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Ren H, Xiao Y, Tang B, Shi Y, Zeng Z, Qiu X, Ding Y, Xiao R. The Price of Beauty: A Literature Review on Non-Tuberculous Mycobacteria Infection After Cosmetic Procedures. Aesthet Surg J 2024; 44:NP574-NP584. [PMID: 38591553 DOI: 10.1093/asj/sjae076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
Non-tuberculous mycobacteria (NTM) infection of the skin and soft tissues is a complication of cosmetic procedures. The incidence of cutaneous NTM infections has increased significantly as aesthetic operations have become more commonplace. With the rise of cosmetic tourism, the geographic expansion of NTM infections is a major concern. Due to the unique pathogenesis of NTM infections, diagnosis and treatment remain significant challenges for clinicians. Clinical management relies on a combination of antibiotic therapy with drug susceptibility testing and appropriate surgical debridement. Some new drugs, photodynamic therapy, and bacteriophage therapy have been developed in recent years, and may improve the aesthetic outcomes. This review summarizes the cosmetic procedures prone to NTM infections in recent years and their clinical features. We propose a 2-stage treatment procedure, including a hospitalization phase and a follow-up phase. We aim to increase the alertness of clinicians to NTM infections for timely detection and treatment. LEVEL OF EVIDENCE: 3
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2
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Ghafari G, Newcomer J, Rigali S, Liszewski W. Permanent makeup: A review of its technique, regulation, and complications. J Am Acad Dermatol 2024:S0190-9622(24)00848-X. [PMID: 38901732 DOI: 10.1016/j.jaad.2024.01.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/19/2023] [Accepted: 01/05/2024] [Indexed: 06/22/2024]
Abstract
Permanent makeup (PMU) is a popular form of tattooing used to replace or enhance the use of daily makeup. The purpose of this literature review is to provide an overview of PMU, with a particular focus on its use, regulation, and potential complications reported in the literature. In the United States, there is significant variation in the regulation and training required to perform PMU. Adverse outcomes of PMU include infectious, allergic, and inflammatory complications. These complications may be more common if proper hygiene and aftercare practices are not followed. Cosmetically, PMU may shift or have an altered appearance if the underlying skin is treated with cosmetic fillers or local anesthetics. Given the popularity of PMU and its cosmetic uses, dermatologists should be aware of the PMU industry, potential complications, and how best to manage complications.
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Affiliation(s)
- Ghazal Ghafari
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Jack Newcomer
- Department of Dermatology, Northwestern University, Chicago, Illinois.
| | - Sarah Rigali
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Walter Liszewski
- Department of Dermatology, Northwestern University, Chicago, Illinois; Division of Cancer Epidemiology and Prevention, Department of Preventative Medicine, Northwestern University, Chicago, Illinois
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3
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Staheli CF, Dacy NN, Brown SC, Parekh P. Incarcerated Ink: A Case of Mycobacterium chelonae. Cureus 2024; 16:e58186. [PMID: 38741831 PMCID: PMC11089834 DOI: 10.7759/cureus.58186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2024] [Indexed: 05/16/2024] Open
Abstract
A 30-year-old African American male presented with pain and swelling of the right foot one month after receiving a tattoo on this foot in prison. During his admission for presumed cellulitis, he developed a rash on his contralateral (left) leg, which had been tattooed 10 months prior. A biopsy of the contralateral (left) leg showed acute, chronic, and granulomatous inflammation with a differential diagnosis including infection. His overall condition and both legs worsened, prompting biopsy and tissue culture of the right ankle and foot. Pathology of the right foot showed a granulomatous reaction. Culture grew Mycobacterium chelonae. This case highlights the importance of considering infectious etiologies for rashes appearing within tattoos and represents the importance of a full investigation to obtain the correct diagnosis.
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Affiliation(s)
- Clayton F Staheli
- Department of Dermatology, Texas A&M Health Science Center, Bryan, USA
| | - Nicole N Dacy
- Department of Dermatology, Baylor Scott & White Medical Center - Temple, Temple, USA
| | - Shannon C Brown
- Department of Dermatology, Baylor Scott & White Medical Center - Temple, Temple, USA
| | - Palak Parekh
- Department of Dermatology, Baylor Scott & White Medical Center - Temple, Temple, USA
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4
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Bălăceanu-Gurău B, Apostol E, Caraivan M, Ion A, Tatar R, Mihai MM, Popa LG, Gurău CD, Orzan OA. Cutaneous Adverse Reactions Associated with Tattoos and Permanent Makeup Pigments. J Clin Med 2024; 13:503. [PMID: 38256637 PMCID: PMC10816451 DOI: 10.3390/jcm13020503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Tattooing is the procedure of implanting permanent pigment granules and additives into the dermal layer of the skin, serving various purposes such as decoration, medical identification, or accidental markings. There has been a significant rise in the popularity of decorative tattooing as a form of body art among both teenagers and young adults. Thus, the incidence of tattoos is increasing, with expanding applications such as permanent makeup, scar camouflage, nipple-areola, lips, and eyebrows tattooing, and utilization in oncological radiotherapy such as colon marking. However, there have been reported a broad range of adverse reactions linked to tattooing, encompassing allergic reactions, superficial and deep cutaneous infections, autoimmune disorders induced by the Koebner phenomenon, cutaneous tumors, and others. These reactions exhibit different onset times for symptoms, ranging from immediate manifestations after tattoo application to symptoms emerging several years later. Given the limited information on a tattoo's side effects, this review aims to elucidate the clinical spectrum of cutaneous complications of tattoos in different patients. The analysis will investigate both allergic and nonallergic clinical presentations of tattoo-related side effects, microscopic findings from skin biopsies, and therapeutic outcomes. This exploration is essential to improve our understanding of tattoo-related cutaneous complications and associated differential diagnoses and highlight the significance of patient awareness regarding potential risks before getting a tattoo.
