• The Journal of the Korean Society for Microbiology
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• v.18 no.1
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• pp.47-52
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• 1983

During the last three years, it has become evident that patients with tuberculosis-like diseases due to the Mycobacterium avium-intracellulare complex(referred to M. avium complex; MAC) in Korea are more frequently observed than were assumed earlier. However, the incidence of various serotypes of the MAC isolated from patients with tuberculosis-like diseases has not been clarified. In this study, the serotypes of 16 strains of the MAC isolated from sputa of persons who had radiographic abnormalities of the lungs were determined by bacterial agglutination test with reference sera. The serotypable strains belonged to 7 serotypes, i.e., M. avium 13 were 4 strains(25.0%), M. avium 8 and 14 each 3 strains(18.8%), M. avium 5, 7, 12 and 18 one strain(6.3%), respectively. Two strains(12.5%) were not typable.

• Tuberculosis and Respiratory Diseases
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• v.74 no.1
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• pp.28-31
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• 2013

We present a case of congenital cystic adenomatoid malformation (CCAM) in a 25-year-old male who was presented with chronic cough. Chest radiography revealed an abnormal mass-like shadow in the right lower pulmonary zone. A contrast enhanced computed tomography showed an 11 cm solid, cystic mixed mass on the right lower lobe. A right lower lobectomy was performed by video-assisted thoracoscopic surgery without complications. The gross specimen showed a massive cavitation with multiloculated cysts of varying size, consistent with CCAM, along with noticeable granulomatous inflammation. Non-tuberculosis mycobacteria were isolated from a bronchial wash specimen, and the resected tissue homogenates were positive for Mycobacterium avium-intracellulare complex by polymerase chain reaction.

• Tuberculosis and Respiratory Diseases
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• v.67 no.5
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• pp.395-401
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• 2009

As the prevalence of tuberculosis declines, the proportion of nontuberculous mycobacterial (NTM) lung disease is increasing in Korea. The combined use of liquid and solid media increases the sensitivity of mycobacterial culture and shortens culture time. Because NTMs are ubiquitous in the environment, NTM lung disease requires strict diagnostic criteria to prevent over-diagnosis of NTM lung disease. Mycobacterium avium complex is the most common pathogen of NTM lung disease in Korea and present in two forms: upper lobe cavitary and nodular bronchiectatic form. Decision of treatment of NTM lung disease depends on the infecting species and overall condition of the patient. Because medical therapy requires the use of multiple drugs over 18 to 24 months, surgery for localized disease may be useful for those species refractory to medical therapy.

• The Journal of the Korean Society for Microbiology
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• v.17 no.1
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• pp.87-93
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• 1982

Two cases of pulmonary disease in a 54 year-old female and a 70 year-old male patient due to Mycobacterium avium-intracellulare complex(MAIC) and a case of pulmonary infection ina 69 year-old male patient due to M. fortuitum(MF) were found recently in this institute. All three patients had a long history of anti-tuberculous chemotherapy because they were initially diagnosed as pulmonary tuberculosis. A 70 year-old male patient infected with MAIC had an unsuccessful chemotherapy history of isoniazid(INH), para-aminosalicylic acid(PAS) and streptomycin(SM) with an incomplete, temporary, symptomatic improvement, for three years since 1964 when he was first diagnosed as pulmonary tuberculosis on physical examination. A 54 year-old female patient infected with MAIC also had an unsuccessful chemotherapy history with the various anti-tuberculous drugs since 1958. Both patients discharged large number of MAIC in their sputum specimens for at least more than one year, but no M. tuberculosis at all. A 69 year-old male patient infected with MF was diagnosed as moderately advanced pulmonary tuberculsis in 1977. Combined chemotherapy with INH+PAS+pyrazinamide(PZA) improved his clinical symptoms, however, his chest radiograph was deteriorated again in 1980 one year after he stopped therapy. Therefore he started chemotherapy again with INH+ethionamide(TH)+cycloserine(CS) but no improvement was noticed. MF was cultured from his sputum in August 1981 and he continuously discharged the same bacilli until last examination of January 1982. Whether all three patients were initially !infected with nontuberculous mycobacteria or complicated with predisposing tuberculosis was not clear because there were no reliable bacteriological examination records.

• Tuberculosis and Respiratory Diseases
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• v.74 no.3
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• pp.124-128
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• 2013

Pleural effusion is a rare complication in non-tuberculous mycobacterial infection. We report a case of Mycobacterium intracellulare pleuritis with idiopathic pulmonary fibrosis in a 69-year-old man presenting with dyspnea. Pleural effusion revealed lymphocyte dominant exudate. M. intracellulare was identified using a polymerase chain reaction-restriction fragment length polymorphism method and liquid cultures of pleural effusion and pleural biopsy. After combination therapy for M. intracellulare pulmonary disease, the patient was clinically well at a 1-month follow-up.

