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Journal of Clinical Microbiology, March 2003, p. 1240-1244, Vol. 41, No. 3
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.3.1240-1244.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Clinical Implications of Mycobacterium kansasii Species Heterogeneity: Swiss National Survey

Department of Microbiology,¹ Division of Infectious Diseases, University Hospital, Lausanne,² Division of Infectious Diseases, University Hospital,³ Swiss National Center for Mycobacteria, Department of Medical Microbiology, University of Zurich, Zurich,⁴ Department of Microbiology,⁵ Division of Infectious Diseases, University Hospital, Bern,⁶ Department of Microbiology,⁷ Outpatient Department of Internal Medicine, University Hospital, Basel,⁸ Department of Microbiology, University Hospital, Geneva,⁹ Cantonal Institute of Bacteriology,¹⁰ Division of Infectious Diseases, Cantonal Hospital, Lugano, Switzerland,¹¹

Received 25 July 2002/ Returned for modification 28 October 2002/ Accepted 3 December 2002

Several subtypes of Mycobacterium kansasii have been described, but their respective pathogenic roles are not clear. This study investigated the distribution of subtypes and the pathogenicity of M. kansasii strains (n = 191) isolated in Switzerland between 1991 and 1997. Demographic, clinical, and microbiological information was recorded from clinical files. Patients were classified as having an infection according to the criteria of the American Thoracic Society. Subtypes were defined by PCR-restriction enzyme analysis of the hsp65 gene. Subtype 1 comprised 67% of the isolates (n = 128), while subtypes 2 and 3 comprised 21% (n = 40) and 8% (n = 15), respectively. Other subtypes (subtypes 4 and 6 and a new subtype, 7) were recovered from only 4% of patients (n = 8). M. kansasii subtype 1 was considered pathogenic in 81% of patients, while M. kansasii subtype 2 was considered pathogenic in 67% of patients and other subtypes were considered pathogenic in 6% of patients. The majority of patients with M. kansasii subtype 2 were immunocompromised due to the use of corticosteroids (21% of patients) or coinfection with HIV (62.5% of patients). Subtyping M. kansasii may improve clinical management by distinguishing pathogenic from nonpathogenic subtypes.

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