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Affiliation(s)
- Beatrice Bălăceanu-Gurău
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Eliza Apostol
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | | | - Ana Ion
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Raluca Tatar
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, 010621 Bucharest, Romania
| | - Mara Mădălina Mihai
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Liliana Gabriela Popa
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Cristian-Dorin Gurău
- Orthopedics and Traumatology Clinic, Clinical Emergency Hospital, 014451 Bucharest, Romania;
| | - Olguța Anca Orzan
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
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5
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Yoon S, Kondakala S, Moon MS, Huang MCJ, Periz G, Foley SL, Kweon O, Kim SJ. Recalls of tattoo and permanent makeup inks in the United States and a follow-up microbiological survey of inks with a previous recall history. Front Public Health 2023; 11:1279884. [PMID: 38026365 PMCID: PMC10668429 DOI: 10.3389/fpubh.2023.1279884] [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: 08/21/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
In this study, we collected voluntary recall records of tattoo and permanent makeup ink from the U.S. Food and Drug Administration (US FDA) Enforcement Report Database. The recall records contain information, such as recall date, manufacturer, ink color, reason for recall, and the microorganisms detected from the ink samples. Between 2003 and 2021, a total of 15 voluntary tattoo ink recalls occurred in the U.S. market, involving over 200 tattoo inks marketed by 13 manufacturers and one distributor. Fourteen recalls were due to microbial contamination, and one recall was due to allergic reaction. As follow-up, a microbiological survey of 28 tattoo inks of new batches from seven manufacturers having products that were previously recalled was conducted. Aerobic plate count (APC) and enrichment culture methods based on the FDA's Bacteriological Analytical Manual (BAM) were used to detect microbial contamination. The results revealed that six out of 28 tattoo inks were contaminated with bacteria and were produced by two manufacturers. The level of microbial contamination was less than 250 CFU/g in three of the tattoo inks and between 1 × 103 and 1 × 105 CFU/g in the other three inks. Eleven bacterial isolates were identified, including spore-forming Bacillus-related species and potentially pathogenic species. Overall, this study shows that some tattoo ink products produced by manufacturers with a recall history continue to be contaminated with microorganisms. This highlights the need for ongoing monitoring and quality control of such products.
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Affiliation(s)
- Sunghyun Yoon
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, United States
| | - Sandeep Kondakala
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, United States
| | - Mi Sun Moon
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, MD, United States
| | - Mei-Chiung J. Huang
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, MD, United States
| | - Goran Periz
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, College Park, MD, United States
| | - Steven L. Foley
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, United States
| | - Ohgew Kweon
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, United States
| | - Seong-Jae Kim
- Division of Microbiology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, United States
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6
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Lange K, Janßen S, Dimmers F, Homey B, Jansen TM. [Nontuberculous mycobacterial infection after tattooing caused by Mycobacterium chelonae]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:711-714. [PMID: 37341750 PMCID: PMC10480254 DOI: 10.1007/s00105-023-05173-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/22/2023]
Abstract
We report the case of a healthy young man who presented to our clinic with itchy skin lesions in the area of a tattoo on the back of the left hand. Bioptic and cultural confirmation of the pathogens led to the diagnosis of Mycobacterium chelonae infection. We initiated antibiotic therapy using azithromycin and linezolid with good response. Our case underlines that besides allergic skin reactions, infections as a complication after tattooing should also be included in the differential diagnosis.
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Affiliation(s)
- K Lange
- Klinik für Dermatologie, Medizinische Fakultät, Heinrich-Heine-Universität, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - S Janßen
- Klinik für Dermatologie, Medizinische Fakultät, Heinrich-Heine-Universität, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - F Dimmers
- Klinik für Dermatologie, Medizinische Fakultät, Heinrich-Heine-Universität, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - B Homey
- Klinik für Dermatologie, Medizinische Fakultät, Heinrich-Heine-Universität, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - T M Jansen
- Klinik für Dermatologie, Medizinische Fakultät, Heinrich-Heine-Universität, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
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7
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Sakatoku Y, Okada Y, Takahashi Y. A rare spontaneous breast abscess due to Mycobacterium chelonae: a case report. Surg Case Rep 2023; 9:125. [PMID: 37405585 DOI: 10.1186/s40792-023-01706-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/23/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Mycobacterium chelonae, a nontuberculous mycobacterium, commonly causes skin, soft tissue, eye, pulmonary, catheter-related, and post-surgical infections in patients with immunosuppression or trauma. M. chelonae breast infections are rare, and most cases occur following cosmetic surgery. Here, we report the first case of spontaneous breast abscess due to M. chelonae. CASE PRESENTATION A 22-year-old Japanese woman presented at our hospital with swelling and pain in the right breast for the past 2 weeks without any fever. She had a 19-month-old child and stopped breastfeeding 1 month after giving birth. The patient had no history of trauma or breast surgeries, no family history of breast cancer, and was not immunocompromised. Breast ultrasonography revealed a heterogeneous hypoechoic lesion with multiple fluid-filled areas suspected to be abscesses. Dynamic contrast-enhanced magnetic resonance imaging revealed a 64 × 58 × 62 mm, ill-defined, high-signal-intensity lesion with multiple ring enhancements in the upper half of the right breast. The first diagnosis was inflammatory breast cancer or granulomatous mastitis with abscess. A core needle biopsy led to drainage of pus. Gram staining did not reveal any bacteria in the pus, but the colonies from the biopsy grew on blood and chocolate agar cultures. Mass spectrometry detected M. chelonae in these colonies. Histopathological findings revealed mastitis without malignancy. The patient's treatment regimen was oral clarithromycin (CAM) based on susceptibility. Three weeks later, although the pus had reduced, the induration in the breast did not resolve; therefore, multidrug antibiotic treatment was initiated. The patient received amikacin and imipenem infusion therapy for 2 weeks, followed by continuation of CAM. Three weeks later, tenderness in the right breast recurred with slight pus discharge. Hence, minocycline (MINO) was added to the treatment. The patient stopped CAM and MINO treatment 2 weeks later. There was no recurrence 2 years after treatment. CONCLUSION We report a case of M. chelonae breast infection and abscess formation in a 22-year-old Japanese woman without obvious risk factors. M. chelonae infection should be considered in cases of intractable breast abscess, even in patients without immunosuppression or trauma.
