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Mycobacterium fortuitum is a nontuberculous species of the phylum actinobacteria (Gram-positive bacteria with high guanine and cytosine content, one of the dominant phyla of all bacteria), belonging to the genus mycobacterium.

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 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 [minimum inhibitory concentrations (MICs)], which have been highlighted for the initiation of antimicrobial therapy (Kothavade RJ et al., 2012).

Description

Gram-positive, nonmotile and acid-fast rods (1-3 µm 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, usually off-white or cream colored. May be butyrous, waxy, multilobate and even rosette clustered (dilute inocula).
On Malachite green 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.

Differential characteristics

Differentiation from M. fortuitum subsp. acetamidolyticum by its ability to utilise L-glutamate and its inability to utilise acetamide as simultaneous nitrogen and carbon source. Both subspecies share an identical 5'-16S rDNA sequence. However, the ITS sequences are different.

Pathogenesis

Different types of sporadic infections:^[1] pulmonary disease, local abscesses.
Postoperative sternal wound infections, endocarditis, meningitis, and osteomyelitis.
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 and quinolones, doxycycline and minocycline, and sulfonamides. Isolates of this mycobacterium are susceptible to the beta-lactam antibiotics, belonging to the carbopenam subgroup, such as Imipenem. Imipenem is a broad spectrum antibiotic produced by the bacteria Streptomyces cattleya. 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, dust, rivers, lakes and tap water.
First isolated from a 25-year old patient (syringe abscess) in Rio de Janeiro.
Also isolated from lymph glands of cattle and systemic or nodular infection of frogs.

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

^ Mycobacterium Fortuitum at eMedicine

UpToDate Contents

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1. HIV陰性患者において急速に増悪する抗酸菌感染症 rapidly growing mycobacterial infections in hiv negative patients
2. HIV感染患者における非結核性抗酸菌（MACを除く）の概要 overview of nontuberculous mycobacteria excluding mac in hiv infected patients
3. 小児における非結核性抗酸菌の皮膚および軟部組織感染症の概要 overview of nontuberculous mycobacterial skin and soft tissue infections in children
4. 成人における非結核性抗酸菌による骨髄炎の治療 treatment of osteomyelitis due to nontuberculous mycobacteria in adults
5. HIV陰性患者における非結核性抗酸菌感染症の概要 overview of nontuberculous mycobacterial infections in hiv negative patients

English Journal

Development of multiplex PCR assays based on the 16S-23S rRNA internal transcribed spacer for the detection of clinically relevant nontuberculous mycobacteria.

Ngan GJ, Ng LM, Jureen R, Lin RT, Teo JW.SourceNational University Hospital, Department of Laboratory Medicine, Singapore, Singapore.
Letters in applied microbiology.2011 May;52(5):546-54. doi: 10.1111/j.1472-765X.2011.03045.x. Epub 2011 Mar 28.
Aims:? To accelerate the identification and differentiation of clinically relevant nontuberculous mycobacteria (NTM) with two sets of multiplex PCR (mPCR) targeting the 16S-23S rRNA internal transcribed spacer (ITS) region for timely patient management. Methods and Results:? Two mPCR assays were
PMID 21395629

Japanese Journal

症例報告臀部に生じたMycobacterium fortuitumによる皮下膿瘍の1例

白樫祐介,吉田哲也,藤本篤嗣 [他]
臨床皮膚科 64(13), 1065-1068, 2010-12
NAID 40017433382

Related Pictures

★リンクテーブル★

リンク元	「ラニヨン分類」「M. fortuitum」「フォーチュイタム菌」
関連記事	「Mycobacterium」

「ラニヨン分類」

Mycobacterium fortuitum
	A scanning electron micrograph of Mycobacterium fortuitum
Scientific classification
Kingdom:	Bacteria
Phylum:	Actinobacteria
Order:	Actinomycetales
Suborder:	Corynebacterineae
Family:	Mycobacteriaceae
Genus:	Mycobacterium
Species:	M. fortuitum
Binomial name
	Mycobacterium fortuitum; Da Costa Cruz 1938, ATCC 6841

　　[★]

英: Runyon classification
同: Runyon分類
関: 抗酸菌

[show details]

ラニアン分類 : 1 件
ラニャン分類 : nothing
ラニヤン分類 : 
ラニョン分類 : 
ラニヨン分類 : 4 件

ラニアン分類 Runyon : nothing
ラニャン分類 Runyon : nothing
ラニヤン分類 Runyon : 
ラニョン分類 Runyon : 
ラニヨン分類 Runyon : 3 件

分類				菌種名
培養可能菌	遅発育菌	結核菌群		Mycobacterium tuberculosis
				Mycobacterium bovis
				Mycobacterium microti
				Mycobacterium africanum
		非結核性抗酸菌群	I群菌光発色菌	Mycobacterium kansasii
				Mycobacterium marinum
				Mycobacterium simiae
				Mycobacterium asiaticum
			II群菌暗発色菌	Mycobacterium flavescens
				Mycobacterium gordonae
				Mycobacterium scrofulaceum
				Mycobacterium szulgai
			III群菌非光発色菌	Mycobacterium avium complex
				Mycobacterium celatum
				Mycobacterium haemophilum
				Mycobacterium gastri
				Mycobacterium genavense
				Mycobacterium malmoense
				Mycobacterium nonchromogenicum
				Mycobacterium shimoidei
				Mycobacterium terrae
				Mycobacterium trivale
				Mycobacterium ulcerans
				Mycobacterium xenopi
	迅速発育菌		IV群菌	Mycobacterium abscessus
				Mycobacterium fortuitum group
				Mycobacterium chelonae group
				Mycobacterium phlei
				Mycobacterium smegmatis
				Mycobacterium vaccae
培養不能菌				Mycobacterium leprae

参考

http://www.jata.or.jp/rit/rj/319kataki10.pdf#search='%E8%BF%85%E9%80%9F%E7%99%BA%E8%82%B2%E7%BE%A4+rapid+group'

「M. fortuitum」

　　[★]

マイコバクテリウム・フォーチュイタム

関: Mycobacterium fortuitum

「フォーチュイタム菌」

　　[★]

ラ: Mycobacterium fortuitum
関: 非定型抗酸菌

「Mycobacterium」

　　[★] マイコバクテリウム属

[1] Mycobacterium Fortuitum at eMedicine

匿名

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案内

案内

Mycobacterium fortuitum