The clinical management of cesarean section-acquired Mycobacterium abscessus surgical site infections

Abstract

Introduction: Rapidly growing mycobacteria (RGM) can cause a broad spectrum of both community and healthcare-associated infections in humans. The aim of this study was to report the clinical management and outcomes of successive patients following cesarean delivery with healthcare-associated surgical site infections (SSIs) caused by RGM. Methodology: Patients who were admitted to Chung Shan Medical University Hospital, Taichung, Taiwan, between September 2006 and July 2008, and who developed SSIs following cesarean delivery at an obstetrics hospital and were then referred to our hospital, were enrolled. Demographic characteristics of the patients and clinical isolates were obtained retrospectively and an environmental investigation was performed. PCR-restriction fragment length polymorphism (PCR-RFLP) analysis of the hsp65gene and pulsed-field gel electrophoresis (PFGE) of large genomic DNA restriction fragments were applied to differentiate Mycobacterium species. Results: Seventeen patients were diagnosed with RGM infections by microbiology and/or histopathology. Mycobacterial isolates by PCR-RFLP analysis from 15 patients revealed Mycobacterium abscessus (M. abscessus) and M. lentiflavum. Most of the patients received surgical debridement and combination antimicrobial therapy and were eventually cured. Conclusions: Our study demonstrates the potential that RGM infections have in causing healthcare-associated SSIs. Surgery plus prolonged combination antimicrobial therapy seemed to be an effective option for the management of M. abscessus infections.

Prolonged postprocedural outbreak of Mycobacterium massiliense infections associated with ultrasound transmission gel

“…Using the search terms '(Taiwan AND (Mycobacterium abscessus)) OR (Taiwan AND (Mycobacterium chelonae)),' we retrieved seven relevant articles from 70 results [21][22][23][24][25][26][27]. In addition to the CGMH cases, another case was retrieved from the records of the monthly meetings of the Infectious Diseases Society (http://www.idsroc.org.tw/DB/Cases/42/201/201.pdf).…”

Comparing the Utilities of Different Multilocus Sequence Typing Schemes for Identifying Outbreak Strains of Mycobacterium abscessus subsp. massiliense

“…massiliense ST23 (CC3), thereafter referred to as the "globally successful clone" (10,11). Other outbreaks occurring after ultrasound-guided procedures, acupuncture, injections, dental, ophthalmological, cardiac, obstetric, and cosmetic surgeries due to M. abscessus continue to be reported worldwide (12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Postcesarean section wound infection caused by Mycobacterium massiliense

“…21 Although publications regarding plastic surgery or cosmetic surgery related to M. abscessus surgical site infections are plentiful, 22e24 we found only one previous publication related to M. abscessus in a C sectionrelated surgical site infection. 2 In the article, 13 laboratory-confirmed M. abscessus infected post C-section patients were treated by oral clarithromycin, intravenous imipenem/cilastatin, and intravenous amikacin. Among these 13 patients, 10 had satisfactory outcomes, but three had unknown posttreatment outcomes.…”

“…1 Although the M. abscessus complex has frequently been described in cases of wound infection following cosmetic surgery, we only found one published case of postsurgical wound infection following cesarean section (C section) involving the M. abscessus complex. 2 The current taxonomy of the M. abscessus complex is controversial. The complex is now thought to consist of three subspecies: M. abscessus subsp.…”