Antimicrobial Susceptibility Testing, Drug Resistance Mechanisms, and Therapy of Infections with Nontuberculous Mycobacteria

Brown‐Elliott, Barbara A.; Nash, Kevin A.; Wallace, Richard J.

doi:10.1128/cmr.05030-11

Cited by 444 publications

(442 citation statements)

References 451 publications

(742 reference statements)

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“…Pulmonary and disseminated diseases caused by M. fortuitum group are rare [12]. Cutaneous involvement usually occurs in immunocompetent patients with a clinical picture similar to our patient.…”

Section: Discussionmentioning

confidence: 84%

Complicated skin and soft tissue infection with Mycobacterium fortuitum following excision of a sebaceous cyst in Taiwan

Tsai

Chen

Liao

et al. 2016

J Infect Dev Ctries

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Mycobacterium fortuitum group (M. fortuitum), also known as rapidly growing Mycobacteria, can cause pyogenic infections in human beings, most commonly in immunocompromised patients. Herein, we present a 40-year-old immunocompetent male patient who underwent planned excision of a sebaceous cyst in the abdominal wall. He suffered from tender erythematous lesions with purulent discharge around the healing wound that developed 2 weeks after surgery. Gram stain, bacterial and fungal culture results of the wound were negative. A diagnosis of nontuberculous mycobacteria was made from a wound culture from the area of operative debridement, which was subsequently confirmed to be M. fortuitum group using PCR-restriction fragment length polymorphism analysis of the hsp65 gene. The patient received 4 weeks of parenteral imipenem/cilastatin 500 mg every 6 hours and amikacin 500 mg every 12 hours, plus oral clarithromycin 500 mg twice daily, and the wound recovered completely. He was discharged and followed up regularly at our outpatient clinic, and continued taking oral ciprofloxacin and clarithromycin 500 mg twice daily for 6 months. This case highlights the importance of strict aseptic precautions even during minor procedures, and also the characteristics of M. fortuitum infections in immunocompetent patients, which usually develop as localized postsurgical wound infections. We also share our experience in successfully treating a M. fortuitum complicated skin and soft tissue infection.

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Section: Discussionmentioning

confidence: 84%

Complicated skin and soft tissue infection with Mycobacterium fortuitum following excision of a sebaceous cyst in Taiwan

Tsai

Chen

Liao

et al. 2016

J Infect Dev Ctries

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“…A pesar de que los estudios de la actividad de macrolidos contra el M. fortuitum, encuentran que el 80% de los asilamientos son susceptibles a claritromicina, existe la preocupación del desarrollo de resistencia a estos medicamentos debido a la reciente detección del gen erm (39 y 41) en estas especies. Este gen codifica una enzima metilasa que adhiere 1 o 2 grupos metil al 23s rRNA, previniendo que los macrolidos se unan al ribosoma bacteriano (12,13) . El tiempo de tratamiento antibiótico oscila entre los 4-6 meses.…”

Section: Discussionunclassified

Confección por Mycobacterium fortuitum y Mycobacterium tuberculosis en abscesos esplénicos en un paciente con VIH

