Molecular diagnosis of cutaneous non-tuberculous mycobacterial infection compared to conventional culture method at Institute of Dermatology, Bangkok

Name: Htet, May Soe

Organization : Rangsit University. College of Medicine

Name: Tanawatt Kootiratrakarn

Organization : Institute of Dermatology

Name: Praneet Sajjachareonpong

Organization : Institute of Dermatology

Name: Mingkwan Supanapong

Organization : Institute of Dermatology

Name: Wanchanida Khumkong

Organization : Institute of Dermatology

Name: Walai-orn Pratchyapruit

Organization : Institute of Dermatology

Name: Chavalit Supsrisunjai

Organization : Institute of Dermatology

Email : chervilius@gmail.com

LCSH: Molecular diagnosis

LCSH: Sequences (Mathematics)

LCSH: Polymerase chain reaction

Abstract: With increasing prevalence of cutaneous non-tuberculous mycobacterial (NTM) infection in Thailand, molecular diagnostic methods such as PCR and gene sequencing have played an important role in diagnosis and management of the disease. Although culture is still the gold standard for diagnosis, molecular diagnosis provides faster results enabling prospect of better clinical outcome. We aimed to compare the efficacy of Polymerase Chain Reaction (PCR) and sequencing technique using direct tissue sample to conventional culture method, and also to study the clinical characteristics of cutaneous NTM infections at the Institute of Dermatology. The medical records of all cases with confirmed diagnosis of cutaneous NTM infection during 2016 - 2020, with the results of both culture and PCR/gene sequencing using 16S-23S intergenic spacer region (ITS region) and 16S rRNA using fresh tissue, formalin-fixed, paraffin-embedded tissue (FFPE) sample were collected. Of all medical records, only 52 cases met our criteria, where only 9 cases had both positive culture and PCR from fresh tissue. Notably, regarding fresh tissue specimen, there were significantly more cases of positive culture than the molecular test when analyzed by Fisher’s Exact test at p <0.05. Neither the duration of lesions (≤4 weeks or >4 weeks) nor the morphology had any correlation with the molecular result. M. abscessus was the most common pathogen followed by M. marinum. Of note, 32 cases (64%) showed non-specific histological features. Most patients had combination therapy with 2 or 3 antibiotics. Combination of clarithromycin with either ciprofloxacin or co-trimoxazole was commonly used. In conclusion, conventional culture is the gold standard for diagnosis. Negative PCR results in most cases may result from inadequate tissue sampling showing less sensitivity. In addition, our study was limited by the small number of cases during the period of research.

King Mongkut's University of Technology North Bangkok. Central Library

Address: BANGKOK

Email: library@kmutnb.ac.th

Created: 2023

Modified: 2024-04-29

Issued: 2024-04-29

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BibliograpyCitation : In Rangsit University. The 8th RSU International Research Conference on Sciences and Technology 2023 (RSUCON 2023) (pp.172-178). Pathum Thani : Rangsit University

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