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Affiliation(s)
- Yayoi Sakatoku
- Department of Surgery, Handa City Hospital, 2-29 Toyo-Cho, Handa-City, Aichi, 475-8599, Japan.
| | - Yoshito Okada
- Department of Surgery, Handa City Hospital, 2-29 Toyo-Cho, Handa-City, Aichi, 475-8599, Japan
| | - Yohei Takahashi
- Department of Diagnostic Pathology, Handa City Hospital, 2-29 Toyo-Cho, Handa-City, Aichi, 475-8599, Japan
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8
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Negi S, Bala L, Shukla S, Chopra D. Tattoo inks are toxicological risks to human health: A systematic review of its ingredients, fate inside skin, toxicity due to polycyclic aromatic hydrocarbons, primary aromatic amines, metals, and overview of regulatory frameworks. Toxicol Ind Health 2022; 38:417-434. [PMID: 35592919 DOI: 10.1177/07482337221100870] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Today, tattooing has become very popular among people all over the world. Tattooists, with the help of tiny needles, place tattoo ink inside the skin surface and unintentionally introduce a large number of unknown ingredients. These ingredients include polycyclic aromatic hydrocarbons (PAHs), heavy metals, and primary aromatic amines (PAAs), which are either unintentionally introduced along with the ink or produced inside the skin by different types of processes for example cleavage, metabolism and photodecomposition. These could pose toxicological risks to human health, if present beyond permissible limits. PAH such as Benzo(a)pyrene is present in carbon black ink. PAAs could be formed inside the skin as a result of reductive cleavage of organic azo dyes. They are reported to be highly carcinogenic by environmental protection agencies. Heavy metals, namely, cadmium, lead, mercury, antimony, beryllium, and arsenic are responsible for cancer, neurodegenerative diseases, cardiovascular, gastrointestinal, lungs, kidneys, liver, endocrine, and bone diseases. Mercury, cobalt sulphate, other soluble cobalt salts, and carbon black are in Group 2B, which means they may cause cancer in humans. Cadmium and compounds of cadmium, on the other hand, are in Group 1 (carcinogenic to humans). The present article addresses the various ingredients of tattoo inks, their metabolic fate inside human skin and unintentionally added impurities that could pose toxicological risk to human health. Public awareness and regulations that are warranted to be implemented globally for improving the safety of tattooing.
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Affiliation(s)
- Sandeep Negi
- School of Dental Sciences, Department of Biochemistry, 301429Babu Banarasi Das University, Lucknow, India.,Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, 538266CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India
| | - Lakshmi Bala
- School of Dental Sciences, Department of Biochemistry, 301429Babu Banarasi Das University, Lucknow, India
| | - Saumya Shukla
- School of Dental Sciences, Department of Biochemistry, 301429Babu Banarasi Das University, Lucknow, India.,Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, 538266CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India
| | - Deepti Chopra
- Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, 538266CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India
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9
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Bacteriophage treatment of disseminated cutaneous Mycobacterium chelonae infection. Nat Commun 2022; 13:2313. [PMID: 35504908 PMCID: PMC9064978 DOI: 10.1038/s41467-022-29689-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/24/2022] [Indexed: 01/01/2023] Open
Abstract
Mycobacterium chelonae is a rare cause of chronic disseminated cutaneous infections in immunocompromised patients. Multidrug-resistant M. chelonae infections present a challenge for treatment, and prolonged antimicrobial courses lead to significant toxicities and further antimicrobial resistance. We report a case of refractory cutaneous disseminated M. chelonae infection in a patient with seronegative arthritis on immunotherapy with tofacitinib that was treated with combination antimicrobial, surgical, and single bacteriophage therapy with excellent clinical response. The patient developed neutralizing antibodies against the bacteriophage but continues to have stable improvement of disease with negative biopsies and no evidence of bacterial resistance to the phage.
