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Akazawa N, Itoh N, Ishibana Y, Murakami H, Okumura S. Successful management of surgical site infection caused by Mycobacterium mageritense in a breast cancer patient. J Infect Chemother 2024; 30:800-805. [PMID: 38272263 DOI: 10.1016/j.jiac.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/14/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
Mycobacterium mageritense (M. mageritense), a nontuberculous mycobacterium, is classified as a rapidly growing mycobacterium, class IV in the Runyon Classification. This bacterium is found in soil, water, and other habitats. Infections caused by M. mageritense are relatively rare and no treatment protocol has been established. Herein, we report a case of skin and soft tissue infection caused by M. mageritense. A 49-year-old woman underwent surgery for right breast cancer. Four months after surgery, a surgical site infection was found, and M. mageritense was identified in the wound culture using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Based on the sensitivity results, the patient was treated with levofloxacin and doxycycline for 4 months. In addition to antimicrobial agents, aggressive surgical interventions led to a favorable course of treatment. In conclusion, successful treatment of skin and soft tissue infections with M. mageritense requires surgical intervention whenever possible, aggressive susceptibility testing, and appropriate antimicrobial therapy.
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Affiliation(s)
- Nana Akazawa
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
| | - Naoya Itoh
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Yuichi Ishibana
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Hiromi Murakami
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Seiko Okumura
- Department of Plastic and Reconstructive Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
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2
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Alhariri HE, Kwayess R, Behlau I. Pacemaker infection at generator site by Mycobacterium mageritense: A case report and review of the literature. SAGE Open Med Case Rep 2024; 12:2050313X241233196. [PMID: 38384984 PMCID: PMC10880517 DOI: 10.1177/2050313x241233196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/29/2024] [Indexed: 02/23/2024] Open
Abstract
We herein report an unusual case of Mycobacterium mageritense pacemaker infection at generator site in a 62-year old female with no pertinent past medical history. Pacemaker-related infections caused by nontuberculous mycobacteria are rare but can lead to significant morbidity and mortality. Mycobacterium mageritense is rarely reported in pacemaker infections and is challenging to treat due to resistance to many antimicrobial agents. In our case, the patient's pacemaker infection did not respond to standard treatment, leading to complete device removal. Our case highlights the challenges in treating Mycobacterium Mageritense, especially that our patient had a more resistant organism than those reported previously in literature. To our knowledge, such cases are infrequently reported in the literature.
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Affiliation(s)
| | - Rola Kwayess
- Division of Endocrinology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Irmgard Behlau
- Division of Infectious Diseases and Travel Medicine, Department of Medicine, Mount Auburn Hospital, Cambridge, MA, USA
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3
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Hashimoto N, Kani N, Makino S, Naka T, Miyakawa H, Okamoto K, Uwatoko R, Bessho S, Iio R, Ueda Y, Hayashi T. Fatal peritoneal dialysis-associated peritonitis caused by Mycobacterium mageritense: a case report with review. RENAL REPLACEMENT THERAPY 2023. [DOI: 10.1186/s41100-023-00457-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Background
Peritonitis is a serious and potentially fatal complication of peritoneal dialysis. We report a case of fatal peritonitis caused by Mycobacterium mageritense that was detected for the first time in peritonitis.
Case presentation
A male patient in his 60 s undergoing peritoneal dialysis was admitted for catheter diversion with exit-site renewal. The patient had a refractory exit-site infection. Mycobacterial culture was not performed at the exit site prior to admission. After the surgery, the patient developed a fever, and a cloudy effluent was observed. Various antibiotics, including anti-tuberculosis drugs, were administered; however, his symptoms did not improve. The catheter was removed on the thirty-seventh day of admission. Bacteria positive for Ziehl–Neelsen staining were found in the peritoneal sample collected during the surgery. Since nontuberculous mycobacteria were considered the cause of peritonitis, the patient was administered imipenem/cilastatin, amikacin, and clarithromycin. However, he died of septic shock on the fifty-first day after admission. Mycobacterium mageritense was detected in the ascites culture after death.
