immunodominat antigens like as 6-kDa Early Secretory Antigenic Target (ESAT-6) and Culture Filtrate Protein (CFP-10) may act as potential makers for TB diagnosis.,,, Based on these studies, Interferon-Gamma Release Assays (IGRAs) based detection are important developments in the diagnostic for TB. The advantage of IGRA to detect MTBC-specific antigens encoded in region of difference (RD) 1 and increased specificity towards detection of MTBC infection. A recent assessment showed that IFN-γ assays using MTB RD1 antigens, including ESAT-6 and CFP-10, may have advantages over tuberculin skin testing.,,, Various INF-γ commercial kits available are as commercial: enzyme-linked immunospot T SPOT-TB assay (United Kingdom) and QuantiFERON-TB, and its enhanced versions QuantiFERON-TB Gold and QuantiFERON-TB Gold in-Tube assays (Australia). In India, Government of India has banned the use of blood-based serodiagnostic kits for TB and has discouraged the use of tests such as TB Gold in 2012.
Rapid and precise detection of mycobacteria could help in additional patients from needless treatment in cases of NTM. A new, simple, and rapid assays Immunochromatographic test (standard deviation [SD] MPT64 TB Ag Kit) developed by SD Bioline, South Korea which facilitates rapid detection and differentiation of MPT 64 antigen in M. tuberculosis isolates and NTM.,,, MPT 64 TB Ag kit is highly sensitive and speedy identification of MTBC, together with M. tuberculosis, Mycobacterium africanum, Mycobacterium bovis, and substrains of M. bovis BCG.,,, The study reported the sensitivity was found to 99% and 100% specificity from MPT64 TB Ag test., The advantage of MPT64 TB Ag test are easily and direct culture positive specimens does not require any extraordinary equipment and easily distinguish between MTBC and NTM.,
| Molecular Typing Methods|| |
Molecular genotyping studies on mycobacterial species provide insights into epidemiological behavior, evolution, and transmission of the mycobacteria. Reported typing studies, and taxonomical relations have been established between species and subspecies., These methods are available for molecular typing, i.e. pulsed-field gel electrophoresis and random amplified polymorphic DNA (RAPD). RAPD is easy to perform and often applied in the investigation of, for instance, pseudo-outbreaks. Fluorescent amplified fragment length polymorphism is based on fluorophore-labeled PCR primers, which building the amplified fragments detectable to an automated DNA sequences. Other genome segments are used in genotyping are repetitive elements like insertion sequences (IS).
IS6110 is especially members of the MTBC, and it can be used as a significant useful diagnostic marker in the identification of MTBC. It has been widely used as epidemiological, typing, and identification of MTBC. Various IS reported for NTM, IS900, and IS901 used as biomarkers as identification of Mycobacterium paratuberculosis and M. avium strains, IS1245 is using for typing of M. avium, identification of Mycobacterium celatum by IS1407, IS1395 M. xenopi and both IS2404 and IS2606 for Mycobacterium ulcerans, IS1245 for M. avium for genotyping and identification of NTM.
IS6110-RFLP is using as “gold standard” typing for M. tuberculosis. The advantage of IS6110-RFLP are simple do, less time consuming, and need a little quantity of genomic DNA from clinical specimens and/or culture isolates from NTM.
Mycobacterial intergenic repetitive units-variable number of tandem repeats (MIRUs-VNTR) is a powerful technique for epidemiology, phylogeny, and group of genetic elements used for genotyping of TB. The principle of this technique is based on DNA segments have “tandem repeated” sequences at loci dispersed in the region of the M. tuberculosis genome. This tool is applicable for MTBC and NTM (M. tuberculosis, Mycobacterium leprae, M. ulcerans and M. avium). They are very short repetitive sequences which are readily incorporated or deleted by DNA polymerase and therefore highly variable in length between strains.,, Various studies showed that 15 MIRU's found in M. tuberculosis, they were also able to differentiate between phylogenetic lineages and 22 MIRU's were identified in M. avium. The advantage of MIRU-VNTR typing is easy to perform, inexpensive, adaptable technique, and high discriminatory and reproducibility.