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10
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Nontuberculous mycobacterial skin and soft tissue infection in Hawai'i. BMC Infect Dis 2022; 22:360. [PMID: 35410188 PMCID: PMC9004129 DOI: 10.1186/s12879-022-07345-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/31/2022] [Indexed: 11/27/2022] Open
Abstract
Background Hawaiʻi has the highest nontuberculous mycobacterial (NTM) lung infection prevalence in the United States. Limited data regarding skin and soft tissue infections (SSTI) due to NTM in Hawaiʻi exists. This study describes patient demographics, clinical courses of infection, treatment patterns, and clinical outcomes of NTM SSTIs in Hawaiʻi.
Methods A retrospective chart review (n = 50) of patients diagnosed and treated at Hawaiʻi Pacific Health facilities for NTM SSTIs between January 2010 and July 2021 was conducted. Patient demographics, clinical course, and treatment data were collected from electronic medical records.
Results Half of the patient population consisted of females, and the average age of patients during infection was 49 years (SD = 25.6). The majority of cases (80%) were caused by rapidly growing mycobacteria (RGM), most commonly Mycobacterium abscessus. NTM SSTI by race were Asian (48%), White (28%), and Native Hawaiian and Other Pacific Islanders (16%). Almost all Asian patients with NTM SSTI were Filipino or Japanese. Diagnosis was frequently delayed. The average time to diagnosis was 116 days. Most patients achieved complete resolution (72%) following a prolonged course of antimicrobial treatment (mean = 196 days) with surgical debridement. Conclusion Increased awareness among physicians and the community of non-mycobacterial skin infections is essential in Hawaiʻi due to the high prevalence of NTM and the high percentage of predisposed populations. Increased awareness of NTM could reduce delayed diagnosis and improve patient care. Further studies are required to inform optimal treatment and diagnostic strategies, improve patient outcomes, and aid public health surveillance efforts.
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11
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Chen YC, Hsu HT, Wang SH. Tattoo-associated lichen nitidus. DERMATOL SIN 2022. [DOI: 10.4103/1027-8117.360037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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12
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van der Bent SAS, Rauwerdink D, Oyen EMM, Maijer KI, Rustemeyer T, Wolkerstorfer A. Complications of tattoos and permanent makeup: overview and analysis of 308 cases. J Cosmet Dermatol 2021; 20:3630-3641. [PMID: 34605159 DOI: 10.1111/jocd.14498] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Worldwide 10-20% of the population is tattooed. However, tattoo complications can occur, such as allergic tattoo reactions, infections, and manifestations of autoimmune dermatoses. Despite the growing popularity of tattoos and changes in tattoo ink composition over the last decades, little is known about these complications, its clinical aspects, pathomechanism, and relative occurrence. OBJECTIVE The aim of this article is to describe the types and clinical aspects of dermatological tattoo complications, its relative occurrence and underlying conditions. METHODS We performed a retrospective cohort study enrolling all patients with tattoo complications from the Tattoo Clinic. Tattoo complications were categorized into infections, inflammatory tattoo reactions, neoplasms, or miscellaneous reactions and correlated to clinical data. RESULTS Of the total of 326 patients, 301 patients were included with 308 complications. The majority of the complications were chronic: 91.9%. Allergic red tattoo reactions and chronic inflammatory black tattoo reactions (CIBTR) accounted for 50.2% and 18.2%, respectively, of all tattoo complications. Of these CIBTR reactions, extracutaneous involvement was found in 21.4%, including tattoo-associated uveitis (7.1%) and systemic sarcoidosis (14.2%). Of all black tattoo reactions, systemic sarcoidosis was found in 7.8%. CONCLUSION Tattoos can cause a wide range in complications that may start years after getting the tattoo. The most frequent tattoo reactions are allergic red tattoo reactions and chronic inflammatory black tattoo reactions, making these the most relevant for the dermatologist. CIBTR have a high percentage of multi-organ involvement, and therefore, screening for sarcoidosis, including ocular involvement, is advised.
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Affiliation(s)
- S A S van der Bent
- Tattoo Clinic (Tattoo poli), Department of Dermatology, Alrijne Hospital, Leiden, The Netherlands.,Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands
| | - D Rauwerdink
- Tattoo Clinic (Tattoo poli), Department of Dermatology, Alrijne Hospital, Leiden, The Netherlands
| | - E M M Oyen
- Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands
| | - K I Maijer
- Department of Dermatology, Tergooi Hospital, Hilversum, The Netherlands
| | - T Rustemeyer
- Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands
| | - A Wolkerstorfer
- Academic Tattoo Clinic Amsterdam, Department of Dermatology, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands
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13
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Sindoni A, Valeriani F, Gallè F, Liguori G, Romano Spica V, Vitali M, Protano C. Adverse effects related to tattoos in the community setting: a systematic review. J Epidemiol Community Health 2021; 75:1023-1028. [PMID: 34253557 DOI: 10.1136/jech-2021-216874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/26/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Tattoos were historically associated with deviant behaviours or religious and other social purposes, but in the last decades, they have gained increasing popularity and have become a mainstream. The aim of this systematic review is to assess the literature evidence about decorative tattoos complications, considering both infective and non-infective risks. METHODS This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. We searched the following electronic bibliographic databases: PubMed, Scopus and Web of Science (science and social science citation index). RESULTS The literature search resulted in 6473 studies. A total of 207 full articles were considered potentially relevant and were reviewed independently by researchers. After full-text evaluation, 152 of 207 articles were excluded, as they did not meet selection criteria. The remaining 55 studies were included in the systematic review and their quality assessment was performed. Ten studies reported microbiological complications, 37 reported non-microbiological effects and eight reported either microbiological and non-microbiological complications. CONCLUSIONS Several well-known and uncommon risks are associated with tattooing and tattoo after-care. Public health authorities could take into account health education programmes for tattooists and customers in order to prevent health complications in people with tattoos. PROSPERO REGISTRATION NUMBER CRD42020177972.
