Outbreak of Nontuberculous Mycobacteria Joint Prosthesis Infections, Oregon, USA, 2010–2016

Buser, Genevieve L.; Laidler, Matthew R.; Cassidy, P. Maureen; Moulton-Meissner, Heather; Beldavs, Zintars G.; Cieslak, Paul R.

doi:10.3201/eid2505.181687

Cited by 19 publications

(8 citation statements)

References 16 publications

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“…Non-tuberculous mycobacterial species are highly resistant to common medical disinfectants, and the infections are mostly related to iatrogenic invasive procedures that are commonly considered in the treatment of traumatic fractures and in certain traumatic treatments (including puncture and acupuncture) ( Cusumano et al, 2017 ; Dickison et al, 2019 ; Philips et al, 2019 ). In the series of cases investigated herein, the most common causes were identified to be previous history of musculoskeletal trauma, percutaneous inoculation, and prior bone and joint surgery, while only one patient exhibited the presence of NTM infection after undergoing prosthetic joint surgery, a cause that was different from the common causes of infection in prosthetic joint surgery reported in the literature ( Buser et al, 2019 ; Goldstein et al, 2019 ). Among 25 patients, only three patients were immunosuppressed, a finding that was consistent with that published in previous reports ( Park et al, 2014 ; Johnson and Stout, 2015 ).…”

Section: Discussionmentioning

confidence: 72%

Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020

Chen²,

Yang³

et al. 2021

Front. Microbiol.

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Non-tuberculous mycobacterial (NTM) infection of the musculoskeletal system is rare but poses a grave threat to public health. These infections yield non-specific symptoms that remain undetected until the development of the later stages of the disease. In this study, we performed a retrospective review of 25 cases of musculoskeletal NTM infection at two tertiary medical centres over a 5-year period to determine the clinical features and improve the current clinical diagnosis and treatment. The most common mycobacterial species detected were Mycobacterium fortuitum in eleven patients, Mycobacterium abscessus in eight patients, Mycobacterium houstonense in three patients, Mycobacterium avium in two patients, and Mycobacterium smegmatis in one patient. The sites of infection included the limbs and joints, most commonly the knee (ten patients) and foot (six patients). The median duration from the onset of symptoms to diagnosis was 2.5 months (0.8–13.5 months). Deep sinus tracts extending to the surgical site were observed in 60% of the patients (15/25), and granulomatous inflammation and granulomatous inflammation with necrosis occurred in 60% of the patients (15/25). All patients underwent surgical treatment for infection control, and all patients, except one, received antimycobacterial therapy based on drug sensitivity assays. The median duration of the antimicrobial chemotherapy was 5 months (range: 3–20 months). At the final follow-up, 24 patients presented with absence of recurrence and one patient succumbed owing to heart failure after debridement. Our findings highlight the importance of vigilance and improvements in the diagnostic methods for musculoskeletal NTM infection. Aggressive surgical treatment and antimycobacterial drug treatment can help achieve satisfactory results.

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Section: Discussionmentioning

confidence: 72%

Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020

Chen²,

Yang³

et al. 2021

Front. Microbiol.

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“…Infection is frequently acquired through inhalation (i.e., aerosol, showers) or inoculation (trauma, plastic surgery, acupuncture). Outbreaks due to NTM are also well reported in the literature (Buser et al, 2019;Lyman et al, 2017).…”

Section: Introductionmentioning

confidence: 77%

Non-tuberculous mycobacterial infections—A neglected and emerging problem

Ahmed

Tiberi

Farooqi

et al. 2020

International Journal of Infectious Diseases

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Non-tuberculous mycobacteria (NTM) are ubiquitous dwellers of environmental niches and are an established cause of natural and nosocomial infections. The incidence of NTM infections is rising owing to a growing population of immunocompromised and vulnerable individuals, complex medical and surgical procedures, as well as increased awareness and diagnostic capabilities. The prevalence of different NTM varies between continents, regions, and countries. The true global burden of pulmonary and extrapulmonary disease is unknown and estimates are subject to under and/or over-estimation. Diagnosis requires confirmation by isolation of NTM along with clinical and radiological criteria, which may be suboptimal at all levels. Susceptibility testing is complex and clinical breakpoints are not available for many of the drugs. Frequently, NTM infections are not considered until late in the course of disease. Improved and rapid detection of tuberculosis cases in high-burden countries has, however, also brought NTM infections into the limelight, and has identified a need for research efforts towards rapid diagnostic tests and the identification of biomarkers to monitor the treatment response in patients with NTM infections.

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“…Thus, there is sparse empirical evidence for NTM management in musculoskeletal infection. NTM infections are heterogeneously distributed across the globe, with identifiable geographic trends in clusters of infections [28][29][30] . Although debated, the literature demonstrates an increase in the reported incidence of NTM infections across certain regions 31,32 .…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Nontuberculous Mycobacterium Infection Following Anterior Cruciate Ligament Reconstruction

et al. 2023

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Background:Although infection following anterior cruciate ligament (ACL) reconstruction is rare, these cases have potentially catastrophic ramifications. Nontuberculous mycobacteria (NTM) are ubiquitous, located in the water supply and soil. Our objective was to review the literature to characterize NTM infection following ACL reconstruction.Methods:A database search was performed for arthroscopic ACL reconstructions that resulted in a postoperative diagnosis of NTM infection.Results:The literature search returned 6 case reports that met the inclusion criteria. The initial postoperative presentation occurred after 3 to 52 weeks, which is consistent with reports of postoperative NTM infection.Conclusions:The common indolent course of NTM infection hinders prompt diagnosis and treatment. Organism susceptibility testing is crucial for effective treatment and limiting unnecessary antibiotic exposure.Clinical Relevance:The duration of medical treatment for NTM infection is 4 to 6 months, depending on the severity of disease and species. Based on the aggregate literature, we recommend removal of local implants if the infection is localized and without articular involvement. However, in cases of articular involvement, all fixation and graft material should be removed.

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Outbreak of Nontuberculous Mycobacteria Joint Prosthesis Infections, Oregon, USA, 2010–2016

Cited by 19 publications

References 16 publications

Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020

Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020

Non-tuberculous mycobacterial infections—A neglected and emerging problem

A Systematic Review of Nontuberculous Mycobacterium Infection Following Anterior Cruciate Ligament Reconstruction

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