Samples mycobacterium. Medical search. Frequent questions

Typically, the organism is Mycobacterium fortuitum or Mycobacterium chelonae . (ajronline.org)
The Mycobacterium avium complex (MAC) was the most frequently identified group (37% of strains) followed by Mycobacterium gordonae (25%) and Mycobacterium xenopi (12%) among the slowly growing mycobacteria (SGM), while the Mycobacterium chelonae/abscessus group (11%) were the most frequently identified rapidly growing mycobacteria (RGM). (unige.ch)
The most common species isolated were Mycobacterium fortuitum, M. flavescens and M. chelonae. (who.int)
Les espèces les plus couramment isolées étaient Mycobacterium fortuitum, M. flavescens et M. chelonae. (who.int)
If M chelonae, Mycobacterium abscessus or any rapidly growing mycobacteria (RGM)infection is discovered, additional testing for underlying disease may be needed. (medscape.com)

We also look for problems with unusual bacteria or fungi, and in the course of looking for fungi, we also found the nontuberculous mycobacteria. (cdc.gov)
Sputum stain for mycobacteria is a test to check for a type of bacteria that cause tuberculosis and other infections. (medlineplus.gov)
Simultaneous sputum liquefaction, bacteria heat inactivation (99°C/30 min), and enrichment for mycobacteria DNA were achieved using an equal volume of thermo-protection buffer (4 M KCl, 0. (ox.ac.uk)
Seven lineages of Mycobacterium tuberculosis (MTB), the bacteria that causes "Tuberculosis" (TB), have been identified till date [ 1 ]. (hindawi.com)
Mycobacteria are a large group of aerobic bacteria that produce filamentous pellicles similar to molds when grown in liquid media. (medscape.com)
As the EPA-designated reference laboratory for NY State, the Environmental Biology Laboratory analyzes water samples submitted by state agencies and local health departments for organisms indicative of fecal pollution (thermotolerant coliforms, E. coli , enterococci) and overall water quality (heterotrophic bacteria, total coliforms). (wadsworth.org)
The MBT Mycobacteria IVD software Module allows processing of more challenging mass spectra than those obtained from most other bacteria. (bruker.com)
The team detected sequences from the TB bacteria in all eight sputum samples they investigated and were able to assign the bacteria to a known lineage in seven of the samples. (news-medical.net)
Contact with different species of environmental Mycobacterium can cause acquired immunity to M. tuberculosis or increase the efficacy of BCG vaccine protection (M. vaccae, M. microti), although some species of these bacteria reduce the efficacy of BCG vaccine (M. scrofulaceum) [8,10-13]. (who.int)
is a contagious infection caused by the airborne bacteria Mycobacterium tuberculosis . (msdmanuals.com)
Diagnosis Tuberculosis is a chronic contagious infection caused by the airborne bacteria Mycobacterium tuberculosis . (msdmanuals.com)
Examination of direct smears for acid fast bacilli is the widely used method for the detection of mycobacteria, but lacks the desired specificity and relatively large number of bacteria is needed for detection. (who.int)
Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. (who.int)

Mycobacterium avium-intracellulare complex infections are becoming an increasing concern in veterinary medicine because they affect livestock, wildlife, and companion animals. (frontiersin.org)
Mycobacterium avium-intracellulare complex (MAC) infections are becoming an increasing concern in veterinary medicine because they occur in a wide range of animals, including domestic animals ( 1 ), ruminant and non-ruminant wildlife ( 2 ), and companion animals ( 3 , 4 ). (frontiersin.org)
This article reviews the dermatologic manifestations of Mycobacterium avium-intracellulare (MAI, or MAC) infection. (medscape.com)
See also Mycobacterium Avium-Intracellulare . (medscape.com)
In the United States, Mycobacterium avium-intracellulare (MAI, or MAC) infection is considered a nonreportable infectious disease. (medscape.com)
It is important to consider cutaneous infection with Mycobacterium avium-intracellulare (MAI, or MAC) in patients with antibiotic-resistant cellulitis, nonhealing nodules, and ulcers, as well as in patients who are immunosuppressed with evidence of disseminated MAI (DMAI) infection. (medscape.com)
These microphages also can be detected in infection due to Mycobacterium avium intracellulare, cryptococcosis, or other parasitic organisms (usually observed in patients who are immunosuppressed with HIV disease). (medscape.com)

