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Journal of Clinical Microbiology, November 2001, p. 4058-4065, Vol. 39, No. 11
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.11.4058-4065.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Burden of Unidentifiable Mycobacteria in a Reference Laboratory

Enrico Tortoli,1,* Alessandro Bartoloni,2 Erik C. Böttger,3 Stefan Emler,4 Carlo Garzelli,5 Enrico Magliano,6 Antonia Mantella,2 Nalin Rastogi,7 Laura Rindi,5 Claudio Scarparo,8 and Pasquale Urbano9

Regional Mycobacteria Reference Center, Microbiology and Virology Laboratory, Careggi Hospital,1 Infectious Diseases Unit,2 and Institute of Microbiology,9 University of Florence, Florence, Department of Experimental Pathology, Medical Biotechnologies, Infectivology and Epidemiology, University of Pisa, Pisa,5 Regional Mycobacteria Reference Center, Microbiology Unit, Niguarda "Ca Granda" Hospital, Milan,6 and Regional Mycobacteria Reference Center, San Bortolo Hospital, Vicenza,8 Italy; Institute of Medical Microbiology, University of Zurich,3 and SmartGene,4 Zurich, Switzerland; and Tuberculosis and Mycobacteria Unit, Pasteur Institute of Guadaloupe, Pointe a Pitre, Guadaloupe, France7

Received 14 May 2001/Returned for modification 14 August 2001/Accepted 8 September 2001

Modern identification techniques at the genomic level have greatly improved the taxonomic knowledge of mycobacteria. In adjunct to nucleic acid sequences, mycobacterial identification has been endorsed by investigation of the lipidic patterns of unique mycolic acids in such organisms. In the present investigation, the routine use of high-performance liquid chromatography (HPLC) of mycolic acids, followed by the sequencing of the 16S rRNA, allowed us to select 72 mycobacterial strains, out of 1,035 screened, that do not belong to any of the officially recognized mycobacterial species. Most strains (i.e., 47) were isolated from humans, 13 were from the environment, 3 were from animals, and 9 were from unknown sources. The majority of human isolates were grown from the respiratory tract and were therefore most likely not clinically significant. Some, however, were isolated from sterile sites (blood, pleural biopsy, central venous catheter, or pus). Many isolates, including several clusters of two or more strains, mostly slow growers and scotochromogenic, presented unique genetic and lipidic features. We hope the data reported here, including the results of major conventional identification tests, the HPLC profiles of strains isolated several times, and the whole sequences of the 16S rRNA hypervariable regions of all 72 mycobacteria, may encourage reporting of new cases. The taxonomy of the genus Mycobacterium is, in our opinion, still far from being fully elucidated, and the reporting of unusual strains provides the best background for the recognition of new species. Our report also shows the usefulness of the integration of novel technology to routine diagnosis, especially in cases involving slow-growing microorganisms such as mycobacteria.

* Corresponding author. Mailing address: Centro Regionale di Riferimento per la Diagnostica dei Micobatteri, Laboratorio di Microbiologia e Virologia, Piastra dei Servizi, Ospedale di Careggi, viale Morgagni 85, 50154 Florence, Italy. Phone: 39-055-4279199. Fax: 39-055-4279830. E-mail: e.tortoli{at}libeso.it.

Journal of Clinical Microbiology, November 2001, p. 4058-4065, Vol. 39, No. 11
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.11.4058-4065.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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