Pulmonary Isolation of Multidrug resistant “Mycobacterium simulans” and Mycobacterium tuberculosis from a patient in the Horn of Africa
Authors: Anthony Levasseur
Michel Drancourt
Jeremy Delerce
Emeline Baptiste
Fériel Bouzid
Djaltou Aboubaker Osman
Warsama Ibrahim Arreh
Mohamed Osman Hassan
Eric Garnotel
Journal: Scientific Reports (2018)
Discipline: Multidisciplinary
Keywords: pulmonary infections; non-tuberculous mycobacteria; multi-drug resistant tuberculosis; strain FB-527; Mycobacterium simulans
Affiliations: Aix Marseille Univ, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France., Centre d'Études et de Recherche de Djibouti (CERD), Institut de Recherche Médicinale (IRM), Djibouti, Djibouti., Hôpital pneumo-phtisiologie Chakib Saad Omar, Djibouti, Djibouti., Hôpital d'instruction des armées Alphonse Laveran, Marseille, France., Aix Marseille Univ, IRD, MEPHI, IHU Méditerranée Infection, Marseille, France. .

Abstract:  In low-income countries of the Horn of Africa, pulmonary infections are usually considered as tuberculosis, which diagnosis relies on clinical data and positive microscopic observation. This strategy allows non-tuberculous mycobacteria to escape detection, facilitating their emergence in populations. A non-tuberculous mycobacterium strain FB-527 was unexpectedly cultured from the sputum of a Djiboutian patient otherwise diagnosed with multi-drug resistant (MDR) tuberculosis. The sequencing of the rpoB and 16S rRNA genes showed that the isolate was identical to strain FI-09026 previously named "Mycobacterium simulans" and reported only once from a Somali patient. Strain FB-527 mimicked Mycobacterium tuberculosis colonies and enzymatic profile using API ZYM strip and was in vitro resistant to rifampicin and isoniazid. Isolation of two MDR mycobacteria complicated the diagnosis and therapeutic management of the patient. We here report on the complete description of strain FB-527 and strain FI-09026 including genome sequencing, finalizing the description of the proposed new species "Mycobacterium simulans". 

Retracted: No

PubPeer comments:
 In this paper, the authors mentioned that the patient provide a consent before to be recruited in the study. The patient having a tobacco issue and perform the study with different type of test. The patient lived in Djibouti. This paper don t mention any approval from an ethics committee in Djibouti. This paper mentioned an approval under the IHU ethics committee no. 2016-025. We can note that several other papers mentioned the same ethics approval number. Usually, one ethical approval number is attached to one protocol. In the other paper, we can note : different type of bacteria, patients in another country for a different indication (tuberculosis), ... It should be in the public interest to understand how a same ethical approval number for a protocol can cover so many different type of situations. - [Extended spectrum of antibiotic susceptibility for tuberculosis, Djibouti] - [u201cMycobacterium mephinesiau201d, a Mycobacterium terrae complex species of clinical interest isolated in French Polynesia] - [Pulmonary Isolation of Multidrug resistant u201cMycobacterium simulansu201d and Mycobacterium tuberculosis from a patient in the Horn of Africa] - [FISH and PNA FISH for the diagnosis of Q fever endocarditis and vascular infections.] - [Fluorescence in situ hybridization, a complementary molecular tool for the clinical diagnosis of infectious diseases by intracellular and fastidious bacteria] - [Fluorescent in situ hybridization can be used as a complementary assay for the diagnosis of Tropheryma whipplei infection] ,