Mycobacterium abscessus , a nontuberculous mycobacterium found in water and soil, is an opportunistic pathogen responsible for waterborne illness outbreaks in health care settings ( 1 ). (cdc.gov)
On October 31, PADOH collected 21 environmental samples from faucets, aerators, showerheads and drains, filtered water and ice machines, and water samples from clinical care areas where residents with M. abscessus colonization or infection resided. (cdc.gov)
[ 6 ] Person-to-person spread is extremely uncommon, although in 2012 the first known outbreak of respiratory Mycobacterium abscessus subsp massiliense disease occurring in a population of patients with cystic fibrosis (CF) was reported. (medscape.com)

Mycobacterial species other than Mycobacterium tuberculosis and Mycobacterium leprae are classified as atypical mycobacteria, nontuberculous mycobacteria (NTM), or environmental mycobacteria. (medscape.com)
Nontuberculous mycobacteria (NTM) refer to all mycobacteria, excluding Mycobacterium tuberculosis complex and Mycobacterium leprae . (degruyter.com)
There are currently 71 recognized or proposed species of Mycobacterium [1], all of which, except M. tuberculosis complex and M. leprae, are considered as environmental mycobacteria and can usually be isolated from environmental samples including water, soil and dust [2]. (who.int)
PCR positive results for the detection of M. leprae in PB patients can be increased by collecting slit skin smears, periodontium and saliva samples. (bvsalud.org)

Differential characteristics Phylogenetic analysis, based on an evaluation of 16S rDNA sequences, places M. lentiflavum in an intermediate position between rapidly and slowly growing mycobacteria, closely related to Mycobacterium simiae and Mycobacterium genavense. (wikipedia.org)
1996. Isolation and characterization of a unique group of slowly growing mycobacteria: description of Mycobacterium lentiflavum sp. (wikipedia.org)

Fresh sputum samples were collected for culturing and conducted polymerase chain reaction using BL-specific primers. (hindawi.com)
Since PCR is too expensive to use in routine laboratories in Sri Lanka, one center could function as a reference laboratory where clinical samples can be tested using Polymerase Chain Reaction. (who.int)
FIND) has partnered with Cepheid, Inc. (Sunnyvale, CA) and the University of Medicine and Dentistry of New Jersey (UMDNJ, Newark, NY) to develop a TB-specific automated, cartridge-based nucleic amplification assay (Xpert MTB/RIF) based on the GeneXpert multi-disease platform, currently unique in its simplification of molecular testing with fully integrated and automated sample preparation, amplification and detection required for real-time polymerase chain reaction. (bvsalud.org)

Among 38,065 samples analyzed during the study period, 411 were culture-positive for NTM, representing 236 strains, and 231 episodes of care which occurred in 222 patients. (unige.ch)
From 220 samples, 91 grew positive cultures (41.4%) and 161 different strains were diagnosed. (who.int)
Results obtained from Restriction fragment length polymorphism typing show that the mahority of circulating Mycobacterium tuberculosis strains in Sri Lanka belong to a limited number of families, but the degree of IS6160 DNA polymorphism among strains were high. (who.int)
There is no cross-reactivity with non-tuberculous mycobacteria, and TB and rifampicin resistance were correctly detected in the presence of non-tuberculous DNA or mixed susceptible and resistant strains. (bvsalud.org)

Mycobacterium fortuitum is a rapidly growing nontuberculous mycobacterium (NTM), classified in the Runyon group IV. (medscape.com)
M fortuitum is isolated with increasing frequency from clinical samples. (medscape.com)
[ 2 ] Mycobacterium fortuitum has been reported as a commensal on human skin. (medscape.com)

Coenzyme A (CoA) is a fundamental co-factor for all life, involved in numerous metabolic pathways and cellular processes, and its biosynthetic pathway has raised substantial interest as a drug target against multiple pathogens including Mycobacterium tuberculosis . (nature.com)
The most commonly encountered mycobacterium pathogens, however, are species of MAC. (wcponline.com)
The genus Mycobacterium includes the important pathogens of the Mycobacterium tuberculosis complex (MTC) and the nontuberculous mycobacteria (NTM). (bruker.com)
Mycobacterium avium complex (MAC) is the most common of the pathogens and can cause several different patterns of abnormalities [ 1 , 2 ]. (ajronline.org)
Nontuberculous mycobacteria (NTM) are increasingly identified in industrialized countries, and their role as pathogens is more frequently recognized. (unige.ch)

