Skin and Soft-Tissue Infections Due to Rapidly Growing Mycobacteria

Abstract

Background: Rapidly growing mycobacteria (RGM) are increasingly being recognized as potential pathogens. RGM, particularly Mycobacterium abscessus, Mycobacterium fortuitum, and Mycobacterium chelonae, have been observed in both pulmonary and extrapulmonary infections including cutaneous, soft-tissue, and wound infections. However, there are limited reports of these potential pathogens from skin and soft-tissue infections. Moreover, the drug susceptibility profile of RGM is largely unknown in several regions of the world. Methods: We analyzed reports on RGM isolated from skin and soft-tissue infections globally for details of RGM species and drug susceptibility profile. We also analyzed the drug susceptibility profile of four RGM isolates, obtained from skin and soft-tissue infections in our laboratory, by broth microdilution method. Results: In the reports reviewed, the most common RGM isolated from skin and soft-tissue infections were M. abscessus (184/475, 38.7%), M. fortuitum (150/475, 31.5%), M. chelonae (72/475, 15%), and M. chelonae–M. abscessus complex (46/475, 9.6%). However, drug susceptibility was tested only in 26/39 (66.6%) reports. In our own laboratory, we obtained three isolates of M. abscessus and one isolate of M. fortuitum from one case of breast abscess and three cases of postsurgical wound infections. Maximum susceptibility of M. abscessus was observed to clarithromycin, amikacin, and linezolid. The M. fortuitum isolate was susceptible to clarithromycin, amikacin, clofazimine, and linezolid. Conclusion: Paucity of information available on RGM isolated from skin and soft-tissue infections highlights the need to be aware of the pathogenic potential and the drug susceptibility profile of these organisms.

Presence of indicator bacteria, Shiga toxin-producing Escherichia coli, and nontuberculous mycobacteria in oregano

“…M. fortuitum, M. conceptionense, and M. porcinum belong to the Mycobacterium fortuitum group, which are able to cause clinical mycobacteriosis in fish and other animals, including humans (Pavlik et al, 2021). In particular, M. fortuitum, the mycobacterial species most isolated in this study, is the main NTM associated with skin and soft-tissue infections worldwide (Kumar et al, 2021). Additionally, M. fortuitum has been isolated from patients with NTM illness (Escobar-Escamilla et al, 2014;Lopez-Luis et al, 2020) and from food items (Cerna-Cortes et al, 2015;Cerna-Cortes et al, 2016;Cerna-Cortes et al, 2019) in Mexico City.…”

A young woman with Mycobacterium chelonae complex infection caused by facial stem cell injection

“…The most prevalent clinically relevant species among RGMs are M. fortuitum, M. chelonae, and M. abscessus. 3 M. chelonae has been identified in aquatic organisms, water, and soil. 4 It frequently results in a broad range of infections, including those that affect the skin and soft tissues, particularly the eyes and extremities.…”

“…wolinskyi , and pigmented RGM are the six main groups that make up RGM. The most prevalent clinically relevant species among RGMs are M. fortuitum, M. chelonae , and M. abscessus 3 . M. chelonae has been identified in aquatic organisms, water, and soil 4 .…”

A nosocomial outbreak of Mycobacterium Abscessus infection in a private hospital of Shanghai, China, 2021

“…A number of infections due to M. abscessus, ranging from pulmonary disease, skin infections to severe sepsis, have been documented in the literature but few reports focus on hospital-onset outbreak [12][13][14] , especially in patients with chronically ventilated patients. This study described an outbreak involving long-stay inpatients that suffered with M. abscessus infection at the same room in a private hospital.…”