JCM Accepts, published online ahead of print on 28 October 2009

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J. Clin. Microbiol. doi:10.1128/JCM.01602-09
Copyright (c) 2009, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Clinical significance of Mycobacterium asiaticum isolates in Queensland, Australia.

Miriam Grech, Robyn Carter, and Rachel Thomson

Dept of Thoracic Medicine, The Prince Charles Hospital Brisbane; QLD Mycobacterial Reference Laboratory, Pathology Queensland, Royal Brisbane and Women's Hospital campus, Brisbane; Dept. of Thoracic Medicine, The Prince Charles Hospital Brisbane, Queensland Tuberculosis Control Centre (QTBCC), Brisbane

BACKGROUND: Mycobacterium asiaticum was first reported as a cause of human disease in 1982, with only a few cases in the literature to date. This study aims to review the clinical significance of M. asiaticum isolates in Queensland.

METHODS: A retrospective review (1989-2008) of patients with M. asiaticum isolates was conducted. Data was collected through the Queensland TB Control Centre database. Disease was defined in accordance with the American Thoracic Society criteria.

RESULTS: Twenty four patients (13 Female) had a positive culture of M. asiaticum, many residing around the Tropic of Capricorn. M. asiaticum was responsible for pulmonary disease (n=2), childhood lymphadenitis (n=1), olecranon bursitis (n=1), 6 cases of possible pulmonary disease and 2 possible wound infections. Chronic lung disease was a risk factor for pulmonary infection, and wounds/lacerations for extrapulmonary disease. Extrapulmonary disease responded to local measures. Pulmonary disease responded to ethambutol/isoniazid/rifampicin, plus pyrazinamide for the first two months in one patient, and amikacin/azithromycin/minocycline in another patient.

CONCLUSION: Whilst M. asiaticum is rare in Queensland, there appears to be an environmental niche. Although often a colonizer, it can be a cause of pulmonary and extrapulmonary disease. Treatment of pulmonary disease remains challenging. Extrapulmonary disease does not mandate specific NTM treatment.