Medical tourists have developed chronic NTM infections (particularly rapidly growing mycobacteria) of surgical sites, breast prostheses, and injection sites. (medscape.com)
Rapid diagnosis of mycobacterial infections and quantitation of Mycobacterium tuberculosis load by two real-time calibrated PCR assays. (microbiologyresearch.org)
[ 8 ] and that Mycobacterium avium and Mycobacterium intracellulare (known together as M avium complex [MAC]) infections are the main driver of this increase. (medscape.com)
Invasive infections with Mycobacterium chimaera were reported in patients with previous open chest surgery and exposure to contaminated heater-cooler units (HCUs). (eurosurveillance.org)
Healthcare-associated prosthetic heart valve, aortic vascular graft, and disseminated Mycobacterium chimaera infections subsequent to open heart surgery. (eurosurveillance.org)

To this spectrum of pulmonary diseases caused by atypical mycobacteria, a new granulomatous disease process that has been referred to as "hot tub lung" has been described in the literature [ 11 - 13 ]. (ajronline.org)

ABSTRACT This study was done to characterize at the species level Mycobacterium spp. (who.int)
ABSTRACT This research compared the numbers and types of different Mycobacterium species in soil samples taken from 2 areas of Golestan province, Islamic Republic of Iran, 1 with a high prevalence of tuberculosis and 1 with a low prevalence. (who.int)

Here, we report the case of a 22-year-old woman with renal and lymph node Mycobacterium xenopi infection. (degruyter.com)

There are 32 species of mycobacteria that are pathogenic to humans, including M. tuberculosis. (wcponline.com)
legionellae, pathogenic protozoa and Mycobacterium avium complex and additionally tests medical marijuana for microbial contaminants. (wadsworth.org)

Molecular typing of Mycobacterium spp. (who.int)
Mycobacterial colonies were isolated from a popliteal lymph node aspirate sample and molecular typed by SNPs typing of the genes gyrB and rpsA , the 3′ region of the hsp65 gene and the internal transcribed spacer (ITS), and MIRU-VNTR analysis. (frontiersin.org)
To integrate primary health care services with a specialist Mycobacterium tuberculosis molecular biology laboratory to develop a world-class platform for the evaluation of new diagnostics. (sun.ac.za)
particularly the sample recognition receptor (PRR) methods of the host, which notices pathogen-associated molecular patterns (PAMPs) of Mtb. (tbdb.org)
Molecular tests like the Xpert Mycobacterium tuberculosis and rifampicin (MTB/RIF) Ultra assay using bronchoalveolar lavage fluid (BALF) are a promising alternative. (umn.edu)
All samples were cultured and then identified by molecular methods . (bvsalud.org)

Here we report the first structure of a full-length CoaBC, from the model organism Mycobacterium smegmatis , describe how it is organised as a dodecamer and regulated by CoA thioesters. (nature.com)
each organism was detected in samples from cats with and without diarrhea. (avma.org)
The MBT compares the mass spectrum of an unknown organism with the dedicated library of reference mass spectra, which covers 182 of the currently known 201 mycobacteria. (bruker.com)
In Sri Lanka definitive diagnosis of tuberculosis depends on the culture of mycobacteria, but the slow growth of the organism delays the diagnosis. (who.int)

Mycobacterium tuberculosis can sometimes be identified by doing nucleic acid amplification tests (NAATs) on certain types of samples. (msdmanuals.com)

Similarly, interferon-gamma release assays (IGRA) may help identify a true Mycobacterium tuberculosis infection. (medscape.com)

