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A Case of Chronic Gordonia otitidis Lung Infection Initially Regarded as Nontuberculous Mycobacterial Lung Disease

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초록

The genus Gordonia is one of the mycolic acid-containing aerobic actinomycetes. This genus has 38 named species that are widespread in the natural environment; however, Gordonia species rarely cause human infections. A 76-year-old woman presented with cough and sputum for over 1 year and was suspected of having nontuberculous mycobacterial (NTM) lung disease. An NTM isolate from the sputum was initially identified as Mycobacterium lentiflavum or Mycobacterium genavense by genotypic identification targeting internal transcribed spacer (ITS). However, the isolate was finally confirmed as Gordonia otitidis by sequencing of 16S rRNA, gyrB and secA1 genes. In patients with suspected NTM lung disease, the etiologic agent might be an organism other than NTM such as G. otitidis but still be identified as NTM without sequencing of 16S rRNA or other genes. Especially in case that a possible NTM isolate is identified as M. lentiflavum or M. genavense by the genotypic method targeting ITS, additional genotypic tests such as sequencing of 16S rRNA and other genes would be necessary for more reliable identification. (Ann Clin Microbiol 2017;20:-16)

Abstract

The genus Gordonia is one of the mycolic acid-containing aerobic actinomycetes. This genus has 38 named species that are widespread in the natural environment; however, Gordonia species rarely cause human infections. A 76-year-old woman presented with cough and sputum for over 1 year and was suspected of having nontuberculous mycobacterial (NTM) lung disease. An NTM isolate from the sputum was initially identified as Mycobacterium lentiflavum or Mycobacterium genavense by genotypic identification targeting internal transcribed spacer (ITS). However, the isolate was finally confirmed as Gordonia otitidis by sequencing of 16S rRNA, gyrB and secA1 genes. In patients with suspected NTM lung disease, the etiologic agent might be an organism other than NTM such as G. otitidis but still be identified as NTM without sequencing of 16S rRNA or other genes. Especially in case that a possible NTM isolate is identified as M. lentiflavum or M. genavense by the genotypic method targeting ITS, additional genotypic tests such as sequencing of 16S rRNA and other genes would be necessary for more reliable identification. (Ann Clin Microbiol 2017;20:-16)

참고문헌 (7)

  1. Kang Y, "Phylogenetic studies of Gordonia species based on gyrB and secA1 gene analyses", Mycopathologia, 167, pp.95~105 (2009)
  2. Arenskötter M, "Biology of the metabolically diverse genus Gordonia", Appl Environ Microbiol, 70, pp.3195~3204 (2004)
  3. Kim R, "Mandell, Douglas, and Bennett’s principles and practice of infectious diseases", pp.2381~ (2015), Saunders
  4. Blaschke AJ, "Gordonia species: emerging pathogens in pediatric patients that are identified by 16S ribosomal RNA gene sequencing", Clin Infect Dis, 45, pp.483~486 (2007)
  5. Iida S, "Gordonia otitidis sp. nov., isolated from a patient with external otitis", Int J Syst Evol Microbiol, 55, pp.1871~1876 (2005)
  6. Shen FT, "Phylogenetic analysis of members of the metabolically diverse genus Gordonia based on proteins encoding the gyrB gene", Res Microbiol, 157, pp.367~375 (2006)
  7. Ma TK, "Peritoneal-dialysis related peritonitis caused by Gordonia species:report of four cases and literature review", Nephrology (Carlton), 19, pp.379~383 (2014)

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