Skin and soft tissue infections due to rapidly growing mycobacteria

Abstract

Purpose of reviewThe aim of this article is to review skin and soft tissue infections due to rapidly growing mycobacteria (RGM), with a particular focus on recently published literature (2021–2022).Recent findingsRGM are increasingly reported as a cause of skin and soft tissue infections, both in the community setting and as a cause of nosocomial outbreaks. Recent advances in molecular methods have expanded the number of species of RGM and resulted in increased diagnosis. New treatment options are under evaluation particularly for Mycobacterium abscessus, the most difficult-to-treat among RGM.SummaryRGM are an uncommon cause of skin and soft tissue infections and a high clinical suspicion together with advanced laboratory facilities are required for diagnosis. Species identification and antimicrobial susceptibility testing are essential to drive appropriate treatment, which combines surgical debridement with prolonged antimycobacterial combination therapy.

Investigating Mtr and MshC as potential targets in the fight against Mycobacterium abscessus infections

“…the skin via a wound or inhalation of aerosols with contaminated soil or water (11,33). Moreover, recent studies demonstrated the occurrence of person-to-person transmission between CF patients in a healthcare setting, raising concerns regarding the ability of the pathogen to spread and the impact it will have on public health (13,18).…”

“…Skin and soft tissue disease include the infection of the skin, cartilage, tendons and fat layers, and is generally a localized disease with symptoms such as redness and swelling (33,39). Unlike MABC-PD, skin and soft tissue disease can be found in healthy individuals without preexisting conditions, mostly in a healthcare settings (28,40).…”

“…Disseminated disease predominantly occurs in patients with preexisting conditions including HIV or other immunosuppressive conditions (41). (19,33,42).…”

“…Because NTM-PD is regularly mistaken for MDR-TB and due to the close relation of some RGM species, correct differentiation between mycobacterial species is of utmost importance (33,43). Therefore, diagnosis of MABC disease relies on clinical (symptoms), microbiologic (cultures), and radiologic (imaging) criteria (38).…”

“…Mycobacterial cultures are recognized as the golden standard in which a sputum sample or skin biopsy can be used to grow the pathogen, combined with fluorescent or Ziehl-Neelsen staining methods to confirm the presence of mycobacteria (18,33,44). For a more precise identification, molecular methods can be employed after culture growth.…”