• Tuberculosis and Respiratory Diseases
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• v.82 no.1
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• pp.15-26
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• 2019

The pathogen Mycobacterium avium complex (MAC) is the most common cause of nontuberculous mycobacterial pulmonary disease worldwide. The decision to initiate long-term antibiotic treatment is difficult for the physician due to inconsistent disease progression and adverse effects associated with the antibiotic treatment. The prognostic factors for the progression of MAC pulmonary disease are low body mass index, poor nutritional status, presence of cavitary lesion(s), extensive disease, and a positive acid-fast bacilli smear. A regimen consisting of macrolides (clarithromycin or azithromycin) with rifampin and ethambutol has been recommended; this regimen significantly improves the treatment of MAC pulmonary disease and should be maintained for at least 12 months after negative sputum culture conversion. However, the rates of default and disease recurrence after treatment completion are still high. Moreover, treatment failure or macrolide resistance can occur, although in some refractory cases, surgical lung resection can improve treatment outcomes. However, surgical resection should be carefully performed in a well-equipped center and be based on a rigorous risk-benefit analysis in a multidisciplinary setting. New therapies, including clofazimine, inhaled amikacin, and bedaquiline, have shown promising results for the treatment of MAC pulmonary disease, especially in patients with treatment failure or macrolide-resistant MAC pulmonary disease. However, further evidence of the efficacy and safety of these new treatment regimens is needed. Also, a new consensus is needed for treatment outcome definitions as widespread use of these definitions could increase the quality of evidence for the treatment of MAC pulmonary disease.

• Archives of Pharmacal Research
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• v.25 no.3
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• pp.215-228
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• 2002

It is now more than two decades since the AIDS epidemic began with a cluster of Pneumocystis carinii pneumonia (PCP) in a community of homosexual men. Since then, many other infections have been characterized as opportunistic infections secondary to HIV infection. These include, but are not limited to, infections with Toxoplasma gondii, Cytomegalovirus (CMV), Mycobacterium avium complex (MAC), and Cryptococcus neoformans. Over the last two decades, there have been dramatic improvements in diagnosis, prevention and treatment of all these infections. As a result, in North America and Western Furope the rates of opportunistic infections secondary to AIDS have decreased substantially. We will review these common opportunistic infections below.

• Biomedical Science Letters
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• v.19 no.2
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• pp.132-141
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• 2013

Mycobacterium isolates were retrospectively identified, antibiotics susceptibility test results and basic clinical data were analyzed for the 715, excepted 308 in 1,023 specimens, from a mycobacterial laboratory at a tertiary care hospital from September 2002 to December 2008. Their male to female ratio was 1.12 to 1 (379 male, 336 female). The median age of study population was 47 years (range from 10 to 93 years). Distribution of Mycobacterium species was 90.1% of total were isolates Mycobacterium tuberculosis, and 9.9% of the total non-tuberculosis Mycobacterium isolated, and Among nontuberculosis Mycobacterium isolates, 60.6% were Mycobacterium avium complex, 14.1% were isolates Mycobacterium abscessus, and 12.7% were isolates Mycobacterium intracellulare. Among 526 Mycobacterium tuberculosis isolates, 81.7% isolates were susceptible to first line antibiotics, 18.3% were resistant to one or more antibiotics. Non-tuberculosis Mycobacterium isolates, all were resistant to two or more antibiotics. Multi-antibiotic resistant tuberculosis rate was show 10.2% of total specimens. Isolated Mycobacterium species, 19.2% were multi-antibiotic resistant tuberculosis, and the rate of nontuberculosis Mycobacterium resistant to isoniazid and rifampin was very highly 84.5%. Thus among acid fast bacilli culture positive cases, Mycobacterium tuberculosis and non-tuberculosis Mycobacterium were must exactly identification and antibiotic sensitivity test. It was considered to help to select of the antibiotic in preventive medicine.

• Tuberculosis and Respiratory Diseases
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• v.67 no.1
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• pp.32-36
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• 2009

We report a case of disseminated Mycobacterium intracellulare infection in a 31-year-old man who had been diagnosed as having dermatomyositis and systemic lupus erythematosus 3-years prior. The patient developed a left pleural effusion M. intracellulare was repeatedly isolated from the pleural fluid. After antimycobacterial treatment, the patient's pleural effusion resolved, but a left knee joint effusion developed newly and M. intracellulare was cultured from the joint fluid. At present, the patient has been taking antimycobacterial medication for 15 months but his left knee joint fluid remains positive for M. intracellulare. To our knowledge, this is the second reported case of disseminated NTM infection in a non-HIV infected patient in Korea.

• The Journal of the Korean Society for Microbiology
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• v.34 no.5
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• pp.491-500
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• 1999

A recent study showed that comparative sequence analysis of rpoB DNAs could reveal natural relationships in genus Mycobacterium [J Clin Microbial. 37 (6). 1999]. rpoB DNAs showed interspecies variation and intraspecies conservation. Based on these data, we developed polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) protocols which enable species differentiation in genus Mycobacterium. When this assay was applied to 24 clinical isolates identified as M. avium complex (MAC) by biochemical test, these were successfully differentiated into M. avium and M. intracellulare. These results were concordant with those obtained by 16s rDNA analysis. It is the first report that PCR-SSCP analysis of rpoB DNA could be used for species differentiation of MAC strains.