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Affiliation(s)
- Alessandro Sindoni
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Federica Valeriani
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Vincenzo Romano Spica
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy
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14
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Yu E, Forg P, Crum-Cianflone NF. Case Series and Review of the Literature of Mycobacterium chelonae Infections of the Lower Extremities. J Foot Ankle Surg 2021; 59:1084-1091. [PMID: 32507603 DOI: 10.1053/j.jfas.2019.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/08/2019] [Accepted: 11/09/2019] [Indexed: 02/03/2023]
Abstract
Mycobacterium chelonae infections involving the lower extremities are rare clinical entities that present a diagnostic challenge given its diverse clinical presentations ranging from superficial (e.g., cellulitis, painful vesicular lesions) to deep (e.g., tenosynovitis) infections. We present 1 cases of M chelonae infections of the feet diagnosed 6 to 12 months after initial symptoms representing the difficulty of diagnosing this condition. Both cases were successfully managed with aggressive surgical debridement and long durations of antibiotic therapy with long-term care. A comprehensive review of the literature of M chelonae infections of the lower extremities was performed to provide summary data on the presenting symptoms, examination findings, predisposing conditions, and management approaches of this rare, but emerging clinical entity. Our cases and comprehensive review serve to raise awareness of atypical mycobacterial infections, including M chelonae, and advocate for the early consideration of mycobacterial cultures in the diagnostic workup of chronic lower extremity infections especially in the setting of poor initial response to standard antibacterial therapies.
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Affiliation(s)
- Edmund Yu
- Resident Physician, Department of Podiatric Medicine and Surgery, Scripps Mercy Hospital, San Diego, CA.
| | - Patricia Forg
- Attending Physician, Department of Podiatric Medicine and Surgery, Scripps Mercy Hospital, San Diego, CA
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15
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Bittencourt TL, da Silva Prata RB, de Andrade Silva BJ, de Mattos Barbosa MG, Dalcolmo MP, Pinheiro RO. Autophagy as a Target for Drug Development Of Skin Infection Caused by Mycobacteria. Front Immunol 2021; 12:674241. [PMID: 34113346 PMCID: PMC8185338 DOI: 10.3389/fimmu.2021.674241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 04/28/2021] [Indexed: 12/11/2022] Open
Abstract
Pathogenic mycobacteria species may subvert the innate immune mechanisms and can modulate the activation of cells that cause disease in the skin. Cutaneous mycobacterial infection may present different clinical presentations and it is associated with stigma, deformity, and disability. The understanding of the immunopathogenic mechanisms related to mycobacterial infection in human skin is of pivotal importance to identify targets for new therapeutic strategies. The occurrence of reactional episodes and relapse in leprosy patients, the emergence of resistant mycobacteria strains, and the absence of effective drugs to treat mycobacterial cutaneous infection increased the interest in the development of therapies based on repurposed drugs against mycobacteria. The mechanism of action of many of these therapies evaluated is linked to the activation of autophagy. Autophagy is an evolutionary conserved lysosomal degradation pathway that has been associated with the control of the mycobacterial bacillary load. Here, we review the role of autophagy in the pathogenesis of cutaneous mycobacterial infection and discuss the perspectives of autophagy as a target for drug development and repurposing against cutaneous mycobacterial infection.
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Affiliation(s)
| | | | | | | | - Margareth Pretti Dalcolmo
- Helio Fraga Reference Center, Sergio Arouca National School of Public Health, Fiocruz, Rio de Janeiro, Brazil
| | - Roberta Olmo Pinheiro
- Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
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16
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Gu CH, Zhao C, Hofstaedter C, Tebas P, Glaser L, Baldassano R, Bittinger K, Mattei LM, Bushman FD. Investigating hospital Mycobacterium chelonae infection using whole genome sequencing and hybrid assembly. PLoS One 2020; 15:e0236533. [PMID: 33166284 PMCID: PMC7652343 DOI: 10.1371/journal.pone.0236533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/20/2020] [Indexed: 11/21/2022] Open
Abstract
Mycobacterium chelonae is a rapidly growing nontuberculous mycobacterium that is a common cause of nosocomial infections. Here we describe investigation of a possible nosocomial transmission of M. chelonae at the Hospital of the University of Pennsylvania (HUP). M. chelonae strains with similar high-level antibiotic resistance patterns were isolated from two patients who developed post-operative infections at HUP in 2017, suggesting a possible point source infection. The isolates, along with other clinical isolates from other patients, were sequenced using the Illumina and Oxford Nanopore technologies. The resulting short and long reads were hybrid assembled into draft genomes. The genomes were compared by quantifying single nucleotide variants in the core genome and assessed using a control dataset to quantify error rates in comparisons of identical genomes. We show that all M. chelonae isolates tested were highly dissimilar, as indicated by high pairwise SNV values, consistent with environmental acquisition and not a nosocomial point source. Our control dataset determined a threshold for evaluating identity between strains while controlling for sequencing error. Finally, antibiotic resistance genes were predicted for our isolates, and several single nucleotide variants were identified that have the potential to modulated drug resistance.