Conclusion
This is, to our knowledge, the first report of peritonitis caused by Mycobacterium mageritense. In patients undergoing peritoneal dialysis, when a refractory exit-site infection is observed, mycobacterial culture is necessary to prevent the development of peritonitis.
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Maheshwari S, Parakh S, Das SM, Ahuja A, Jha SN, Agrawal R, Gupta V, Luthra S. Multifocal Serpiginoid Choroiditis Due to Mycobacterium Mageritense following Laparoscopic Hysterectomy in an Immunocompetent Host. Ocul Immunol Inflamm 2023; 31:236-241. [PMID: 35050821 DOI: 10.1080/09273948.2021.2018713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE To report nontubercular choroiditis, caused by Mycobacterium mageritense isolated using MALDI-TOF MS, following laparoscopic hysterectomy in an immunocompetent patient. CASE REPORT A 42-year-old female presented with gradual, painless diminution of vision in the right eye for six weeks. She had undergone laparoscopic hysterectomy two months back. BCVA was 2/60 OD. Clinical presentation and imaging all pointed to a diagnosis of serpiginous-like choroiditis. Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) had led to isolation of Mycobacterium mageritense. Patient was treated with systemic antibiotics. At 3 months follow up, BCVA improved to 6/60; fundus showed healed choroiditis and chorioretinal thinning. CONCLUSION Atypical mycobacterial infections associated with laparoscopic surgeries can rarely lead to debilitating systemic bacteremia resulting in profound visual impairment. The importance of timely diagnosis using specific and sophisticated methods such as MALDI-TOF MS as well as maintaining aseptic precautions perioperatively during major surgeries cannot be overemphasized.
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Affiliation(s)
| | - Shweta Parakh
- Drishti Eye Institute, Drishti Eye Institute, Dehradun, India
| | | | - Alok Ahuja
- Dr. Ahuja's Pathology and Imaging Centre, Dr. Ahuja's Pathology and Imaging Centre, Dehradun, India
| | - Shashi Nath Jha
- Sir Ganga Ram Hospital, Sir Ganga Ram Hospital, New Delhi, India
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Vishali Gupta
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Saurabh Luthra
- Drishti Eye Institute, Drishti Eye Institute, Dehradun, India
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García-Boyano M, Baquero-Artigao F, Toro C, Alguacil-Guillén M, Lázaro-Perona F, Calvo C. Mycobacterium mageritense Lymphadenitis in Child. Emerg Infect Dis 2022; 28:752-753. [PMID: 35202540 PMCID: PMC8888222 DOI: 10.3201/eid2803.211486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Although human infections caused by Mycobacterium mageritense are rare, there are some case reports involving sinusitis, pneumonia, and hospital-acquired infections in adults. We report a case of lymphadenitis caused by M. mageritense in a child in Spain.
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A Case of Laryngeal Infection Secondary to Mycobacterium mageritense in an Immunocompetent Patient. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2021. [DOI: 10.1097/ipc.0000000000001054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Koyama T, Funakoshi Y, Imamura Y, Nishimura S, Fujishima Y, Toyoda M, Kiyota N, Tanino H, Minami H. Device-related Mycobacterium mageritense Infection in a Patient Treated with Nivolumab for Metastatic Breast Cancer. Intern Med 2021; 60:3485-3488. [PMID: 33994435 PMCID: PMC8627816 DOI: 10.2169/internalmedicine.6550-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Treatment with anti-programmed cell death-1 (PD-1) antibodies improves the anti-cancer immune response and can provide a meaningful clinical benefit to cancer patients. However, this treatment can result in specific autoimmune toxicities, termed immune-related adverse events (irAEs). Although irAEs are well recognized, the development of infectious diseases due to this treatment is not often observed. Some recent reports have indicated that patients who receive anti-PD-1 antibodies are at a higher risk for tuberculosis than others. However, reports on nontuberculous mycobacterial infection during anti-PD-1 antibody treatment are still rare. We herein report the first case of Mycobacterium mageritense infection during anti-PD-1 antibody treatment.
