03101nas a2200445   4500000000100000008004100001653000900042653002300051653001800074653003000092653001100122653001300133653001100146653001800157653000900175653001600184653001800200653003200218653004900250653001400299653003600313653002400349653003100373100001000404700001200414700001200426700001100438700001100449700000900460700001100469700001000480700001200490700001000502245019400512856008900706300000800795490000700803520183100810022001402641       2015                            d10aAged10aBacterial Proteins10aBase Sequence10aDNA Transposable Elements10aFemale10agenotype10aHumans10aLung Diseases10aMale10aMiddle Aged10aMycobacterium10aMycobacterium avium Complex10aMycobacterium avium-intracellulare Infection10aPhylogeny10aPolymorphism, Single Nucleotide10aRNA, Ribosomal, 16S10aTomography, X-Ray Computed1 aKim S1 aPark HY1 aJeong B1 aJeon K1 aHuh HJ1 aKi C1 aLee NY1 aHan S1 aShin SJ1 aKoh W00aMolecular analysis of clinical isolates previously diagnosed as Mycobacterium intracellulare reveals incidental findings of "Mycobacterium indicus pranii" genotypes in human lung infection.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589961/pdf/12879_2015_Article_1140.pdf  a4060 v153 a<p><strong>BACKGROUND: </strong>Mycobacterium intracellulare is a major cause of Mycobacterium avium complex lung disease in many countries. Molecular studies have revealed several new Mycobacteria species that are closely related to M. intracellulare. The aim of this study was to re-identify and characterize clinical isolates from patients previously diagnosed with M. intracellulare lung disease at the molecular level.</p>

<p><strong>METHODS: </strong>Mycobacterial isolates from 77 patients, initially diagnosed with M. intracellulare lung disease were re-analyzed by multi-locus sequencing and pattern of insertion sequences.</p>

<p><strong>RESULTS: </strong>Among the 77 isolates, 74 (96 %) isolates were designated as M. intracellulare based on multigene sequence-based analysis. Interestingly, the three remaining strains (4 %) were re-identified as "Mycobacterium indicus pranii" according to distinct molecular phylogenetic positions in rpoB and hsp65 sequence-based typing. In hsp65 sequevar analysis, code 13 was found in the majority of cases and three unreported codes were identified. In 16S-23S rRNA internal transcribed spacer (ITS) sequevar analysis, all isolates of both species were classified within the Min-A ITS sequevar. Interestingly, four of the M. intracellulare isolates harbored IS1311, a M. avium-specific element. Two of three patients infected with "M. indicus pranii" had persistent positive sputum cultures after antibiotic therapy, indicating the clinical relevance of this study.</p>

<p><strong>CONCLUSIONS: </strong>This analysis highlights the importance of precise identification of clinical isolates genetically close to Mycobacterium species, and suggests that greater attention should be paid to nontuberculous mycobacteria lung disease caused by "M. indicus pranii".</p>
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