|Year : 2019 | Volume
| Issue : 1 | Page : 58-59
Response to comment on report of two cases of cutaneous Mycobacterium abscessus infection complicating professional decorative tattoo
Po-Hua Chen1, Chia-Hua Wu2
1 Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan
2 Department of Dermatology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
|Date of Web Publication||28-Mar-2019|
No. 1, Changde St., Zhongzheng District., Taipei City 10048
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chen PH, Wu CH. Response to comment on report of two cases of cutaneous Mycobacterium abscessus infection complicating professional decorative tattoo. Dermatol Sin 2019;37:58-9
|How to cite this URL:|
Chen PH, Wu CH. Response to comment on report of two cases of cutaneous Mycobacterium abscessus infection complicating professional decorative tattoo. Dermatol Sin [serial online] 2019 [cited 2019 Jun 20];37:58-9. Available from: http://www.dermsinica.org/text.asp?2019/37/1/58/255036
For identification of species of nontuberculous mycobacteria (NTM), traditional methods as phenotypic laboratory identification have been primarily based on growth in <7 days, typical Gram stain and colony morphology, acid-fastness, the absence of pigmentation, and a positive arylsulfatase at 3 days. Modern techniques of speciation are accelerated via the development of molecular analysis of selected genes, such as 16S rRNA, rpoB, and hsp65. Currently, polymerase chain reaction (PCR) sequencing and PCR hybridization are the qualified standards which plagued by lengthy turnaround times and the need for trained personnel. Novel techniques such as matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and whole-genome sequencing demonstrate new generation and great potential as evidenced by recently published literature.,
The detail steps of mycobacterial isolation in our study are described below. The skin sample was ground, digested, and decontamination. Then, the specimen is inoculated to the culture plate. Two kinds of culture system are adopted. One is Löwenstein–Jensen medium plate combined with CO2 incubator at 35.0°C–37.7°C; the other one is mycobacteria growth indicator tube (MGIT) medium plate with MGIT 960 system. Positivity for either culture system confirms the presence of Mycobacterium. Thus, further subculture and biochemistry study will be done to identify the species. 7H11 medium plate is used to cultivate the colony. Biochemistry test including niacin, urease, tween 80, nitrate reduction, and arylsulfatase are also performed. According to the colonial phenotype and biochemistry results, the subspecies are differentiated., The steps are reformatted as algorithm as [Figure 1] showed.
|Figure 1: Algorithm of reformatted steps to identify nontuberculous mycobacteria and differentiate the species|
Click here to view
Nontuberculous mycobacteria as a large group of approximately 186 currently recognized unique Mycobacterium species are known have limited impact on human health in the majority., Therefore, it would be more necessary and vital to early identify the species causing infection and harm to life. As the evolution of knowledge to the NTM species identification, we will have clues to approach more and chance to reach an effective therapeutic management in time.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Brown-Elliott BA, Philley JV. Rapidly growing mycobacteria. Microbiol Spectr 2017;5: TNMI7-0027-2016.
Yam WC, Yuen KY, Kam SY, Yiu LS, Chan KS, Leung CC, et al.
Diagnostic application of genotypic identification of mycobacteria. J Med Microbiol 2006;55:529-36.
El Khéchine A, Couderc C, Flaudrops C, Raoult D, Drancourt M. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry identification of mycobacteria in routine clinical practice. PLoS One 2011;6:e24720.
Choudhury S, Tan YE, Lee WB. MALDI-TOF identification of rapidly growing mycobacteria from fungal media in a biosafety level 2 laboratory. Pathology 2016;48:288-90.
Hsueh PR, Teng LJ, Yang PC, Chen YC, Ho SW, Luh KT, et al.
Recurrent catheter-related infection caused by a single clone of Mycobacterium chelonae
with two colonial morphotypes. J Clin Microbiol 1998;36:1422-4.
Cortes MA, Nessar R, Singh AK. Laboratory maintenance of Mycobacterium abscessus.
Ch. 10. Curr Protoc Microbiol 2010; Unit 10D.1.1-10D.1.12.
Parte AC. LPSN – List of prokaryotic names with standing in nomenclature. Nucleic Acids Res 2014;42:D613-6.
Donohue MJ. Increasing nontuberculous mycobacteria reporting rates and species diversity identified in clinical laboratory reports. BMC Infect Dis 2018;18:163.