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Affiliation(s)
- Taiji Koyama
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Japan
| | - Yohei Funakoshi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Japan
| | - Yoshinori Imamura
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Japan
| | - Sho Nishimura
- Division of Infectious Diseases, Department of Medicine, Kobe University Hospital, Japan
| | - Yoshimi Fujishima
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Japan
| | - Masanori Toyoda
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Japan
| | - Naomi Kiyota
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Japan
- Cancer Center, Kobe University Hospital and Graduate School of Medicine, Japan
| | - Hirokazu Tanino
- Division of Breast and Endocrine Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Japan
- Cancer Center, Kobe University Hospital and Graduate School of Medicine, Japan
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Soria-Herrera RJ, Dominguez-Gonzalez KG, Rumbo-Pino R, Piña-Lazaro A, Alvarez-Perez JJ, Rivera-Gutierrez S, Ponce-Saavedra J, Ortiz-Alvarado R, Gonzalez-Y-Merchand JA, Yahuaca-Juarez B, Cerna-Cortes JF. Occurrence of Nontuberculous Mycobacteria, Salmonella, Listeria monocytogenes, and Staphylococcus aureus in Artisanal Unpasteurized Cheeses in the State of Michoacan, Mexico. J Food Prot 2021; 84:760-766. [PMID: 33290541 DOI: 10.4315/jfp-20-286] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/03/2020] [Indexed: 11/11/2022]
Abstract
ABSTRACT This study investigated the presence of nontuberculous mycobacteria (NTM) for the first time in two types of unpasteurized fresh cheese produced in the state of Michoacan, Mexico. We tested for this pathogen, along with the others, to broaden the study of microbiological quality in 60 samples of cheese, 30 fresh and 30 Adobera, which were collected from six artisanal cheese factories (ACFs). The hygienic conditions of these establishments and the practices of cheese manufacture were generally poor. Although Mycobacterium bovis was not detected, four cheese samples harbored NTM isolates. The four NTM isolates were identified using three molecular markers (hsp65, rrs, and rpoB genes) that corresponded to Mycolicibacterium fortuitum (n = 3) and Mycolicibacterium mageritense (n = 1). All 60 cheese samples analyzed had unsatisfactory microbiological quality according to the Mexican Official Guideline. Regarding fresh cheeses, all 30 samples analyzed were positive for aerobic mesophilic bacteria, total coliforms, fecal coliforms, and yeasts and molds. Escherichia coli and Staphylococcus aureus were present in 23 and 21 samples, respectively. Listeria monocytogenes was identified in a sample and was isolated from a bulk milk tank in the same ACF. With regard to Adobera cheeses, all samples were positive for aerobic mesophilic bacteria, total coliforms, fecal coliforms, yeasts and molds, and S. aureus. E. coli was isolated from 28 samples. Salmonella was isolated from a sample and from a wooden shovel used in the manufacture of the cheeses in the same ACF. Thus, the consumption of unpasteurized fresh cheese may represent a public health risk. Because of this, health authorities should enforce the legislation that forbids the processing of cheese with unpasteurized milk and encourage producers to follow good manufacturing practices from original ingredients, through the production process of the cheese, to its sale to assure a safe product. HIGHLIGHTS
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Affiliation(s)
- Ricardo Jiovanni Soria-Herrera
- Facultad de Quimico Farmacobiologia, Universidad Michoacana de San Nicolas de Hidalgo, Tzintzuntzan 173, Col. Matamoros, Morelia Michoacan 58240, Mexico.,Departamento de Microbiologia, Escuela Nacional de Ciencias Biologicas-Instituto Politecnico Nacional, Prolongacion Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomas, Ciudad de Mexico 11340, Mexico
| | - Karla Gabriela Dominguez-Gonzalez
- Facultad de Quimico Farmacobiologia, Universidad Michoacana de San Nicolas de Hidalgo, Tzintzuntzan 173, Col. Matamoros, Morelia Michoacan 58240, Mexico
| | - Rebeca Rumbo-Pino
- Facultad de Quimico Farmacobiologia, Universidad Michoacana de San Nicolas de Hidalgo, Tzintzuntzan 173, Col. Matamoros, Morelia Michoacan 58240, Mexico
| | - Arizbeth Piña-Lazaro
- Facultad de Quimico Farmacobiologia, Universidad Michoacana de San Nicolas de Hidalgo, Tzintzuntzan 173, Col. Matamoros, Morelia Michoacan 58240, Mexico
| | - Jose Jesus Alvarez-Perez
- Facultad de Quimico Farmacobiologia, Universidad Michoacana de San Nicolas de Hidalgo, Tzintzuntzan 173, Col. Matamoros, Morelia Michoacan 58240, Mexico
| | - Sandra Rivera-Gutierrez
- Departamento de Microbiologia, Escuela Nacional de Ciencias Biologicas-Instituto Politecnico Nacional, Prolongacion Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomas, Ciudad de Mexico 11340, Mexico.,ORCID: https://orcid.org/0000-0003-1556-9956 [S.R.G.]
