Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug;50(4):981-987.
doi: 10.1007/s15010-022-01780-4. Epub 2022 Mar 23.

Clinical characteristics and the diagnostic role of molecular tests in musculoskeletal infections caused by nontuberculous Mycobacterium: a single-center experience

Cheon Hoo Jeon  1 , Si-Ho Kim  1 , Hae Suk Cheong  2 , Dong Hee Kim  3 , Yu-Ji Lee  1 , Eun Phil Heo  4 , Yu Mi Wi  5
Affiliations

Clinical characteristics and the diagnostic role of molecular tests in musculoskeletal infections caused by nontuberculous Mycobacterium: a single-center experience

Cheon Hoo Jeon et al. Infection. 2022 Aug.

Abstract

Purpose: We retrospectively investigated NTM musculoskeletal infections to understand the clinical characteristics as well as the diagnostic performance of molecular tests as a useful supplementary test.

Methods: A retrospective cohort study was conducted from January 2016 to December 2019. Intraoperative specimens for culture and pathological analysis were obtained during surgery under sterile conditions. AdvanSure TB/NTM real-time PCR (LG Life Sciences, Seoul, Korea) and PCR-reverse blot hybridization assay (REBA, REBA Myco-ID; YD Diagnostics, Yongin, Republic of Korea) was performed directly from tissue specimens for the rapid and accurate identification of 20 mycobacterial species.

Results: A series of 24 patients was identified during the study period. Agricultural/aquatic exposure were predisposing factors in 9 patients, trauma in 4 patients, but no predisposing host factor was identified for 11 patients. Twenty-two patients presented with tenosynovitis and two with arthritis with substantial delays between initial presentation of symptoms and microbiologic diagnosis, with a median of 147 days (range 5-396 days). Pathologic tissue examination of musculoskeletal NTM infections was positive for chronic granulomatous inflammation in 18 cases. Fifteen were positive in the culture study, and nine were positive only in the molecular study using tissue specimens. All 6 M. ulcerans/M. marinum isolates were identified only by PCR.

Conclusions: This study is an important reminder that NTM infections should be a part of the differential diagnosis in patients with chronic musculoskeletal infections refractory to regular treatment. Although molecular test cannot replace the conventional smear and culture methods, it can be used as a useful supplementary test especially in diagnosing M. marinum infection.

Keywords: Identification; NTM; Nontuberculous mycobacteria; Polymerase chain reaction; Tenosynovitis.

PubMed Disclaimer

References

    1. Brode SK, Marchand-Austin A, Jamieson FB, Marras TK. Pulmonary versus nonpulmonary nontuberculous mycobacteria, Ontario Canada. Emerg Infect Dis. 2017;23:1898–901. https://doi.org/10.3201/eid2311.170959 . - DOI - PubMed - PMC
    1. Henkle E, Hedberg K, Schafer SD, Winthrop KL. Surveillance of extrapulmonary nontuberculous mycobacteria infections, Oregon, USA, 2007–2012. Emerg Infect Dis. 2017;23:1627–30. https://doi.org/10.3201/eid2310.170845 . - DOI - PubMed - PMC
    1. Hermansen TS, Ravn P, Svensson E, Lillebaek T. Nontuberculous mycobacteria in denmark, incidence and clinical importance during the last quarter-century. Sci Rep. 2017;7:6696. https://doi.org/10.1038/s41598-017-06931-4 . - DOI - PubMed - PMC
    1. Ricotta EE, Adjemian J, Blakney RA, Lai YL, Kadri SS, Prevots DR. Extrapulmonary nontuberculous mycobacteria infections in hospitalized patients, United States, 2009–2014. Emerg Infect Dis. 2021;27:845–52. https://doi.org/10.3201/eid2703.201087 . - DOI - PubMed - PMC
    1. Wi YM. Treatment of extrapulmonary nontuberculous mycobacterial diseases. Infect Chemother. 2019;51:245–55. https://doi.org/10.3947/ic.2019.51.3.245 . - DOI - PubMed - PMC

MeSH terms

LinkOut - more resources