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Volume 18, Number 1—January 2012
Letter

Mycobacterium riyadhense Pulmonary Infection, France and Bahrain

Sylvain GodreuilComments to Author , Hélène Marchandin, Anne-Laure Michon, Mikael Ponsada, Georges Chyderiotis, Patrick Brisou, Abdul Bhat, and Gilles Panteix
Author affiliations: Institut National de la Santé et de la Recherche Médicale Unité 1058, Montpellier, France (S. Godreuil); Hôpital Arnaud de Villeneuve, Montpellier (S. Godreuil, H. Marchandin, A.-L. Michon); Université Montpellier 1, Montpellier (H. Marchandin, A.-L. Michon); Laboratoire Biomnis, Lyon, France (M. Ponsada, G. Chyderiotis, G. Panteix); Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France (P. Brisou); Awali Hospital, Awali, Bahrain (A. Bhat)

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Table

Clinical characteristics, drug susceptibility testing, and outcome for 3 case-patients with Mycobacterium riyadhense infection, France and Bahrain*

Patient age, y/sex Clinical situation Molecular-based identification of M. riyadhense
 Drug susceptibility pattern, drug (MIC, µg/mL) interpretation Antimicrobial drug therapy Treatment duration, outcome
Gene % Sequence similarity with type strain GenBank accession nos.
19/M†
 Bone infection in left maxillary sinus
 16S rRNA, rpoB, hsp65
 Type strain
 EU27464, FJ786256, EU921671
 AMK (10.0) R; CYC (20.0) S; CIP (2.0) S; CLF (<0.5) S; CLR (<2.0) S; EMB (5.0) S; INH (1.0) I; PAS (>1.0) R; PRO (<1.0) S; RFB (0.2) S; RIF (0.2) S; STR (5.0) S‡
 INH, RFP, EMB; then INH, RFP
 9 mo, cured
39/F§
 Pulmonary infection
 16S rRNA¶, rpoB, hsp65
 99.8, 99.8, 100
 JF896094, JF896096, JF896098
 AMK (<1.0) S; CIP (1.0) S; CLR (0.12) S; DOX (16.0) R; EMB (<0.5) S; ETH (0.3) S; INH (0.5) S; LZD (<1.0) S; MOX (<0.12) S; RFB (<0.25) S; RIF (<0.12) S; STR (1.0) S; TMP/SMX (<0.12/2.38) NA#
 INH, RFP, EMB, PZA; then INH, RFP
 1 y, cured
43/M** Pulmonary infection 16S rRNA¶, rpoB, hsp65 99.8, 99.7, 99.1 JF896095, JF896097, JF896099 AMK (<1.0) S; CIP (0.12) S; CLR (0.12) S; EMB (<0.5) S; ETH (0.3) S; DOX (4.0) R; INH (0.25) S; LZD (<1.0) S; MOX (<0.12) S; RFB (<0.25) S; RIF (<0.12) S; STR (<0.5) S; TMP/SMX (<2.0/38.0) NA# CLR, CIP; then INH, RFP, EMB, PZA, CLR, CIP; then INH, RFP, CLR, CIP 1 y, relapse; 8 mo, cured

*AMK, amikacin; R, resistant; CYC, cycloserine; S, susceptible; CIP, ciprofloxacin; CLF, clofazimine; CLR, clarithromycin; EMB, ethambutol; INH, isoniazid; I, intermediate; PAS, para-aminosalicylate sodium; PRO, prothionamide; RFB, rifabutin; RIF, rifampin; STR, streptomycin ; RFP, rifapentine; DOX, doxycycline; ETH, ethionamide; LZD, linezolid; MOX, moxifloxacin; TMP/SMX, trimethoprim/sulfamethoxazole; NA, not available; PZA, pyrazinamide.
†Patient in Saudi Arabia; reported by van Ingen et al. (1).
‡Drug susceptibility testing was performed by using the agar dilution method.
§Patient in France.
¶Low 16S rRNA gene polymorphism between several mycobacterial species.
#Drug susceptibility testing was performed by using broth microdilution panels (SLOMYCO Sensititer; Trek Diagnosis Systems, Cleveland< OH, USA) and interpreted according to standards of the National Committee for Clinical Laboratory Standards (3).
**Patient in Bahrain.

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References
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