Multilocus sequence typing is a typing method for strain classification that indexed variation in multiple housekeeping genes and also based on DNA sequencing-based method which shows nucleotide variations presence in sets of genetic loci. This could help in finding out the source of the epidemic and new infection. However, it acceptable the purpose of the unpredictability between subspecies and strains of M. avium, enhanced genetic divergence and established to be precious in investigations of NTM.,
| Conclusion|| |
NTM infection is a major concern for both diagnose and treatment worldwide. Molecular methods are a valuable tool in reduces the possibility of an inadequate treatment of NTM infections. This may gradually replace conventional methods for the identification and differentiation of NTM. Molecular typing methods may also facilitate the analysis of the outbreaks and track transmission patterns in the community.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Ahmed I, Jabeen K, Hasan R. Identification of non-tuberculous mycobacteria isolated from clinical specimens at a tertiary care hospital: A cross-sectional study. BMC Infect Dis 2013;13:493.
Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al
. An official ATS/IDSA statement: Diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007;175:367-416.
Gopinath K, Singh S. Non-tuberculous mycobacteria in TB-endemic countries: Are we neglecting the danger? PLoS Negl Trop Dis 2010;4:e615.
Wallace RJ, O'Brein R, Glassroth J, Raleigh J, Dutta A. Diagnosis and treatment of disease caused by non tuberculous mycobacteria. Am Rev Respir Dis 1990;1990:940-53.
O'Brien RJ, Geiter LJ, Snider DE Jr. The epidemiology of nontuberculous mycobacterial diseases in the United States. Results from a national survey. Am Rev Respir Dis 1987;135:1007-14.
Tsukamura M, Kita N, Shimoide H, Arakawa H, Kuze A. Studies on the epidemiology of nontuberculous mycobacteriosis in Japan. Am Rev Respir Dis 1988;137:1280-4.
Choudhri S, Manfreda J, Wolfe J, Parker S, Long R. Clinical significance of nontuberculous mycobacteria isolates in a Canadian tertiary care center. Clin Infect Dis 1995;21:128-33.
Chakrabarti A, Sharma M, Dubey ML. Isolation rates of different mycobacterial species from Chandigarh (North India). Indian J Med Res 1990;91:111-4.
Singh AK, Maurya AK, Umrao J, Kant S, Kushwaha RA, Nag VL, et al
. Role of genotype(®) Mycobacterium
common mycobacteria/additional species assay for rapid differentiation between Mycobacterium tuberculosis
complex and different species of non-tuberculous mycobacteria. J Lab Physicians 2013;5:83-9.
] [Full text]
Cassidy PM, Hedberg K, Saulson A, McNelly E, Winthrop KL. Nontuberculous mycobacterial disease prevalence and risk factors: A changing epidemiology. Clin Infect Dis 2009;49:e124-9.
Corcoran TE, Thomas KM, Myerburg MM, Muthukrishnan A, Weber L, Frizzell R, et al
. Absorptive clearance of DTPA as an aerosol-based biomarker in the cystic fibrosis airway. Eur Respir J 2010;35:781-6.
Paramasivan CN, Govindan D, Prabhakar R, Somasundaram PR, Subbammal S, Tripathy SP. Species level identification of non-tuberculous mycobacteria from South Indian BCG trial area during 1981. Tubercle 1985;66:9-15.
Karak K, Bhattacharyya S, Majumdar S, De PK. Pulmonary infection caused by mycobacteria other than M. tuberculosis
in and around Calcutta. Indian J Pathol Microbiol 1996;39:131-4.
] [Full text]
Das BK, Sharma VK, Bhau LN, Saxena SN, Bhardwaj BK. Characterisation of mycobacterial strains from clinical specimens. Indian J Pathol Microbiol 1982;25:19-27.
Myneedu VP, Verma AK, Bhalla M, Arora J, Reza S, Sah GC, et al
. Occurrence of non-tuberculous mycobacterium in clinical samples - A potential pathogen. Indian J Tuberc 2013;60:71-6.
Ulukanligil M, Aslan G, Tasçi S. A comparative study on the different staining methods and number of specimens for the detection of acid fast bacilli. Mem Inst Oswaldo Cruz 2000;95:855-8.
