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Approximately 21 human cases of infection with Mycobacterium conceptionense have been reported. However, most cases were outside the United States, and optimal treatment remains uncertain. We report a case of M. conceptionense pneumonitis in a patient with HIV/AIDS in the United States. The patient was cured with azithromycin and doxycycline.

We are in the midst of a global outbreak of Mycobacterium chimaera infections related to a point source contamination of a widely used surgical device, the 3T heater-cooler unit. More than 250000 heart bypass procedures using heater-cooler devices are performed in the United States every year. It is estimated that 60% of these operations use the device associated with this outbreak. Most of the reported cases present with a disseminated infection that is striking in both the latency of presentation and the high mortality. The diagnosis can be elusive due to intermittent bacteremia and normal echocardiography. Therapy includes several months of antibiotics, and surgical intervention appears to be critical for successful outcomes. Here, we review diagnostic methods and treatment options to guide clinicians in the management of this complicated infection., (© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Mycobacterium sherrisii was first described as a novel species in 2004 but recently has begun to be more formally recognized with the use of new sequencing techniques. There have only been about 10 cases reported internationally, and we report the first case of M sherrisii in the United States. The mycobacterium was isolated from acid-fast bacilli cultures of a specimen obtained from a bronchoalveolar lavage and blood in a newly diagnosed HIV-infected, US-born patient presenting with sepsis. The patient was started on streptomycin, ethambutol, azithromycin, and rifampin with an improved clinical course. This report indicates the clinical presentation along with the varying drug susceptibilities to the emerging M sherrisii.

Mycobacterium liflandii causes a fatal frog disease in captive anurans. Here we report, to our knowledge, the first epizootic of mycobacteriosis in a European colony of clawed frogs (Silurana tropicalis), previously imported from a United States biologic supply company. Our findings suggest the emerging potential of this infection through international trade.

Even in the 21st century, tuberculosis continues to be a problem. Although the number of cases continues gradually to decrease in the United States, cases get more difficult to treat, specifically those that are multiple-drug resistant. Infection of one-third of the world's population ensures that tuberculosis will not disappear in the near future. In light of this, it will be useful to know the goals for the health care system and how these goals may be accomplished. Laboratory testing in the mycobacteriology field is experiencing more changes today than ever before. Determining what assays will be most useful to the clinician is a challenge, and acceptance of the new technology by the medical community an even greater one. Clinicians must use the best available resources to determine the most appropriate care for their patients and work together with the laboratory to ensure that the communication channels are open. This review focuses on current state-of-the-art resources useful for accurate and rapid laboratory diagnosis of mycobacterial infections.

Objective: To compile a list of mycobacteriology competencies and to investigate the importance and emphasis of these competencies as perceived by clinical laboratory educators of three program types., Design: Use of a survey instrument, which included 97 competency statements with Likert-type scales for the quantitative study of importance and emphasis of competencies., Study Selection: Randomly selected sample from all accredited college/university-based clinical laboratory science programs, hospital-based clinical laboratory science programs, and associate-degree clinical laboratory technician programs., Data Synthesis: For analysis, the competencies were divided into eight sub-categories. Means for each competency and each sub-category were calculated. Analysis of variance was used to determine any difference among the three program types for each sub-category of competencies. Chi-square analysis was used to determine significant differences for competencies requiring dichotomous responses., Conclusion: With the significant increase in tuberculosis and other mycobacterioses, the mycobacteriology experience for clinical laboratory students must be validated for relevance.

The clinically important nontuberculous mycobacteria include M. kansasii, M. genavense, M. marinum, M. simiae, M. scrofulaceum and M. szulgai, M. avium, M. haemophilum, M. intracellulare, M. malmoense, M. ulcerans, and M. xenopi, M. abscessus, M. chelonae, M. fortuitum, and (rarely) M. smegmatis. Four clinical syndromes account for nearly all cases: pulmonary disease, lymphadenitis, skin or soft tissue disease, and disseminated disease in AIDS. M. avium and M. intracellulare (known together as M. avium complex), are the most common causes of pulmonary disease, lymphadenitis, and disseminated disease. All four clinical syndromes seem to be increasing in frequency, particularly in immunosuppressed hosts. Nontuberculous mycobacteria are acquired from the environment, but specific reservoirs of these organisms leading to human disease have not been defined.

The algorithm of the mycobacteriology laboratory of the 1990s relies heavily on growth-dependent procedures that are slow and labor intensive. The introduction of nucleic acid-based direct amplification tests portends future laboratories where molecular diagnostic assays will prevail. Financial constraints mandate an interdisciplinary approach to establish clinical pathways and rational tailoring of current protocols to curtail expensive overuse of dwindling resources.

Nontuberculous mycobacterial (NTM) infections are a frequent cause of chronic lymphadenitis in children. Previous studies of NTM antigen skin testing were inconclusive as a result of problems with study design and antigen formulation. The present study was undertaken with the Centers for Disease Control to determine whether newly formulated NTM skin test antigens applied in a double blind manner with a standard purified protein derivative could accurately distinguish NTM infections from those caused by Mycobacterium tuberculosis. Among the 11 children enrolled at our institution the NTM antigens correctly identified the 5 children with culture-proved NTM infections, as well as 2 other children with clinical or histopathologic data consistent with NTM lymphadenitis (P = 0.003, Fisher test). None of the 11 children cross-reacted with the Centers for Disease Control-supplied purified protein derivative. The NTM antigens appear to be useful in the diagnostic evaluation of lymphadenitis and perhaps in the evaluation of children with positive purified protein derivative skin tests.

Mycobacterial cervical lymphadenitis remains a diagnostic challenge for many clinicians despite current advances in diagnostic laboratory techniques. Although much has been done to prevent tuberculosis, cases of mycobacterial disease in endemic form still occur. Six hundred and forty-five patients with tuberculosis were diagnosed and treated at the American University of Beirut Medical Center during the period from 1970 to 1985. Twenty-nine (4.5%) of these patients had proven mycobacterial cervical lymphadenitis. We stress histopathologic examination as the single most important means for diagnosing mycobacterial cervical lymphadenitis. Operation in combination with antituberculous chemotherapy remain the treatments of choice.

Results of the College of American Pathologists Surveys showed a significant improvement of participant performances between 1972 and 1973. Participants in the Special Mycobacterial Survey did much better in speciating mycobacteria than did those in the Comprehensive Microbiology Survey. It is likely that many of the participants in the Comprehensive Microbiology Survey were unaware of their option to select the extent to which they offer service and were evaluated.