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Clinical Microbiology Reviews, January 2004, p. 98-106, Vol. 17, No. 1
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.1.98-106.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Health Impacts of Environmental Mycobacteria{dagger}

Todd P. Primm,1* Christie A. Lucero,1 and Joseph O. Falkinham III2

Department of Biological Sciences and Border Biomedical Research Center, University of Texas at El Paso, El Paso, Texas 79968,1 Department of Biology and Fralin Biotechnology Center, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 240612

Environmental mycobacteria are emerging pathogens causing opportunistic infections in humans and animals. The health impacts of human-mycobacterial interactions are complex and likely much broader than currently recognized. Environmental mycobacteria preferentially survive chlorination in municipal water, using it as a vector to infect humans. Widespread chlorination of water has likely selected more resistant environmental mycobacteria species and potentially explains the shift from M. scrofulaceum to M. avium as a cause of cervical lymphadenitis in children. Thus, human activities have affected mycobacterial ecology. While the slow growth and hydrophobicity of environmental mycobacteria appear to be disadvantages, the unique cell wall architecture also grants high biocide and antibiotic resistance, while hydrophobicity facilitates nutrient acquisition, biofilm formation, and spread by aerosolization. The remarkable stress tolerance of environmental mycobacteria is the major reason they are human pathogens. Environmental mycobacteria invade protozoans, exhibiting parasitic and symbiotic relationships. The molecular mechanisms of mycobacterial intracellular pathogenesis in animals likely evolved from similar mechanisms facilitating survival in protozoans. In addition to outright infection, environmental mycobacteria may also play a role in chronic bowl diseases, allergies, immunity to other pulmonary infections, and the efficacy of bacillus Calmette-Guerin vaccination.

* Corresponding author. Mailing address: Department of Biological Sciences and Border Biomedical Research Center, 500 West University Avenue, The University of Texas at El Paso, El Paso, TX 79968. Phone: (915) 747-5138. Fax: (915) 747-5808. E-mail: tprimm{at}utep.edu.

{dagger} This article is dedicated to the memory of F.M.P.

Clinical Microbiology Reviews, January 2004, p. 98-106, Vol. 17, No. 1
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.1.98-106.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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