Somoskövi A, Hotaling JE, Fitzgerald M, O'Donnell D, Parsons LM, Salfinger M. Lessons from a proficiency testing event for acid-fast microscopy. Chest 2001;120:250-7.
Lipsky BA, Gates J, Tenover FC, Plorde JJ. Factors affecting the clinical value of microscopy for acid-fast bacilli. Rev Infect Dis 1984;6:214-22.
Mahaisavariya P, Manonukul J, Khemngern S, Chaiprasert A. Mycobacterial skin infections: Comparison between histopathologic features and detection of acid fast bacilli in pathologic section. J Med Assoc Thai 2004;87:709-12.
Fukunaga H, Murakami T, Gondo T, Sugi K, Ishihara T. Sensitivity of acid-fast staining for Mycobacterium tuberculosis
in formalin-fixed tissue. Am J Respir Crit Care Med 2002;166:994-7.
Katz HI, Gupta AK. Oral antifungal drug interactions: A mechanistic approach to understanding their cause. Dermatol Clin 2003;21:543-63, viii.
Somoskövi A, Magyar P. Comparison of the mycobacteria growth indicator tube with MB redox, Löwenstein-Jensen, and Middlebrook 7H11 media for recovery of mycobacteria in clinical specimens. J Clin Microbiol 1999;37:1366-9.
Whittier S, Hopfer RL, Knowles MR, Gilligan PH. Improved recovery of mycobacteria from respiratory secretions of patients with cystic fibrosis. J Clin Microbiol 1993;31:861-4.
Carricajo A, Fonsale N, Vautrin AC, Aubert G. Evaluation of BacT/Alert 3D liquid culture system for recovery of mycobacteria from clinical specimens using sodium dodecyl (lauryl) sulfate-NaOH decontamination. J Clin Microbiol 2001;39:3799-800.
Conville PS, Andrews JW, Witebsky FG. Effect of PANTA on growth of Mycobacterium kansasii
in BACTEC 12B medium. J Clin Microbiol 1995;33:2012-5.
Somoskövi A, Bártfai Z, Ködmön C, Hutás I. Routine direct detection of Mycobacterium tuberculosis
with a rapid test of polymerase chain reaction applied to a Hungarian patient population. Orv Hetil 2001;142:2085-90.
Somoskovi A, Mester J, Hale YM, Parsons LM, Salfinger M. Laboratory diagnosis of nontuberculous mycobacteria. Clin Chest Med 2002;23:585-97.
Greco S, Girardi E, Navarra A, Saltini C. Current evidence on diagnostic accuracy of commercially based nucleic acid amplification tests for the diagnosis of pulmonary tuberculosis. Thorax 2006;61:783-90.
Greco S, Rulli M, Girardi E, Piersimoni C, Saltini C. Diagnostic accuracy of in-house PCR for pulmonary tuberculosis in smear-positive patients: Meta-analysis and metaregression. J Clin Microbiol 2009;47:569-76.
Flores LL, Pai M, Colford JM Jr., Riley LW. In-house nucleic acid amplification tests for the detection of Mycobacterium tuberculosis
in sputum specimens: Meta-analysis and meta-regression. BMC Microbiol 2005;5:55.
Sarmiento OL, Weigle KA, Alexander J, Weber DJ, Miller WC. Assessment by meta-analysis of PCR for diagnosis of smear-negative pulmonary tuberculosis. J Clin Microbiol 2003;41:3233-40.
Roth A, Fischer M, Hamid ME, Michalke S, Ludwig W, Mauch H. Differentiation of phylogenetically related slowly growing mycobacteria based on 16S-23S rRNA gene internal transcribed spacer sequences. J Clin Microbiol 1998;36:139-47.
Soini H, Böttger EC, Viljanen MK. Identification of mycobacteria by PCR-based sequence determination of the 32-kilodalton protein gene. J Clin Microbiol 1994;32:2944-7.
