Post Surgical Non-tuberculous Mycobacterium: A Case Series

Abstract

BackgroundThere has been an increase in non-tuberculous mycobacteria (NTM) infection reports in humans. Surgeons are concerned about the link between them and surgical site infections. As a result, it has been challenging to determine just how common this illness is. A two-year study by the authors examines the occurrence of NTM infections after different surgical procedures. Design and methodsResearchers at a tertiary care hospital in central India performed this prospective study over two years. NTM was found in six of the 25 instances of post-surgical wound infections. Ziehl-Neelsen staining, Auramine O-Rhodamine fluorescence staining, Multiplex Real-Time PCR, and Genotyping were used to identify the species. ResultsM. fortuitum, M. chelonae and M.kansasii were isolated from discharge in 2 cases each respectively. NTM isolates evaluated for antibiotic susceptibility pattern were all sensitive to Clarithromycin (100%). One case with prolonged healing had to be intervened with amikacin along with clarithromycin. ConclusionNTM is an infection of uncommon nature which can occur following surgical procedures. Identification of these organisms through sensitive techniques and appropriate therapeutic regimen formulation must be done to tackle this growing menace in health care setups.

Infection du cuir chevelu àMycobacterium abscessusaprès une greffe capillaire subie en Amérique centrale

“…L’étude d’une série de 6 cas d’infection de plaies opératoires causées par des MNT en Inde a fait état d’une réponse à la clarithromycine en monothérapie dans 5 cas sur 6 après 2 mois, 1 cas d’infection à l’épaule ayant nécessité une association de clarithromycine et d’amikacine. Les 6 isolats de MNT étaient sensibles à la clarithromycine et le débridement chirurgical n’a pas été utilisé 14 . Une autre série de 5 cas d’infection par la sousespèce M. abscessus abscessus consécutifs à des interventions chirurgicales esthétiques effectuées en Équateur a été traitée avec succès par débridement chirurgical et antibiothérapie d’association pendant 7 mois 15 .…”

Mycobacterium abscessusscalp infection after hair transplantation in Central America

“…All 6 NTM isolates were susceptible to clarithromycin, and surgical débridement was not performed. 14 Another case series reported 5 M. abscessus subspecies abscessus infections after cosmetic surgical procedures in Ecuador that were successfully treated with surgical débridement and combination antimicrobial therapy for 7 months. 15 A third case series reported 10 surgical site infections caused by NTMs in Venezuela that were successfully treated with a combination of surgical débridement and prolonged combination antimicrobial therapy (> 3 mo), including clarithromycin.…”

Postoperative wound infection by nontuberculous mycobacteria; case series in Dhaka Medical College Hospital of Bangladesh

“…Early detection is hampered and may be due to difficulties of identification, and long‐term medications with lowered tolerance make it more challenging to treat effectively 7,8 . Since treatment differs from species to species, species and subvariants should be identified and recognized from environmental NTM 9 …”

“…7,8 Since treatment differs from species to species, species and subvariants should be identified and recognized from environmental NTM. 9 In Bangladesh, as a Mycobacterium tuberculosis (M.TB) endemic zone, NTM infection is often under-detected, because it can mimic M.TB. In this case series, several cases having persistent chronic discharges from incision wound for several weeks to several months after operation were analysed regarding clinical presentation, diagnosis, treatment and prognosis of NTM infections.…”

“… 7 , 8 Since treatment differs from species to species, species and subvariants should be identified and recognized from environmental NTM. 9 …”