= ‘Atypical Mycobacteria (Non — tuberculosis mycobacteria) anonymous or wuclassified mycobacteria INTRODUCITION:~ Mycobacteria are a family of small. rod- for the purpose of diagnosis and treatment haped bacilli that can be classified into 3 main groups Mycobacterium tuberculosis complex which cari cause tuberculosis: M- duberculosis, bovis. M. africanum, M. microti and M. caneuti. M, leprae and M. lepromatosis which cause Hansen's disease. also called leprosy Nontubereulous mycobacteria (NTM) are all the other mycobacteria which can cause: pulmonary disease resembling tuberculosis, lymphadenitis, skin disease, or disseminated disease. Although over 150 different species of NJM have been described, pulmonary infections are ‘most commonly due 10 Mycobacterium avium complex (MAC), Mycobacterium karsasi, and Mycobacterium abscessus. > Mycobacteria other than tubercle bacilli . that may occasionally cause human disease resembling tuberculosis, have been called atypical mycobacteria. % ‘Theyre also named as anonymous or unclassified mycobacteria, They normally exis a sapropiiytes of soil and waier % They occasionally cause opportunistic disease in man and hence are ‘opportunistic mycobacteria or non ~ tuberculous mycobacteria (NIM) ot my Runyon | organisms (photochromogens) are slow growing, and produce a yellow-orange pigment when exposed to light. > The group includes Mycobacterium kansasii, Mycobacterium marinum, Mycobacterium asiaticum, and Mycobacterium simiae. Mycobacterium sculgai is a photochromogen when grown at 24 degrees, and a scotochromogen at 37 degrees, > In contrast. Runyon classifications tl through IV are considered nonphotochromogens, in that exposure to light does not make them produce pigment which they would not aC develop in dark growing conditions. nisms (scotochromogens) are slow-growing and produce a yellows-or ‘of whether they are grown in the dark or the lizht. i lonae and Mycobacterium scrofulaceum. among gui is a scotochromogen when grown at 37 degrees, us mentionedRunyon 1V; Rapid Growers ® Runyon IV organisins are ry cabin volonies in 5 days), They do Becrepi ania rapid growing for mycobacteria (volonies in 5 days), Sey do >» Mysobacterium __fortuitum, Mycobacteri 1 ~ 5 jun pereurinum. Mysobacterium abscessus, , Mycobacterium thermoresistibile » Some rapidly growing mycobacteria are considered "late-pigmenting” Z CULTURE:- > Non ~ tuberculosis mycobacteria (NM) grow jn lowenstein — jensen (LJ) medium > They also grow in the presence of p-nitrobenzoie acid (PNIB) 500 microgram % This features differentiates NTM form Mtuberculosis which do not gions > Colonies appear within two to three weeks except in ease of rapid growers which produce colonies in four or five days. } Photochromogens form colonies that produce no piyment in the dark but when colonies fare exposed to light for one hour in the presence of air , and reincubated for 24 to 48 hours a yellow orange pigment appears. > Pigment is chemically beta ~ carotene } Scotochromogens produce pigment in the dark. } Non —photochromogens don not form pigment even on exposure (0 light : > Rapid growers may be photo , scoto or non ~ photochromogens CLINICAL MANIFESTATIONS: 2 Soe g 2 oa ‘most of them are environmental sapropfiytes some of these non ~ tuberculous occasionally cause disease in man and animals.2.Pulmonary Disease + These infection resemble tuberculosis, ~ In most but not all cases there is some Predisposing lung disease % Many species are tesponsible but most frequént ones are Maavium ~ intracelluare and M.kansaii 3.Skin Lesions > Buruli uleer:- it is cause by M.uleerans > Leg is most common site of lesions > Incarly stage painful , itehy , hard subcutaneous nodule is formed > The nodule enlarge and the center become soft due to necrosis of subcutaneous tissue. > Later on a deep ulcer is formed ‘Swimming pool granuloma :- > tis caused by M.marinum __-& The disease is also called fish tank granuloma Abscesses:- i and M. fortuitum (rapid growers) cause abscesses following injection when ‘materials are contaminated with these bacteria. are painful and lasts for many months.Culture:- + ‘They grow well on LJ medium Several LJ media should be inoculated with the specimens v7, These are incubated in the dark and in the light at different temperature for distinguishing the species. Biochemical Reactions:- > ‘These are important to differentiate various species of non — tuberculosis mycobacteria. 3