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Affiliation(s)
- Christopher H. Gu
- Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Chunyu Zhao
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Casey Hofstaedter
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Pablo Tebas
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Laurel Glaser
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Robert Baldassano
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Kyle Bittinger
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Lisa M. Mattei
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Frederic D. Bushman
- Department of Microbiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States of America
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17
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Kerkemeyer KL, Darby JD, Green J. Mycobacterium abscessus infection of a new tattoo in an Australian traveller returning from Bali, Indonesia. J Travel Med 2020; 27:5721274. [PMID: 32010949 DOI: 10.1093/jtm/taaa014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 01/25/2020] [Accepted: 01/29/2020] [Indexed: 11/13/2022]
Abstract
Skin infection with atypical mycobacteria can occur following inoculation by tattooing. It may be seen in clinical practice with increasing frequency due to the popularity of tattooing among travellers. Diagnosis requires fresh tissue biopsy requested for mycobacterial culture, and treatment involves prolonged combination antimicrobial therapy guided by sensitivities.
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Affiliation(s)
- Karolina L Kerkemeyer
- Department of Dermatology, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy 3065, Australia
| | - Jonathan D Darby
- Department of Infectious Diseases, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy 3065, Australia
| | - Jack Green
- Department of Dermatology, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy 3065, Australia
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18
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Griffin I, Schmitz A, Oliver C, Pritchard S, Zhang G, Rico E, Davenport E, Llau A, Moore E, Fernandez D, Mejia-Echeverry A, Suarez J, Noya-Chaveco P, Elmir S, Jean R, Pettengill JB, Hollinger KA, Chou K, Williams-Hill D, Zaki S, Muehlenbachs A, Keating MK, Bhatnagar J, Rowlinson MC, Chiribau C, Rivera L. Outbreak of Tattoo-associated Nontuberculous Mycobacterial Skin Infections. Clin Infect Dis 2020; 69:949-955. [PMID: 30452604 DOI: 10.1093/cid/ciy979] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 11/13/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND On 29 April 2015, the Florida Department of Health in Miami-Dade County (DOH Miami-Dade) was notified by a local dermatologist of 3 patients with suspected nontuberculous mycobacterial (NTM) infection after receiving tattoos at a local tattoo studio. METHODS DOH Miami-Dade conducted interviews and offered testing, described below, to tattoo studio clients reporting rashes. Culture of clinical isolates and identification were performed at the Florida Bureau of Public Health Laboratories. Characterization of NTM was performed by the Centers for Disease Control and Prevention and the US Food and Drug Administration (FDA), respectively. Whole-genome sequencing (WGS) and single-nucleotide polymorphism (SNP) analyses were used to construct a phylogeny among 21 Mycobacterium isolates at the FDA. RESULTS Thirty-eight of 226 interviewed clients were identified as outbreak-associated cases. Multivariate logistic regression revealed that individuals who reported gray tattoo ink in their tattoos were 8.2 times as likely to report a rash (95% confidence interval, 3.1-22.1). Multiple NTM species were identified in clinical and environmental specimens. Phylogenetic results from environmental samples and skin biopsies indicated that 2 Mycobacterium fortuitum isolates (graywash ink and a skin biopsy) and 11 Mycobacterium abscessus isolates (5 from the implicated bottle of graywash tattoo ink, 2 from tap water, and 4 from skin biopsies) were indistinguishable. In addition, Mycobacterium chelonae was isolated from 5 unopened bottles of graywash ink provided by 2 other tattoo studios in Miami-Dade County. CONCLUSIONS WGS and SNP analyses identified the tap water and the bottle of graywash tattoo ink as the sources of the NTM infections.
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Affiliation(s)
- Isabel Griffin
- Epidemiology, Disease Control, and Immunization Services, Florida Department of Health in Miami-Dade County, Tallahassee
| | - Ann Schmitz
- Bureau of Epidemiology, Florida Department of Health, Tallahassee.,Office of Public Health Preparedness and Response, Division of State and Local Readiness, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Christine Oliver
- Environmental Health, Florida Department of Health in Miami-Dade County
| | - Scott Pritchard
- Bureau of Epidemiology, Florida Department of Health, Tallahassee
| | - Guoyan Zhang
- Epidemiology, Disease Control, and Immunization Services, Florida Department of Health in Miami-Dade County, Tallahassee
| | - Edhelene Rico
- Epidemiology, Disease Control, and Immunization Services, Florida Department of Health in Miami-Dade County, Tallahassee
| | - Emily Davenport
- Center for State, Tribal, Local, and Territorial Support, CDC, Atlanta, Georgia
| | - Anthoni Llau
- Epidemiology, Disease Control, and Immunization Services, Florida Department of Health in Miami-Dade County, Tallahassee
| | - Emily Moore
- Epidemiology, Disease Control, and Immunization Services, Florida Department of Health in Miami-Dade County, Tallahassee
| | - Danielle Fernandez
- Epidemiology, Disease Control, and Immunization Services, Florida Department of Health in Miami-Dade County, Tallahassee
| | - Alvaro Mejia-Echeverry
- Epidemiology, Disease Control, and Immunization Services, Florida Department of Health in Miami-Dade County, Tallahassee
| | - Juan Suarez
- Epidemiology, Disease Control, and Immunization Services, Florida Department of Health in Miami-Dade County, Tallahassee
| | - Pedro Noya-Chaveco
- Epidemiology, Disease Control, and Immunization Services, Florida Department of Health in Miami-Dade County, Tallahassee
| | - Samir Elmir
- Environmental Health, Florida Department of Health in Miami-Dade County
| | - Reynald Jean
- Epidemiology, Disease Control, and Immunization Services, Florida Department of Health in Miami-Dade County, Tallahassee
| | | | | | - Kyson Chou
- US Food and Drug Administration, Silver Spring, Maryland
| | | | - Sherif Zaki
- Infectious Disease Pathology Branch, CDC, Atlanta, Georgia
| | | | | | - Julu Bhatnagar
- Infectious Disease Pathology Branch, CDC, Atlanta, Georgia
| | - Marie-Claire Rowlinson
- Division of Disease Control and Health Protection, Bureau of Public Health Laboratories, Jacksonville, Florida
