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• W2071006975 abstract "To the Editor: It was with a sinking sense of deja vu, subspecies depressing, that I read the comments of McDonald and Reichman (Chest 1983; 84:511–12) on Baileys proposed classification of disease caused by different mycobacteria (Chest 1983; 84:625–28). It was as if the last 30 years of my professional life and those of a number of my colleagues had disappeared into a black hole. McDonald and Reichman bemoan the “complexity” and “nonclinical” nature of the Runyon classification, and then imply that nothing more happened in the field until the development of the “newer” serologic and lipid analyses. They then propose that “a sorely needed next obvious step is to look at the entire family of mycobacteria.” Where have these authors been since 1954, the year of Timpe and Runyons landmark paper? Hundreds of microbiologists have labored diligently and effectively to bring order to the genus Mycobacterium. Yes, the classification and the tests needed to achieve that classification are complex. The bacilli are not so obliging as to wear bumper stickers announcing their pathogenic proclivities. We classify them on the basis of their phenotypic properties and phylogenetic relationships, put a name on them in accord with an internationally accepted code of bacterial nomenclature, and then try to establish the relationship of members of each named group to various clinical conditions. A specific pattern of clinical association, difficulty in treatment, etc, may be the only features shared by organisms bearing different species names. For these reasons, it is not the responsibility of the scientists to get together with a name for the “major groups;” these major groups do not exist as natural phenomena, although individual species do exist, at least as defined by phenotypic and evolutionary discontinuities that can be measured by current methodology. Clinicians can use any terms to define clinical groups that are useful to them. I have no quarrel with Bailey's proposed classification of diseases in terms of difficulty of treatment. This classification of disease reflects the resistance of members of different species, and looks reasonable and useful to me. However, it should not in any way lead to abandonment of identification of individual strains with species names in clinical reports. That information is needed for diagnosis and for epidemiologic purposes. For example, if several specimens from a patient yield more than one species, as can occur, the interpretation would be different from that of repeated isolation of a single species. The clinical microbiologist must continue to use the well established (albeit still developing) principles to classify and identify mycobacteria. The clinician can then classify disease on the basis of such useful tables as proposed by Bailey." @default.
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• W2071006975 date "1984-09-01" @default.
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• W2071006975 title "Classification of Mycobacteria vs Classification of Mycobacterial Diseases" @default.
• W2071006975 doi "https://doi.org/10.1378/chest.86.3.507-a" @default.
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