Soto-Arquiñigo

García-Pareja

Gotuzzo-Herencia

et al. 2017

Rev Peru Med Exp Salud Publica

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Citar como: Citar como: Soto-Arquíñigo L, García-Pareja M, Gotuzzo-Herencia E, Legua-Leiva P, Sánchez-Herrera M. Confección por Mycobacterium fortuitum y Mycobacterium tuberculosis en abscesos esplénicos en un paciente con VIH. RESUMENLos pacientes con VIH son susceptibles a la infección por micobacterias. En el caso de las micobacterias de crecimiento rápido, grupo al que pertenece el Mycobacterium fortuitum (M. fortuitum), se han descrito infecciones en la piel, pulmones, ganglios linfáticos y enfermedad diseminada. Presentamos el caso de un paciente varón de 43 años, con diagnóstico previo de VIH en tratamiento antirretroviral, que acude por fiebre, astenia, pérdida de peso y diarrea crónica. Se realiza tomografía abdominal y se evidencia hepatoesplenomegalia con lesiones nodulares en el bazo. El cultivo esplénico, finalmente, fue positivo para M. fortuitum, con PCR positivo a Mycobacterium tuberculosis. Los protocolos actuales de tratamiento para este tipo de infecciones se basan en la susceptibilidad mostrada en los cultivos realizados. En lo que respecta a coinfecciones entre M. fortuitum y Mycobacterium tuberculosis, en pacientes VIH positivos, la información es aun menor. Palabras clave: Mycobacterium fortuitum, Mycobacterium tuberculosis; VIH; absceso (Fuente: DeCS BIREME). CO-INFECTION BY Mycobacterium fortuitum AND Mycobacterium tuberculosis IN SPLENIC ABSCESSES IN A PATIENT WITH HIV ABSTRACTPatients with HIV are susceptible to mycobacterium infection. In the case of fast-growing mycobacteria, the group to which Mycobacterium fortuitum (M. fortuitum) belongs, infections have been described in the skin, lungs, lymph nodes and disseminated disease. We present the case of a 43-year-old male patient with pre-diagnosis of HIV in antiretroviral therapy, which comes as a fever, asthenia, weight loss and chronic diarrhea. Abdominal tomography is performed and hepatosplenomegaly is evidenced with nodular lesions in the spleen. The splenic culture was finally positive for M. Fortuitum, with positive PCR to Mycobacterium tuberculosis. The current treatment protocols for this type of infection are based on the susceptibility shown in the cultures performed. With regard to coinfections between M. Fortuitum and Mycobacterium tuberculosis, in HIV positive patients, there are even less information.

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“…Due to a variety of treatment regimens administered in these studies, an optimal multidrug treatment regimen could not be derived. Establishing treatment regimens is further complicated as the published in vitro susceptibility results for specific antibiotics may not be predictive of general treatment success with that particular antibiotic [18,19]. Furthermore, susceptibility testing for M xenopi may be hampered by the poor growth of that agent in vitro [18–20].…”

Section: Discussionmentioning

confidence: 99%

Fatal pulmonary cavitary disease secondary to Mycobacterium xenopi in a patient with sarcoidosis

Abdulfattah

Salhan

Kandel

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

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Introduction: Mycobacterium xenopi (M. xenopi) has low pathogenicity and usually requires either host immune impairment or structural lung disease to cause clinical disease. Fatal cavitary infection in a patient without immunosuppression is rarely presented. Case report: A 62-year-old female with history of sarcoidosis and hypertension presented with cough, fever and dyspnea for one week. Chest imaging showed irregular opacification of upper lung zones. The sputum samples tested positive for acid-fast bacilli (AFB) and the subsequent testing identified M. xenopi. She was started on rifampin, isoniazid, pyrazinamide and ethambutol along with azithromycin, and was discharged with plans to continue the same. A follow up sputum test was negative for AFB. She was, however, readmitted ten months later with sepsis due to pneumonia. Chest imaging revealed worsening cavitary lung lesions. Despite starting her on intravenous antibiotics while continuing anti-tubercular therapy, she developed severe respiratory distress and had to be intubated. Her condition continued to deteriorate and she expired the following day. Conclusion: Fatal cavitary infections with M. xenopi have been reported in the absence of established optimal management. Well-designed studies with sufficient power are needed to establish new treatment guidelines.

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Antimicrobial Susceptibility Testing, Drug Resistance Mechanisms, and Therapy of Infections with Nontuberculous Mycobacteria

Cited by 444 publications

References 451 publications

Complicated skin and soft tissue infection with Mycobacterium fortuitum following excision of a sebaceous cyst in Taiwan

Complicated skin and soft tissue infection with Mycobacterium fortuitum following excision of a sebaceous cyst in Taiwan

Confección por Mycobacterium fortuitum y Mycobacterium tuberculosis en abscesos esplénicos en un paciente con VIH

Fatal pulmonary cavitary disease secondary to Mycobacterium xenopi in a patient with sarcoidosis

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