| | - Calin Chiribau
- Division of Disease Control and Health Protection, Bureau of Public Health Laboratories, Jacksonville, Florida
| | - Lillian Rivera
- Epidemiology, Disease Control, and Immunization Services, Florida Department of Health in Miami-Dade County, Tallahassee
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19
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Abstract
Tattooing and permanent make-up have become mainstream procedures. Many factors play a role in the final outcome of a tattoo and the satisfaction of the customer. The technical and artistic skills of the tattooist will determine the esthetic result and will help to guide the customers in their decision and choice of the tattoo. Although tattooing is by many considered as safe one should be are aware of the risks of complications related to this body modification technique. Some customers have a medical problem and some doubt about the safety of the procedure. People with increased risk of adverse events often seek medical advice prior to decide to get a tattoo or PMU. Physicians should not only be informed about the medical history of their patients but also have some basic knowledge of the practice of tattooing and the effects this procedure can exert on the skin and on the health condition of the patient. Contraindications and special precautions with regard to skin diseases and specific systemic conditions will be addressed in this article.
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Affiliation(s)
- Christa De Cuyper
- Dermatology, AZ Sint-Jan Brugge-Oostende AV, Meiboomstraat 15, 8370 Blankenberge, Belgium.
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20
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Nho SW, Kim M, Kweon O, Kim SJ, Moon MS, Periz G, Huang MCJ, Dewan K, Sadrieh NK, Cerniglia CE. Microbial contamination of tattoo and permanent makeup inks marketed in the US: a follow-up study. Lett Appl Microbiol 2020; 71:351-358. [PMID: 32654157 DOI: 10.1111/lam.13353] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/29/2020] [Accepted: 07/05/2020] [Indexed: 11/28/2022]
Abstract
In a 2018 survey, U.S. Food and Drug Administration (FDA) identified microbial contamination in 42 (49%) of 85 unopened tattoo and permanent makeup (PMU) inks purchased from 13 manufacturers in the US between November 2015 and April 2016. To confirm the results of our previous survey, we evaluated the level of microbial contamination in an additional 27 samples from 10 manufacturers from September 2017 to December 2017, including 21 unopened tattoo and PMU inks which were selected based on our previous survey results and 6 ink diluents that were not previously analysed. Aerobic plate count and enrichment culture methods from the FDA's Bacteriological Analytical Manual revealed 11 (52%) out of 21 inks, from six manufacturers, were contaminated with micro-organisms, with contamination levels up to 3·6 × 108 CFU per gram, consistent with our previous survey results. We identified 25 bacterial strains belonging to nine genera and 19 species. Strains of Bacillus sp. (11 strains, 44%) were dominant, followed by Paenibacillus sp. (5 strains, 20%). Clinically relevant strains, such as Kocuria rhizophila and Oligella ureolytica, were also identified, as similar to the findings in our previous survey. No microbial contamination was detected in any of the six ink diluents.
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Affiliation(s)
- S W Nho
- Division of Microbiology, National Center for Toxicological Research, U.S. FDA, Jefferson, AK, USA
| | - M Kim
- Division of Microbiology, National Center for Toxicological Research, U.S. FDA, Jefferson, AK, USA
| | - O Kweon
- Division of Microbiology, National Center for Toxicological Research, U.S. FDA, Jefferson, AK, USA
| | - S-J Kim
- Division of Microbiology, National Center for Toxicological Research, U.S. FDA, Jefferson, AK, USA
| | - M S Moon
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. FDA, College Park, MD, USA
| | - G Periz
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. FDA, College Park, MD, USA
| | - M-C J Huang
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. FDA, College Park, MD, USA
| | - K Dewan
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. FDA, College Park, MD, USA
| | - N K Sadrieh
- Office of Cosmetics and Colors, Center for Food Safety and Applied Nutrition, U.S. FDA, College Park, MD, USA
| | - C E Cerniglia
- Division of Microbiology, National Center for Toxicological Research, U.S. FDA, Jefferson, AK, USA
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21
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Satyam R, Bhardwaj T, Jha NK, Jha SK, Nand P. Toward a chimeric vaccine against multiple isolates of Mycobacteroides - An integrative approach. Life Sci 2020; 250:117541. [PMID: 32169520 DOI: 10.1016/j.lfs.2020.117541] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/07/2020] [Accepted: 03/08/2020] [Indexed: 01/31/2023]
Abstract
AIM Nontuberculous mycobacterial (NTM) infection such as endophthalmitis, dacryocystitis, and canaliculitis are pervasive across the globe and are currently managed by antibiotics. However, the recent cases of Mycobacteroides developing drug resistance reported along with the improper practice of medicine intrigued us to explore its genomic and proteomic canvas at a global scale and develop a chimeric vaccine against Mycobacteroides. MAIN METHODS We carried out a vivid genomic study on five recently sequenced strains of Mycobacteroides and explored their Pan-core genome/proteome in three different phases. The promiscuous antigenic proteins were identified via a subtractive proteomics approach that qualified for virulence causation, resistance and essentiality factors for this notorious bacterium. An integrated pipeline was developed for the identification of B-Cell, MHC (Major histocompatibility complex) class I and II epitopes. KEY FINDINGS Phase I identified the shreds of evidence of reductive evolution and propensity of the Pan-genome of Mycobacteroides getting closed soon. Phase II and Phase III produced 8 vaccine constructs. Our final vaccine construct, V6 qualified for all tests such as absence for allergenicity, presence of antigenicity, etc. V6 contains β-defensin as an adjuvant, linkers, Lysosomal-associated membrane protein 1 (LAMP1) signal peptide, and PADRE (Pan HLA-DR epitopes) amino acid sequence. Besides, V6 also interacts with a maximum number of MHC molecules and the TLR4/MD2 (Toll-like receptor 4/Myeloid differentiation factor 2) complex confirmed by docking and molecular dynamics simulation studies. SIGNIFICANCE The knowledge harnessed from the current study can help improve the current treatment regimens or in an event of an outbreak and propel further related studies.
