''Mycobacterium fortuitum'' is a nontuberculous species of the phylum

Actinomycetota The ''Actinomycetota'' (or ''Actinobacteria'') are a phylum of all gram-positive bacteria. They can be terrestrial or aquatic. They are of great economic importance to humans because agriculture and forests depend on their contributions to s ...

(

Gram-positive In bacteriology, gram-positive bacteria are bacteria that give a positive result in the Gram stain test, which is traditionally used to quickly classify bacteria into two broad categories according to their type of cell wall. Gram-positive bact ...

bacteria Bacteria (; singular: bacterium) are ubiquitous, mostly free-living organisms often consisting of one biological cell. They constitute a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria were am ...

with high guanine and cytosine content, one of the dominant phyla of all bacteria), belonging to the genus ''

Mycobacterium ''Mycobacterium'' is a genus of over 190 species in the phylum Actinomycetota, assigned its own family, Mycobacteriaceae. This genus includes pathogens known to cause serious diseases in mammals, including tuberculosis ('' M. tuberculosis'') ...

''.

Background

''Mycobacterium fortuitum'' is a fast-growing species that can cause infections. The term "fast growing" is a reference to a growth rate of 3 or 4 days, when compared to other Mycobacteria that may take weeks to grow out on laboratory media. Pulmonary infections of ''M. fortuitum'' are uncommon, but ''Mycobacterium fortuitum'' can cause local skin disease, osteomyelitis (inflammation of the bone), joint infections and infections of the eye after trauma. ''Mycobacterium fortuitum'' has a worldwide distribution and can be found in natural and processed water, sewage, and dirt. Bacteria classified as Mycobacteria, include the causative agents for tuberculosis and leprosy. Mycobacteria are sometimes referred to as “acid-fast bacteria,” a term referencing their response to a laboratory staining technique. This simply means that when microscopic slides of these bacteria are rinsed with an acidic solution, they retain a red dye. ''Mycobacterium fortuitum'' is one of the many species of nontuberculosis mycobacteria (NTM) that are commonly found in the environment. These are not involved in tuberculosis. This does not mean, however, that they will not cause an infection in the right circumstances. ''M. fortuitum'' infection can be a nosocomial (hospital acquired) disease. Surgical sites may become infected after the wound is exposed directly or indirectly to contaminated tap water. Other possible sources of ''M. fortuitum'' infection include implanted devices such as catheters, injection site abscesses, and contaminated endoscopes. Recent publication on Rapidly Growing Mycobacteria (RGM) is available provides the following aspects of RGM: (i) its sources, predisposing factors, clinical manifestations, and concomitant fungal infections; (ii) the risks of misdiagnoses in the management of RGM infections in dermatological settings; (iii) the diagnoses and outcomes of treatment responses in common and uncommon infections in immunocompromised and immunocompetent patients; (iv) conventional versus current molecular methods for the detection of RGM; (v) the basic principles of a promising MALDI-TOF MS, sampling protocol for cutaneous or subcutaneous lesions and its potential for the precise differentiation of ''M. fortuitum'', ''M. chelonae'', and ''M. abscessus''; and (vi) improvements in RGM infection management as described in the recent 2011 Clinical and Laboratory Standards Institute (CLSI) guidelines, including interpretation criteria of molecular methods and antimicrobial drug panels and their break points inimum inhibitory concentrations (MICs) which have been highlighted for the initiation of antimicrobial therapy (Kothavade RJ et al., 2012).

Description

, nonmotile and

acid-fast Acid-fastness is a physical property of certain bacterial and eukaryotic cells, as well as some sub-cellular structures, specifically their resistance to decolorization by acids during laboratory staining procedures. Once stained as part of a sam ...

rods (1-3

µm The micrometre ( international spelling as used by the International Bureau of Weights and Measures; SI symbol: μm) or micrometer ( American spelling), also commonly known as a micron, is a unit of length in the International System of Uni ...

x 0.2-0.4 µm). Sometimes long rods with occasional beaded or swollen cells having non-acid-fast ovoid bodies at one end. Colony characteristics *Smooth hemispheric

colonies In modern parlance, a colony is a territory subject to a form of foreign rule. Though dominated by the foreign colonizers, colonies remain separate from the administration of the original country of the colonizers, the '' metropolitan state'' ...

, usually off-white or cream colored. May be butyrous, waxy, multilobate and even rosette clustered (dilute inocula). *On

Malachite green Malachite green is an organic compound that is used as a dyestuff and controversially as an antimicrobial in aquaculture. Malachite green is traditionally used as a dye for materials such as silk, leather, and paper. Despite its name the dye is ...

containing media, such as Löwenstein-Jensen media, colonies can absorb the green dye. Physiology *Rapid growth on Löwenstein-Jensen media within 2–4 days. *No growth at 45 °C, but grows on

MacConkey agar MacConkey agar is a selective and differential culture medium for bacteria. It is designed to selectively isolate Gram-negative and enteric (normally found in the intestinal tract) bacteria and differentiate them based on lactose fermentation. ...