Of the 120 isolates analysed, 118 (98.3%) were identified as M. tuberculosis complex and 2 (1.7%) were identified as mycobacteria other than M. tuberculosis. (who.int)
The results showed that those 2 isolates were multi-drug resistant and the DNA sequencing analysis showed that the alignment of nucleic acid of DNA in isolates of mycobacteria other than M. tuberculosis was different from that of M. tuberculosis complex. (who.int)
Tuberculosis (TB) is one of the major causes of death related to antimicrobial resistance worldwide because of the spread of Mycobacterium tuberculosis multi- and extensively drug resistant (multi-drug resistant (MDR) and extensively drug-resistant (XDR), respectively) clinical isolates. (frontiersin.org)
Typing of Mycobacterium tuberculosis isolates is of great potential value for basic and epidemiological studies on tuberculosis. (who.int)

mpt64 RT-PCR showed high sensitivity and specificity for the detection of Mycobacterium tuberculosis complex in sputum samples. (microbiologyresearch.org)
Sputum culture grew Mycobacterium avium complex. (medscape.com)
IGRAs are endowed with great specificity, as the antigens used are almost exclusively expressed by the Mycobacterium tuberculosis (MTB) complex, but not Mycobacterium bovis bacille Calmette-Guerin (BCG) [ 1 - 3 ]. (ersjournals.com)
The following is a review of an opportunistic pathogen of primary concern-Mycobacterium avium complex (MAC). (wcponline.com)
The objective of our study was to describe the CT features of "hot tub lung" caused by exposure to Mycobacterium avium complex (MAC) organisms in contaminated water. (ajronline.org)
Mycobacterial species isolated from sputum and grown in culture were examined to distinguish between NTM and the Mycobacterium tuberculosis complex (MTBC). (who.int)
In this study, the potential use of PCR was investigated using the primers Pt8-Pt9 based on the insertion sequence IS 6110 of the Mycobacterium tuberculosis complex (Kolk etal, 1992). (who.int)

According to the World Health Organization (WHO) report, in 2018, tuberculosis (TB), caused by Mycobacterium tuberculosis , was one of the major causes of death related to antimicrobial resistance ( World Health Organization [WHO], 2019a ). (frontiersin.org)
The difference in antimicrobial susceptibility among different mycobacteria species makes identification down to the species level crucial for microbiology laboratories. (bruker.com)
The intrinsic resistance of mycobacteria to most antimicrobial agents is mainly attributed to the synergy between their relatively impermeable cell wall and efflux systems. (unl.pt)

Diagnosis of extrapulmonary tuberculosis by smear, culture, and PCR using universal sample processing technology. (microbiologyresearch.org)
In conclution, DNA amplification is a rapid, reliable and accurate method with a high degree of sensitivity and specificity for the detection of Mycobacterium tuberculosis DNA sequences and it can replace the conventional culture method in the diagnosis of extra pulmonary tuberculosis and tuberculosis meningitis except in the situation when antibiotic sensitivity results are required. (who.int)

Mycobacteria peregrinum. (medscape.com)

Conclusions and Clinical Relevance -Bacteriologic culture of pooled fecal samples provided a valid and cost-effective method for the detection of M paratuberculosis infection in dairy cattle herds and can be used to estimate prevalence of infection within a herd. (avma.org)
Comparison of the Xpert MTB/RIF test with an IS 6110 -TaqMan real-time PCR assay for direct detection of Mycobacterium tuberculosis in respiratory and nonrespiratory specimens. (microbiologyresearch.org)
Rapid and specific detection of Mycobacterium tuberculosis by using the Smart Cycler instrument and a specific fluorogenic probe. (microbiologyresearch.org)
They also said concurrent HPV detection in cervical and oral cavity samples suggests that the anogenital region may be a source of the virus and that autoinoculation may play a transmission role. (umn.edu)
It is a transformative platform built on proven microfluidics technology there already powers real-time PCR across a broad range of applications as Genotyping, gene expression, sample identification, copy number vatiation and Pathogen detection. (ahdiagnostics.dk)
Analysis package to complete detection and visualization of genotypes of HPV and presence of mycobacteria in samples. (ahdiagnostics.dk)
Methods: As part of a case detection study for TB, conducted in three provincial hospitals in Papua New Guinea, sputum samples of suspected tuberculous cases aged 15 years or older were collected from November 2010 to July 2012. (who.int)

Early-morning sputum samples were collected from 170 patients referred to the National Tuberculosis Institute in Sana'a city with suspected pulmonary tuberculosis. (who.int)
Objective: To determine the proportion of non-tuberculous mycobacteria (NTM) in samples of pulmonary tuberculosis (TB) cases from Papua New Guinea who were diagnosed using acid-fast microscopy. (who.int)

