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The susceptibility profile of NTM165 was similar to related species of M. cosmeticum and M. canariasense, which were also highly susceptible to antimycobacterial drugs [12, 13]. Table 1 Phenotypic characteristics of NTM165 and closely related rapidly growing mycobacteria. 3. Discussion MALDI-ToF provided the first Temsirolimus (CCI-779, NSC 683864) clues that this organism was highly similar to M. cosmeticum. However, subsequent molecular analysis showed that NTM165 was genetically dissimilar to the closest matches of M. cosmeticum and M. canariasense, having Pfizer Licensed Compound Library order [14]. Our experience with HPLC identification also parallels previous reports where it has been shown that the technique is inadequate in differentiating species with shared patterns, particularly amongst the fast growers [12�C14]. The first reported strains of M. cosmeticum were obtained from cultures of a sink drain in a nail salon and from a granulomatous lesion of a female mesotherapy patient in Venezuela [15]. The pathogenicity of M. cosmeticum was further demonstrated in additional cases whereby the bacterium was responsible for pulmonary disease, catheter-associated bacteremia and most recently as a colitogenic agent [16, 17]. M. canariasense, akin to M. cosmeticum, is an opportunistic pathogen linked to bacteremia in patients find more with underlying malignant diseases [12, 13, 18]. Therefore, it is not inconceivable that NTM165, being related to these two species, has also pathogenic potential. 4. Conclusion In this report, we describe for the first time the isolation from an ear swab sample of a patient with chronic otitis externa, a novel M. cosmeticum-like NTM, which is believed to be the etiologic agent of the infection. In this study, we highlight the importance of the use of a multiple-pronged approach for the identification and characterization of the microorganism, in particular, the importance of sequencing housekeeping genes to further differentiate closely related mycobacterial species. The 16S rRNA, hsp65, rpoB, and ITS sequences of NTM165 have been deposited in GenBank under the respective accession numbers of ""type"":""entrez-nucleotide"",""attrs"":""text"":""KP012254"",""term_id"":""761662895"",""term_text"":""KP012254""KP012254, ""type"":""entrez-nucleotide"",""attrs"":""text"":""KP012255"",""term_id"":""761662896"",""term_text"":""KP012255""KP012255, ""type"":""entrez-nucleotide"",""attrs"":""text"":""KP012256"",""term_id"":""761662897"",""term_text"":""KP012256""KP012256, and ""type"":""entrez-nucleotide"",""attrs"":""text"":""KP012257"",""term_id"":""761662898"",""term_text"":""KP012257""KP012257.