Molecular techniques have improved the turnaround time of test to identifying mycobacterial organisms. Here. Ann Barrett and colleagues assess the strengths and weaknesses of several methods. (Image: CDC/Dr George P Kubica)
Many mycobacterial species are pathogenic to humans, with infection occurring worldwide. Infection with Mycobacterium tuberculosis is a well-described global phenomenon, but other mycobacterial species are increasingly shown to be the cause of both pulmonary and extrapulmonary infection and are managed differently from M. tuberculosis infection. Rapid and accurate differentiation of mycobacterial species is, therefore, critical to guide timely and appropriate therapeutic and public health management.
The Mycobacterium genus includes Mycobacterium tuberculosis complex (MTBC), which includes M. tuberculosis and M. bovis. There are many other diverse species referred to collectively as ‘mycobacteria other than tuberculosis’ (MOTT), which includes the Mycobacterium avium complex (MAC). The incidence of infection with MTBC in Ireland is relatively high compared to many other European countries, being ranked joint 11th highest of 30 EU countries in 2009.1
Mycobacteria other than tuberculosis are ubiquitous in the environment, being found in soil, food, water and animals, and their capacity to cause disease in humans has been recognised since the 1960s.2 At present, more than 130 species are known and infections due to MOTT represent an increasing proportion of all mycobacterial disease, especially in developed countries, causing pulmonary, lymph node, joint and soft tissue infections.3
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