European Society of Mycobacteriology - Instituto Nacional de Saúde ...

PP-59
A CASE-REPORT OF Mycobacterium thermoresistibile FROM GREECE.
Neonakis Ioannis K 1 , Kontos Fanourios 2 , Gitti Zoe 1 , Baritaki Stavroula 1 , Kosmadakis Georgios 1 , Baritaki Maria 1 , Zerva
Loukia 2 , Spandidos Demetrios A 1
1 - Microbiology Laboratory, University Hospital of Heraklion, Heraklion, Greece.
2 - Clinical Microbiology Laboratory, Medical School of Athens, “Attikon” University Hospital, Athens, Greece.
Mycobacterium thermoresistibile is a non-tuberculous mycobacterium that was first recovered in Japan by Tsukamura in
1966. Although it is strongly associated with pulmonary and dermal diseases, there have only been six reports of its isolation
from clinical samples. Here we report on the first case from Greece.
The mycobacterium was isolated from the solid culture (Lowenstein-Jensen slant at 37 o C) of a sputum sample after 14
days of incubation. The sample was taken from a 67-year-old male, who was a heavy smoker (1pack/day for 30 years)
and had a history of COPD, type II respiratory distress syndrome, diverticulosis and diabetes, and was presented to our
hospital with fever (38 o C), productive cough, dyspnea, weakness, and acute purpura. The chest radiograph revealed an
elevated cardiothoracic ratio, as well as chronic obstructive lung disease, peribronchial infiltrations, consolidations in the
right middle and lower lung zones and a small blunt at the left pneumodiaphragmatic angle.
The Accuprobe Mycobacterium tuberculosis complex assay (Gen-Probe, San Diego, CA) was negative. Accuprobe also
yielded negative results for the Mycobacterium avium complex and Mycobacterium gordonae. Biochemical profile could
not distinguish it from other mycobacteria. The banding patterns obtained with GenoType CM and GenoType AS (Hain,
Lifescience, Nehren, Germany) were not species-specific [GenoType CM: 1,2,3 and 10, and GenoType AS: 1,2,3 and 12].
The identification of M. thermoresistibile was achieved with the amplification and sequencing of the 16S rRNA gene and
the 16S-23S internal transcribed region (GenBank accession: FJ236481).
Moreover, a 439-bp fragment of the 65-kDa heat shock protein (hsp65) gene (GenBank accession: FJ236482) was further
used for restriction fragment length polymorphism analysis with Hae III (New England Biolabs) and BsteII (New England
Biolabs). The BstEII digestion produced two fragments of 235 and 210 bp and the HaeIII digestion produced four fragments
of 180, 135, 70 and 50 bp.
Although M. thermoresistibile is considered pathogenic, it is rarely isolated from clinical samples. Molecular techniques are
essential for its identification.
European Society of Mycobacteriology | 30 th Annual Congress | July 2009 | Porto - Portugal
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