Abstract
FIRST ISOLATION OF MYCOBACTERIUM FARCINOGENES IN AN INDIAN CLINICAL SPECIMEN USING RAPID AND RECENT TECHNOLOGIES

*Bhavini S. Shah, Vipul V. Shah, Hari Shankar P. Ray, Parth S. Shah, Nidhi D. Shah, Kalpesh H. Katudia, Yash Y. Panchal, Nikunj B. Khatri, Upti R. Bhatiya, 6Harsh Toshniwal, Baldev V. patel, Sandip C. Shah and Mandava V. Rao

ABSTRACT

The strains of Mycobacterium (M) farcinogenes are identified in bovine farcy of Zebu cattle in eastern Africa. These cause pathogeneciy in guinea pigs, rarely affect humans. We report here, a case of first time isolation of M. farcinogenes in India a native patient of Ahmedabad. This female patient having age of 32 years old underwent laparoscopy for removal of left complex ovarian cyst in November 2016. After 20 days of surgery, she complained of swelling, pain and discharge from the port site. The patient underwent multiple dressings and multiple courses of antibiotics, but continued with the same symptoms. Abdomen examination with Ultrasonography (USG) in January 2017 showed scar with two sinus opening and discharge. The collection and tissue were sent for microbiological and molecular tests with Histo Pathological Examination (HPE). The HPE result revealed necrotic areas without granuloma but culture of fluid indicated Acid-Fast Bacilli (AFB) smear positive and negative gene Xpert, nucleic acid amplification test (NAAT testing) for evidence of NTM and further supported by LPANTMCM. Then the cultured sample was subjected to Matrix Assisted Laser Desorption Ionization - Time of Flight (MALDI-TOF) which revealed M. farcinogenes with a score of 2.04. The bacterial DNA was then extracted and its 16s Ribosomal ribonucleic acid (rRNA) was used for Sanger sequencing and Next generation sequencing platforms. These observations supported the strain of M. farcinogenes (DSM43637) in our sample supporting earlier genome draft of it. Thus patient was infected with a rare species of M. farcinogenes, first time isolated, identified and reported in India. This patient was treated with relevant antibiotics as per the isolate. She was responded clinically with no discharge from wound site after 45 days and was then discharged continuing the same treatment for 9 months as per treatment regimen. Clinical examination found her free from disease also.

Keywords: M. farcinogenes, HPE, Cyst removal, MALDI-TOF, Sanger Sequencing, Next Generation Sequencing, Discharged culture, Female patient.


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