. Differential characteristics *Differentiation from '' M. fortuitum subsp. acetamidolyticum'' by its ability to use L-glutamate and its inability to use

acetamide Acetamide (systematic name: ethanamide) is an organic compound with the formula CH3CONH2. It is the simplest amide derived from acetic acid. It finds some use as a plasticizer and as an industrial solvent. The related compound ''N'',''N''-dime ...

as simultaneous

nitrogen Nitrogen is the chemical element with the symbol N and atomic number 7. Nitrogen is a nonmetal and the lightest member of group 15 of the periodic table, often called the pnictogens. It is a common element in the universe, estimated at se ...

and

carbon Carbon () is a chemical element with the symbol C and atomic number 6. It is nonmetallic and tetravalent—its atom making four electrons available to form covalent chemical bonds. It belongs to group 14 of the periodic table. Carbon ma ...

source. Both subspecies share an identical 5'-

16S rDNA 16 S ribosomal RNA (or 16 S rRNA) is the RNA component of the 30S subunit of a prokaryotic ribosome (SSU rRNA). It binds to the Shine-Dalgarno sequence and provides most of the SSU structure. The genes coding for it are referred to as 16S rRN ...

sequence. However, the ITS sequences are different.

Pathogenesis

*Different types of sporadic infections: pulmonary disease, local abscesses. *Postoperative sternal wound infections,

endocarditis Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves. Other structures that may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or the ...

meningitis Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or ...

, and

osteomyelitis Osteomyelitis (OM) is an infection of bone. Symptoms may include pain in a specific bone with overlying redness, fever, and weakness. The long bones of the arms and legs are most commonly involved in children e.g. the femur and humerus, while the ...

. *Has produced postoperative infections after breast augmentation surgery. * Biosafety level 2

Treatment

The 2007 guideline “Official American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) statement: diagnosis, treatment, and prevention of non-tuberculosis mycobacterial diseases”, notes that M. fortuitum isolates are usually susceptible to multiple oral antimicrobial agents, including the macrolides, quinolones, some tetracyclines, and sulfonamides, as well as the intravenous carbapenems (e.g. imipenem). Ondansetron HCL (Zofran) is an antiemetic often given to offset the nausea and vomiting that are a common side effect of Imipenem. Severe infections require IV treatment combined with oral antibiotics for a prolonged period, up to several months. The guideline recommends “for serious skin, bone, and soft tissue M fortuitum disease, a minimum of 4 months of therapy with at least two agents with in vitro activity against the clinical isolate is necessary to provide a high likelihood of cure. Surgery is generally indicated with extensive disease, abscess formation, or where drug therapy is difficult.”

Type strain

*Found world-wide in

soil Soil, also commonly referred to as earth or dirt, is a mixture of organic matter, minerals, gases, liquids, and organisms that together support life. Some scientific definitions distinguish ''dirt'' from ''soil'' by restricting the former ...

dust Dust is made of fine particles of solid matter. On Earth, it generally consists of particles in the atmosphere that come from various sources such as soil lifted by wind (an aeolian process), volcanic eruptions, and pollution. Dust in ...

river A river is a natural flowing watercourse, usually freshwater, flowing towards an ocean, sea, lake or another river. In some cases, a river flows into the ground and becomes dry at the end of its course without reaching another body of ...

lake A lake is an area filled with water, localized in a basin, surrounded by land, and distinct from any river or other outlet that serves to feed or drain the lake. Lakes lie on land and are not part of the ocean, although, like the much large ...

s and

tap water Tap water (also known as faucet water, running water, or municipal water) is water supplied through a tap, a water dispenser valve. In many countries, tap water usually has the quality of drinking water. Tap water is commonly used for drinking, ...

. *First isolated from a 25-year-old patient (syringe abscess) in

Rio de Janeiro Rio de Janeiro ( , , ; literally 'River of January'), or simply Rio, is the capital of the state of the same name, Brazil's third-most populous state, and the second-most populous city in Brazil, after São Paulo. Listed by the GaWC as a b ...

. *Also isolated from

lymph gland A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that include ...

s of

cattle Cattle (''Bos taurus'') are large, domesticated, cloven-hooved, herbivores. They are a prominent modern member of the subfamily Bovinae and the most widespread species of the genus '' Bos''. Adult females are referred to as cows and adult ...

and systemic or nodular infection of

frog A frog is any member of a diverse and largely Carnivore, carnivorous group of short-bodied, tailless amphibians composing the order (biology), order Anura (ανοὐρά, literally ''without tail'' in Ancient Greek). The oldest fossil "proto-f ...

s. Strain ATCC 6841 = CCUG 20994 = CIP 104534 = DSM 46621 = IFO (now NBRC) 13159 = JCM 6387 = NCTC 10394. Subsequently, this species has been divided into subspecies ''M. fortuitum'' subsp. ''acetamidolyticum''

References

External links

Type strain of ''Mycobacterium fortuitum'' at Bac''Dive'' - the Bacterial Diversity Metadatabase
{{Taxonbar, from=Q6947023 Acid-fast bacilli fortuitum Bacteria described in 1938