Molecular Epidemiology of Nontuberculous Mycobacteria in a German CF Center and Clinical Course of NTM Positive Patients
Carolin Kröner, Barbara Ganster, Matthias Kappler, Ann-Christin Grimmelt, Bernd H. Belohradsky, Michael Hogardt, Gudrun Laniado, Michael Meissner, Sören Schubert, Matthias Griese
Institute for Clinical Chemistry, Molecular Diagnostics, Medical Microbiology and ygiene Department, Ludwigshafen General Hospital, Ludwigshafen, Germany.
Institute for Medical Microbiology and Infection Control, University Hospital, Johann-Wolfgang-Goethe-University, Frankfurt/Main, Germany.
Max von Pettenkofer Institute of Hygiene and Medical Microbiology, Ludwig-Maximilians-University, Munich, Germany.
Paediatric Pneumology, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany.
DOI: 10.4236/ojmm.2013.31006   PDF    HTML   XML   3,905 Downloads   6,795 Views   Citations

Abstract

Goal of this study was to analyse the clinical course of cystic fibrosis (CF) patients with nontuberculous mycobacteria (NTM) in their respiratory secretions and to investigate the molecular epidemiology of the most prevalent NTM species by multilocus sequence analysis (MLSA). The respiratory specimen and the clinical parameters forced expiratory volume in one second (FEV1), body-mass-index (BMI), erythrocyte sedimentation rate (ESR) 1 h and immunoglobulin G (IgG) of 357 CF patients, 0 - 52.4 years, mean FEV1 2009 81.5% pred were analysed between 1998 and 2010. In 13 patients NTM were detected. 12 of 13 patients carried M. abscessus, for one patient the NTM species was not characterized. 4 patients carried a second NTM species (M. avium, M. chelonae (2x), M. intracellulare). 6 patients exhibited a significant decline in FEV1, however changes in BMI, IgG and ESR were discordant. Molecular genotyping of M. abscessus isolates revealed a unique MLSA pattern in 6 patients. 2 patients harboured identical strains, and one patient a closely related strain. Whether the presence of identical strains is attributed to the acquisition of NTM clones from common environmental sources or to patient-to-patient transmission cannot be definitely clarified. Although cross-in- fection of the three patients with identical/closely related strains in the present cohort is highly unlikely, we recommend strict hygiene measures for all CF patients harbouring NTM.

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C. Kröner, B. Ganster, M. Kappler, A. Grimmelt, B. Belohradsky, M. Hogardt, G. Laniado, M. Meissner, S. Schubert and M. Griese, "Molecular Epidemiology of Nontuberculous Mycobacteria in a German CF Center and Clinical Course of NTM Positive Patients," Open Journal of Medical Microbiology, Vol. 3 No. 1, 2013, pp. 39-47. doi: 10.4236/ojmm.2013.31006.

Conflicts of Interest

The authors declare no conflicts of interest.

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