Abstract
The clinical significance of Mycobacterium lentiflavum, a recently identified nontuberculous mycobacterium, remains uncertain, especially in immunosuppressed cancer patients. The records of all patients in whom M. lentiflavum was identified using a gene sequencing technique between January 2001 and December 2003 were reviewed. The mean age among 12 patients was 51±20 years, and 11 (92%) patients had a hematologic malignancy. Six of seven (86%) hematopoietic stem cell transplant recipients had received allogeneic donor grafts. Nine (75%) patients had predisposing risk factors for infection, seven (58%) had severe lymphocytopenia (<400 cells/μl), five (42%) were receiving systemic corticosteroid therapy, and three (25%) had acute graft-versus-host disease. Only 1 of the 12 (8%) patients had evidence of probable pulmonary M. lentiflavum infection. Six M. lentiflavum strains were initially misidentified as Mycobacterium simiae and Mycobacterium avium-intracellulare complex using traditional biochemical tests. Four M. lentiflavum isolates were tested for antimicrobial susceptibility; they were susceptible to isoniazid, ethambutol, clarithromycin, and amikacin, and resistant to rifampin. M. lentiflavum was not clinically significant, even in these severely immunosuppressed cancer patients.
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Springer B, Wu WK, Bodmer T, Hasse G, Pfyffer GE, Kroppenstedt RM, Schroder KH, Emler S, Kilburn JO, Kirschner P, Telenti A, Coyle MB, Bottger EC (1996) Isolation and characterization of a unique group of slowly growing mycobacteria: description of Mycobacterium lentiflavum sp. nov. J Clin Microbiol 34:1100–1107
Tortoli E, Piersimoni C, Kirschner P, Bartoloni A, Burrini C, Lacchini C, Mantella A, Muzzi G, Tosi CP, Penati V, Scarparo C, Simonetti MT, Bottger EC (1997) Characterization of mycobacterial isolates phylogenetically related to, but different from, Mycobacterium simiae. J Clin Microbiol 35:697–702
Haase G, Kentrup H, Skopnik H, Springer B, Bottger EC (1997) Mycobacterium lentiflavum: an etiologic agent of cervical lymphadenitis. Clin Infect Dis 5:1245–1246
Ngo Niobe S, Bebear CM, Clerc M, Pellegrin JL, Bebear C, Maugein J (2001) Disseminated Mycobacterium lentiflavum infection in a human immunodeficiency virus-infected patient. J Clin Microbiol 39:2030–2032
Tortoli E, Bartoloni A, Erba ML, Levre E, Lombardi N, Mantella A, Mecocci L (2002) Human infections due to Mycobacterium lentiflavum. J Clin Microbiol 40:728–729
Ibanez R, Serrano-Heranz R, Jimenez-Palop M, Roman C, Corteguera M, Jimenez S (2002) Disseminated infection caused by slow-growing Mycobacteria lentiflavum. Eur J Clin Microbiol Infect Dis 21:691–692
Galarrage MC, Torreblanca A, Jimenez MS (2002) Isolation of Mycobacterium lentiflavum in a case of suspected lung cancer. Enferm Infecc Microbiol Clin 20:93–94
Uria MJ, Garcia J, Menendez JJ, Jimenez MS (2003) Mycobacterium lentiflavum infection: case history and review of the medical literature. Enferm Infecc Microbiol Clin 21:274–275
Gaviria JM, Garcia PJ, Garrido SM, Corey L, Boeckh M (2000) Nontuberculous mycobacterial infections in hematopoietic stem cell transplant recipients: characteristics of respiratory and catheter-related infection. Biol Blood Marrow Transplant 6:361–369
Levendoglu-Tugal O, Munoz J, Brudnicki A, Fevzi Ozkaynak M, Sandoval C, Jayabose S (1998) Infections due to nontuberculous mycobacteria in children with leukemia. Clin Infect Dis 27:1227–1230
Roy V, Weisdorf D (1997) Mycobacterial infections following bone marrow transplantation: a 20-year retrospective review. Bone Marrow Transplant 19:467–470
Han XY, Pham AS, Tarrand JJ, Sood PK, Luthra RL (2002) Rapid and accurate identification of mycobacteria by sequencing hypervariable regions of the 16S ribosomal RNA gene. Am J Clin Pathol 118:796–801
National Committee for Clinical Laboratory Standards (2003) Susceptibility testing of mycobacteria, Nocardia, and other aerobic actinomycetes. Approved standard M24-T2. NCCLS, Wayne, PA
Woods GL (2000) Susceptibility testing for mycobacteria. Clin Infect Dis 31:1209–1215
American Thoracic Society (1997) Diagnosis and treatment of disease caused by nontuberculous mycobacteria. Am J Respir Crit Care Med 156(Suppl 1):1–25
Kaplan JE, Hanson D, Dworkin MS, Frederick T, Bertolli J, Lindegren ML, Holmberg S, Jones JL (2000) Epidemiology of human immunodeficiency virus-associated opportunistic infections in the United States: the era of highly active antiretroviral therapy. Clin Infect Dis 30(Suppl 1):5–14
Lerner C, Safdar A, Coppel S (1995) Mycobacterium haemophilum infection in AIDS. Infect Dis Clin Pract 4:233–236
Weinstock DM, Feinstein MB, Sepkowitz KA, Jakubowski A (2003) High rates of infection and colonization by nontuberculous mycobacteria after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 31:1015–1021
White MH, Papadopoulos EB, Small TN, Kiehn TE, Armstrong D (1995) Mycobacterium haemophilum infections in bone marrow transplant recipients. Transplantation 15:957–960
Tortoli E, Cichero P, Piersimoni C, Simonetti MT, Gesu G, Nista D (1999) Use of BACTEC MGIT 960 for recovery of mycobacteria from clinical specimens: multicenter study. J Clin Microbiol 37:3578–3582
Acknowledgements
This work was supported in part by a University Cancer Foundation grant (to X.Y.H.) from The University of Texas M.D. Anderson Cancer Center and by a National Institutes of Health grant (CA16672) for the institutional core DNA sequencing facility. This study was presented in part at the 41st Annual Meeting of the Infectious Diseases Society of America, October 2003, San Diego, CA (Abstract no. 160)
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Safdar, A., Han, X.Y. Mycobacterium lentiflavum, a recently identified slow-growing mycobacterial species: clinical significance in immunosuppressed cancer patients and summary of reported cases of infection. Eur J Clin Microbiol Infect Dis 24, 554–558 (2005). https://doi.org/10.1007/s10096-005-1375-x
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DOI: https://doi.org/10.1007/s10096-005-1375-x