Determination of Clinical Characteristics of Mycobacterium kansasii-Derived Species by Reanalysis of Isolates Formerly Reported as M. kansasii

Abstract

Background: Seven genotypic subtypes of Mycobacterium kansasii were recently demonstrated to represent distinct species based on phylogenomic analysis. Mycobacterium kansasii sensu stricto (formerly known as subtype 1) is most frequently associated with human diseases; only a few studies have compared the diverse clinical characteristics of M. kansasii subtypes, including their drug susceptibilities. We determined the actual incidence of infections caused by each subtype of M. kansasii and identified their clinical characteristics. Methods: We subtyped isolates identified as M. kansasii over the last 10 years at a tertiary care hospital. Percent identity score of stored sequencing data was calculated using curated reference sequences of all M. kansasii subtypes. Clinical characteristics were compared between those classified as subtype 1 and other subtypes. Student's t-test, Wilcoxon rank-sum test, and Fisher's exact test were used for comparisons. Results: Overall, 21.7% of the isolates were identified as species distinct from M. kansasii. The proportion of patients with subtype 1 M. kansasii infection who received treatment was significantly higher than that of patients with other subtype infections (55.3% vs. 7.7%, P = 0.003). Only patients with subtype 1 infection received surgical treatment. Non-subtype 1 M. kansasii isolates showed a higher frequency of resistance to ciprofloxacin and trimethoprim/sulfamethoxazole. Conclusions: Non-subtype 1 M. kansasii isolates should be separately identified in routine clinical laboratory tests for appropriate treatment selection.