When doing the endoscopy, we may have to obtain samples for five or six different laboratory tests. (cdc.gov)
Full-volume, aqueous samples are used to test the ability of a laboratory to identify bacterial indicator organisms in potable and non-potable waters using approved technologies. (wadsworth.org)
Samples of infected fluids may be examined under a microscope and/or sent to a laboratory to be grown (cultured) and tested. (msdmanuals.com)

Objectives -To determine the sensitivity of bacteriologic culture of pooled fecal samples in detecting Mycobacterium paratuberculosis , compared with bacteriologic culture of individual fecal samples in dairy cattle herds. (avma.org)
Results -Ninety-four and 88% of pooled fecal samples that contained feces from at least 1 animal with high (mean, ≥ 50 colonies/tube) and moderate (mean, 10 to 49 colonies/tube) concentrations of M paratuberculosis , respectively, were identified by use of bacteriologic culture of pooled fecal samples. (avma.org)
Prevalences of paratuberculosis determined by bacteriologic culture of pooled and individual fecal samples were highly correlated. (avma.org)
Naser SA, Sagramsingh SR, Naser AS, Thanigachalam S. Mycobacterium avium subspecies paratuberculosis causes Crohn's disease in some inflammatory bowel disease patients. (wjgnet.com)
One theory in particular is that Mycobacterium avium subspecies paratuberculosis (MAP) is intimately linked to the etiology of CD. (wjgnet.com)

To aid in risk factor analysis, participants were asked questions about TB skin testing, disease, exposure to and treatment for Mycobacterium tuberculosis . (cdc.gov)
The type of disease depends on the species of mycobacteria, the route and degree of exposure, and the immune status of the host. (medscape.com)

Isolation of Nontuberculous Mycobacteria from Bovine Raw Lungs Bought in Butchers' Shops. (bvsalud.org)
4.Mycobacterium tuberculosis - isolation and purification. (bvsalud.org)

Heterotrophic plate counts of paired first-catch and post-flush § water samples in a room sink of a resident and the reprocessing room sink where tracheostomy tubes were reprocessed exceeded Environmental Protection Agency (EPA) standards for safe drinking water ¶ ( 3 ). (cdc.gov)
We created an in vivo air sampling model to study airborne transmission of tuberculosis from patients coinfected with human immunodeficiency virus (HIV) and to evaluate environmental control measures. (nih.gov)
The authors' focus was nontuberculous mycobacteria (NTM), ubiquitous environmental microbes that represent a common, growing and clinically significant cause of lung disease [ 5 ]. (ersjournals.com)
During environmental investigations, M. chimaera was detected in samples from used HCUs from three different countries and samples from new HCUs as well as in the environment at the manufacturing site of one manufacturer in Germany. (eurosurveillance.org)
The frequencies of environmental Mycobacterium in the low-prevalence area were much higher than in the high-prevalence area, perhaps due to different environmental factors. (who.int)
The different environmental mycobacteria are very similar and for many years were mistakenly assumed to be M. tuberculosis in patients [1,2]. (who.int)
However, the relative incidence of the environmental Mycobacterium spp. (who.int)
Another reason for the medical importance of environmental Mycobacterium is the potential impact on the immune response. (who.int)

Buruli ulcer (BU) is a neglected tropical skin disease caused by Mycobacterium ulcerans . (dovepress.com)
Chronic skin ulcers consistent with Mycobacterium ulcerans disease ( Figure 1 ) were first described in The Mengo Hospital Notes (Kampala, Uganda) in 1897 by the British physician Albert Cook. (dovepress.com)

Mycobacterium tuberculosis , the bacterium that causes TB, is spread in airborne droplets when people with active disease cough or sneeze. (plos.org)

Occurrence studies of mycobacteria in water have found variable results. (wcponline.com)

Nontuberculous Mycobacteria (NTM) can cause opportunistic disease in animals and humans , causing mycobacteriosis. (bvsalud.org)
8]. The polymerase ease can infect humans and animals, questionnaire administered during chain reaction (PCR) mixture was with outcomes ranging from localized the collection of samples. (who.int)

The family Mycobacteriaceae consists of a single genus, Mycobacterium , which are thin, slightly curved-to-straight, non-spore-forming, nonmotile acid-fast bacilli. (medscape.com)
This trend and the rise of antibiotic resistance in this genus demand improved differentiation among mycobacterium species. (bruker.com)

