Nukui Y, Nakamura H, Ishioka H, Miyamoto H, Okamoto A, Kazumi Y, Yotsuyanagi H, Moriya K, Hatakeyama S
Department of Infection Control and Prevention, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Infection. 2014 Apr;42(2):437-40. doi: 10.1007/s15010-013-0561-5. Epub 2013 Nov 22.
Mycobacterium florentinum is a newly identified, rare, slow-growing species of nontuberculous mycobacteria (NTM). Here, we report a case of M. florentinum-induced synovitis of the wrist in an immunocompromised Japanese patient. M. florentinum was identified by sequence analysis of the rpoB, hsp65, and 16S rRNA genes. The M. florentinum strain in this study could not be differentiated from certain M. triplex strains by the hsp65 or 16S rRNA sequences alone, because they occasionally shared more than 99 % sequence identity. The isolated M. florentinum strain was only susceptible to clarithromycin and amikacin. Initially, the patient was treated with clarithromycin, levofloxacin, and ethambutol, and then with clarithromycin, levofloxacin, and rifampicin. To our knowledge, M. florentinum-induced synovitis has not been previously reported. Our results suggest that, in addition to other well-known pathogenic NTM, the recently identified M. florentinum strain should be considered as a possible cause of synovitis. Moreover, we should be cautious when identifying M. florentinum because this strain closely resembles M. triplex in genotype.
佛罗伦萨分枝杆菌是一种新发现的、罕见的、生长缓慢的非结核分枝杆菌（NTM）。在此，我们报告一例免疫功能低下的日本患者发生的由佛罗伦萨分枝杆菌引起的腕关节滑膜炎病例。通过对rpoB、hsp65和16S rRNA基因进行序列分析鉴定出佛罗伦萨分枝杆菌。本研究中的佛罗伦萨分枝杆菌菌株仅通过hsp65或16S rRNA序列无法与某些三联分枝杆菌菌株区分开来，因为它们偶尔会共享超过99%的序列同一性。分离出的佛罗伦萨分枝杆菌菌株仅对克拉霉素和阿米卡星敏感。最初，该患者接受克拉霉素、左氧氟沙星和乙胺丁醇治疗，随后接受克拉霉素、左氧氟沙星和利福平治疗。据我们所知，此前尚未有佛罗伦萨分枝杆菌引起滑膜炎的报道。我们的结果表明，除了其他知名的致病性非结核分枝杆菌外，最近鉴定出的佛罗伦萨分枝杆菌菌株也应被视为滑膜炎的可能病因。此外，在鉴定佛罗伦萨分枝杆菌时我们应谨慎，因为该菌株在基因型上与三联分枝杆菌非常相似。