Kapur V, Li LL, Hamrick MR, Plikaytis BB, Shinnick TM, Telenti A, et al
. Rapid Mycobacterium
species assignment and unambiguous identification of mutations associated with antimicrobial resistance in Mycobacterium tuberculosis
by automated DNA sequencing. Arch Pathol Lab Med 1995;119:131-8.
Ulrichs T, Munk ME, Mollenkopf H, Behr-Perst S, Colangeli R, Gennaro ML, et al
. Differential T cell responses to Mycobacterium tuberculosis
ESAT6 in tuberculosis patients and healthy donors. Eur J Immunol 1998;28:3949-58.
Ravn P, Demissie A, Eguale T, Wondwosson H, Lein D, Amoudy HA, et al
. Human T cell responses to the ESAT-6 antigen from Mycobacterium tuberculosis
. J Infect Dis 1999;179:637-45.
Arend SM, Andersen P, van Meijgaarden KE, Skjot RL, Subronto YW, van Dissel JT, et al
. Detection of active tuberculosis infection by T cell responses to early-secreted antigenic target 6-kDa protein and culture filtrate protein 10. J Infect Dis 2000;181:1850-4.
Brock I, Munk ME, Kok-Jensen A, Andersen P. Performance of whole blood IFN-gamma test for tuberculosis diagnosis based on PPD or the specific antigens ESAT-6 and CFP-10. Int J Tuberc Lung Dis 2001;5:462-7.
Lalvani A, Pathan AA, McShane H, Wilkinson RJ, Latif M, Conlon CP, et al
. Rapid detection of Mycobacterium tuberculosis
infection by enumeration of antigen-specific T cells. Am J Respir Crit Care Med 2001;163:824-8.
Pai M, DAS J. Management of tuberculosis in India: Time for a deeper dive into quality. Natl Med J India 2013;26:65-8.
Li H, Ulstrup JC, Jonassen TO, Melby K, Nagai S, Harboe M. Evidence for absence of the MPB64 gene in some substrains of Mycobacterium bovis
BCG. Infect Immun 1993;61:1730-4.
Nagai S, Wiker HG, Harboe M, Kinomoto M. Isolation and partial characterization of major protein antigens in the culture fluid of Mycobacterium tuberculosis
. Infect Immun 1991;59:372-82.
Steingart KR, Dendukuri N, Henry M, Schiller I, Nahid P, Hopewell PC, et al
. Performance of purified antigens for serodiagnosis of pulmonary tuberculosis: A meta-analysis. Clin Vaccine Immunol 2009;16:260-76.
Andersen P, Askgaard D, Ljungqvist L, Bennedsen J, Heron I. Proteins released from Mycobacterium tuberculosis
during growth. Infect Immun 1991;59:1905-10.
Harboe M, Nagai S, Patarroyo ME, Torres ML, Ramirez C, Cruz N. Properties of proteins MPB64, MPB70, and MPB80 of Mycobacterium bovis
BCG. Infect Immun 1986;52:293-302.
Chihota VN, Grant AD, Fielding K, Ndibongo B, van Zyl A, Muirhead D, et al
. Liquid vs. solid culture for tuberculosis: Performance and cost in a resource-constrained setting. Int J Tuberc Lung Dis 2010;14:1024-31.
Ismail NA, Baba K, Pombo D, Hoosen AA. Use of an immunochromatographic kit for the rapid detection of Mycobacterium tuberculosis
from broth cultures. Int J Tuberc Lung Dis 2009;13:1045-7.
Maurya AK, Nag VL, Kant S, Kushwaha RA, Kumar M, Mishra V, et al
. Evaluation of an immunochromatographic test for discrimination between Mycobacterium tuberculosis
complex & non tuberculous mycobacteria in clinical isolates from extra-pulmonary tuberculosis. Indian J Med Res 2012;135:901-6.
] [Full text]
Horan KL, Freeman R, Weigel K, Semret M, Pfaller S, Covert TC, et al
. Isolation of the genome sequence strain Mycobacterium avium
104 from multiple patients over a 17-year period. J Clin Microbiol 2006;44:783-9.