| | - Javier Ponce-Saavedra
- Facultad de Biología, Universidad Michoacana de San Nicolas de Hidalgo, Ciudad Universitaria, Morelia Michoacan 58060, Mexico (ORCID: https://orcid.org/0000-0001-6012-3748 [J.P.S.])
| | - Rafael Ortiz-Alvarado
- Facultad de Quimico Farmacobiologia, Universidad Michoacana de San Nicolas de Hidalgo, Tzintzuntzan 173, Col. Matamoros, Morelia Michoacan 58240, Mexico.,(ORCID: https://orcid.org/0000-0001-8169-3838 [R.O.A.])
| | - Jorge Alberto Gonzalez-Y-Merchand
- Departamento de Microbiologia, Escuela Nacional de Ciencias Biologicas-Instituto Politecnico Nacional, Prolongacion Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomas, Ciudad de Mexico 11340, Mexico.,https://orcid.org/0000-0002-6461-3135 [J.A.G.M.]
| | - Berenice Yahuaca-Juarez
- Facultad de Quimico Farmacobiologia, Universidad Michoacana de San Nicolas de Hidalgo, Tzintzuntzan 173, Col. Matamoros, Morelia Michoacan 58240, Mexico
| | - Jorge Francisco Cerna-Cortes
- Departamento de Microbiologia, Escuela Nacional de Ciencias Biologicas-Instituto Politecnico Nacional, Prolongacion Carpio y Plan de Ayala S/N, Col. Casco de Santo Tomas, Ciudad de Mexico 11340, Mexico.,https://orcid.org/0000-0002-4350-9507 [J.F.C.C.]
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Joya CA, Deegan C, Gleeson TD. Mycobacterium mageritense infection following mastectomy and breast reconstruction requiring triple antibiotic therapy and surgical debridement. BMJ Case Rep 2021; 14:14/2/e237618. [PMID: 33542012 PMCID: PMC7868199 DOI: 10.1136/bcr-2020-237618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A 40-year-old woman was referred to infectious disease specialists for a Mycobacterium mageritense skin infection following mastectomy and bilateral reconstruction with deep inferior epigastric perforator flap. Her case demonstrates the difficulty in treating non-tuberculosis mycobacterial infections, especially the rarely seen species. She failed to respond to dual antibiotic therapy containing imipenem-cilastin despite reported sensitivity. Additionally, her course was complicated by intolerance to various regimens, including gastrointestinal distress, a drug rash with eosinophilia and systemic symptoms, and tendinopathy. With few published data, no treatment guidelines, and limited medications from which to choose for M. mageritense, her treatment posed a challenge. She ultimately required aggressive surgical intervention and a triple therapy antibiotic regimen. The duration of our patient's treatment and the extent of her complications suggest a potential need for early surgical intervention in postsurgical wounds infected with M. mageritense that do not respond to conventional treatment.
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Affiliation(s)
- Christie Alyce Joya
- Parasitology, Naval Medical Research Unit No 6, Callao, Peru,Infectious Disease, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Cara Deegan
- School of Medicine, USUHS, Bethesda, Maryland, USA
| | - Todd D Gleeson
- Infectious Disease, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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Singhal L, Bhagat A, Gupta M, Gulati N, Dalal AK, Chander J. Multiple Recalcitrant Draining Sinuses Caused by Mycobacterium mageritense Following Laparoscopic Cholecystectomy: a Case Report and Brief Review of Literature. Jpn J Infect Dis 2020; 73:256-258. [DOI: 10.7883/yoken.jjid.2019.343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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