Mycobacterium tuberculosis belonging to Beijing sublineage (BL) is associated with high tuberculosis (TB) transmission, multidrug resistance, and adverse treatment outcomes. (hindawi.com)
I am looking forward to returning to analyze many more samples and refine our techniques so that we can detect drug resistance directly from metagenomic sequences. (news-medical.net)

Smear microscopy, culture, phenotypic and PRA- hsp65 identification of mycobacteria, and mpt64 RT-PCR were performed. (microbiologyresearch.org)
Traditional methods for mycobacteria identification, primarily culture-based phenotypic methods, may take weeks and are often inaccurate. (bruker.com)

We demonstrate that when combined with fast micro- or analytical flow-rate chromatography, Zeno SWATH MS increases protein identification with low sample amounts. (elifesciences.org)
The recent emergence of advanced mass spectrometry (MS) technology, specifically Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight (MALDI-TOF) MS, enables clinical microbiology laboratories to master the challenge of mycobacteria identification. (bruker.com)
The unparalleled speed of instruments, such as Bruker's IVD-CE MALDI Biotyper ® (MBT) system, in addition to enhanced ease-of-use, high specificity and significantly reduced cost per test, sees MALDI-TOF MS emerging as a go-to technique for mycobacteria identification. (bruker.com)
Samples flagged as mycobacteria will undergo an optimized acquisition method and spectra are automatically compared to the MBT Mycobacteria IVD Library, for sensitive and specific identification. (bruker.com)
Includes software for analysis and interpretation of both HPV genotyping and identification of Mycobacteria. (ahdiagnostics.dk)

Nontuberculous mycobacteria (NTM) are being increasingly isolated in clinical laboratories and present technical and therapeutic challenges. (unl.pt)

Data on skin and soft-tissue infection caused by nontuberculous mycobacteria in Taiwan (1997-2008) suggest that MAI is an important pathogen. (medscape.com)

The Xpert inoculation procedure and sample testing generated no detectable infectious aerosols. (bvsalud.org)

ELISA assay confirmed the immunological specificity of the obtained protein within the presence of MTB-infected human serum samples. (tbdb.org)

We use clinical samples to characterize the immune response in patients diagnosed with LTBI. (jcvi.org)

No periodontium or saliva samples had positive bacteriological results. (bvsalud.org)
Bacteriological examination did not prove to be an efficient technique for the analysis of saliva and periodontium samples. (bvsalud.org)

The first involved finding the nontuberculous mycobacteria and treating the patients. (cdc.gov)
From August 2012 to October 2013, 715 sputum samples from 657 patients were included in the study. (microbiologyresearch.org)
2 In the Democratic Republic of the Congo (then the Belgian Congo), chronic ulcers caused by mycobacteria were reported in 170 patients in the 1940s and 1950s. (dovepress.com)
A 10-year study that included oral rinse sampling in sexually active female adolescents seen at a large healthcare center in New York found that human papillomavirus (HPV) in the oral cavity is common in sexually active patients and that HPV vaccination was linked to a decline in oral cavity HPV detections. (umn.edu)
An early-morning sputum sam- encoding the B-subunit of RNA of droplet particles aerosolized from ple was collected from 170 patients polymerase ( rpoB DNA, 342-360 persons infected with Mycobacterium into wide-mouthed plastic contain- base pairs) was the target region for tuberculosis or by consumption of milk ers. (who.int)

Last year, his team used metagenomics to obtain an outbreak strain genome from stool samples from an E. coli outbreak and to recover TB genomes from ~200-year-old Hungarian mummies. (news-medical.net)

Anatomy15

Organisms33

Diseases34

Chemicals and Drugs83

Analytical, Diagnostic and Therapeutic Techniques and Equipment42

Phenomena and Processes49

Disciplines and Occupations3

Anthropology, Education, Sociology and Social Phenomena1

Technology, Industry, Agriculture1

Information Science4

Health Care12

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Bacteria13

Avium-intracellulare7

Abscessus3

Leprae4

Slowly growing myco2

Polymerase chain re3

Strains4

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Pathogens5

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Atypical mycobacteria1

ABSTRACT2

Xenopi1

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Molecular6

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Diagnosis2

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