Brudey K, Filliol I, Ferdinand S, Guernier V, Duval P, Maubert B, et al
. Long-term population-based genotyping study of Mycobacterium tuberculosis
complex isolates in the French departments of the Americas. J Clin Microbiol 2006;44:183-91.
Tortoli E. Impact of genotypic studies on mycobacterial taxonomy: The new mycobacteria of the 1990s. Clin Microbiol Rev 2003;16:319-54.
Mostowy S, Inwald J, Gordon S, Martin C, Warren R, Kremer K, et al
. Revisiting the evolution of Mycobacterium bovis
. J Bacteriol 2005;187:6386-95.
Goulding JN, Hookey JV, Stanley J, Olver W, Neal KR, Ala'Aldeen DA, et al
. Fluorescent amplified-fragment length polymorphism genotyping of Neisseria meningitidis
identifies clones associated with invasive disease. J Clin Microbiol 2000;38:4580-5.
Narayanan S. Molecular epidemiology of tuberculosis. Indian J Med Res 2004;120:233-47.
van Soolingen D, Bauer J, Ritacco V, Leão SC, Pavlik I, Vincent V, et al
. IS1245 restriction fragment length polymorphism typing of Mycobacterium avium
isolates: Proposal for standardization. J Clin Microbiol 1998;36:3051-4.
Chemlal K, Huys G, Laval F, Vincent V, Savage C, Gutierrez C, et al
. Characterization of an unusual Mycobacterium
: A possible missing link between Mycobacterium marinum
and Mycobacterium ulcerans
. J Clin Microbiol 2002;40:2370-80.
Jagielski T, van Ingen J, Rastogi N, Dziadek J, Mazur PK, Bielecki J. Current methods in the molecular typing of Mycobacterium tuberculosis
and other mycobacteria. Biomed Res Int 2014;2014:645802.
Supply P, Magdalena J, Himpens S, Locht C. Identification of novel intergenic repetitive units in a mycobacterial two-component system operon. Mol Microbiol 1997;26:991-1003.
Hilty M, Yeboah-Manu D, Boakye D, Mensah-Quainoo E, Rondini S, Schelling E, et al
. Genetic diversity in Mycobacterium ulcerans
isolates from Ghana revealed by a newly identified locus containing a variable number of tandem repeats. J Bacteriol 2006;188:1462-5.
Overduin P, Schouls L, Roholl P, van der Zanden A, Mahmmod N, Herrewegh A, et al
. Use of multilocus variable-number tandem-repeat analysis for typing Mycobacterium avium subsp. paratuberculosis
. J Clin Microbiol 2004;42:5022-8.
Kremer K, Arnold C, Cataldi A, Gutiérrez MC, Haas WH, Panaiotov S, et al
. Discriminatory power and reproducibility of novel DNA typing methods for Mycobacterium tuberculosis
complex strains. J Clin Microbiol 2005;43:5628-38.
Gibson A, Brown T, Baker L, Drobniewski F. Can 15-locus mycobacterial interspersed repetitive unit-variable-number tandem repeat analysis provide insight into the evolution of Mycobacterium tuberculosis
? Appl Environ Microbiol 2005;71:8207-13.
Romano MI, Amadio A, Bigi F, Klepp L, Etchechoury I, Llana MN, et al
. Further analysis of VNTR and MIRU in the genome of Mycobacterium avium
complex, and application to molecular epidemiology of isolates from South America. Vet Microbiol 2005;110:221-37.
Aanensen DM, Spratt BG. The multilocus sequence typing network: Mlst.net. Nucleic Acids Res 2005;33:W728-33.
Turenne CY, Collins DM, Alexander DC, Behr MA. Mycobacterium avium subsp. paratuberculosis
and M. avium subsp. avium
are independently evolved pathogenic clones of a much broader group of M. avium
organisms. J Bacteriol 2008;190:2479-87.
Cooksey RC, Jhung MA, Yakrus MA, Butler WR, Adékambi T, Morlock GP, et al
. Multiphasic approach reveals genetic diversity of environmental and patient isolates of Mycobacterium mucogenicum
and Mycobacterium phocaicum
associated with an outbreak of bacteremias at a Texas hospital. Appl Environ Microbiol 2008;74:2480-7.