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Affiliation(s)
- Rohit Satyam
- Department of Biotechnology, Noida Institute of Engineering and Technology (NIET), Greater Noida, India
| | - Tulika Bhardwaj
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio Campus, Finland
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Greater Noida, India.
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Greater Noida, India
| | - Parma Nand
- Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Greater Noida, India
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22
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Atypical Mycobacterial Infection Arising Amid Corticosteroid Therapy for Livedoid Vasculopathy. Case Rep Dermatol Med 2019; 2019:1840280. [PMID: 31687220 PMCID: PMC6800913 DOI: 10.1155/2019/1840280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/30/2019] [Indexed: 11/18/2022] Open
Abstract
Patients who suffer from rare skin diseases may try numerous therapies with many potential side effects before achieving remission. Livedoid vasculopathy (LV) is one such rare disease that lacks a definitive treatment as evidenced by randomized controlled trials. Although corticosteroids help reduce the pain flares associated with LV, they come at the risk of immunosuppression. We present a case of disseminated cutaneous infection of M. chelonae/abscessus arising in a diabetic patient on long-term corticosteroid therapy. This patient required an intensive antibiotic regimen and potentially lifelong antibiotic suppression pending improvement of her disseminated cutaneous infection. We report this case to increase awareness of the diagnostic consideration of atypical, rapidly growing mycobacterial (RGM) infection when encountering patients with a diffuse onset of ulcerative skin nodules amid a background of diabetes and long-term corticosteroid use.
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23
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Answer to November 2019 Photo Quiz. J Clin Microbiol 2019; 57:57/11/e01394-18. [DOI: 10.1128/jcm.01394-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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24
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Abstract
Introduction: Decorative tattooing involves the introduction of exogenous pigments and/or dyes into the dermis to produce a permanent design.Areas covered: This review provides an overview of the current aspects of cutaneous complications associated with permanent tattooing and permanent make-up based on the previous reviews of interest, case series, and case reports of interest. References for this review were found through a search of PubMed by use of the terms 'tattoo', 'tattoos', or 'tattooing'.Expert opinion: Complications include primarily infections, allergy to tattoo pigments, benign, and sometimes malignant tumors arising on tattoos and the localization of various dermatoses to tattoos. Immunocompromised patients and individuals with chronic conditions should be able to discuss with their physician and ask advice before getting tattooed. Tattoo color allergy still remains an unsolved issue. The identification of current culprit failed. It is most likely a byproduct that appears in situ in the skin during the life of the tattooed bearer. Studies involving expert centers are warranted to establish the best treatments for tattoo allergy. The risk of tattoo associated cancers appears to this author as largely overstated. However, case controls studies on large on cohorts of individuals with or without tattoos could help to evaluate whether tattoos have a possible in role in cancers.
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Affiliation(s)
- Nicolas Kluger
- Department of dermatology, allergology and venereology, Helsinki University Central Hospital, Helsinki, Finland.,"Tattoo" Consultation, Department of Dermatology, Bichat-Claude Bernard Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
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25
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Sharma D, Misba L, Khan AU. Antibiotics versus biofilm: an emerging battleground in microbial communities. Antimicrob Resist Infect Control 2019; 8:76. [PMID: 31131107 PMCID: PMC6524306 DOI: 10.1186/s13756-019-0533-3] [Citation(s) in RCA: 739] [Impact Index Per Article: 147.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/30/2019] [Indexed: 12/25/2022] Open
Abstract
Biofilm is a complex structure of microbiome having different bacterial colonies or single type of cells in a group; adhere to the surface. These cells are embedded in extracellular polymeric substances, a matrix which is generally composed of eDNA, proteins and polysaccharides, showed high resistance to antibiotics. It is one of the major causes of infection persistence especially in nosocomial settings through indwelling devices. Quorum sensing plays an important role in regulating the biofilm formation. There are many approaches being used to control infections by suppressing its formation but CRISPR-CAS (gene editing technique) and photo dynamic therapy (PDT) are proposed to be used as therapeutic approaches to subside bacterial biofim infections, especially caused by deadly drug resistant bad bugs.
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Affiliation(s)
- Divakar Sharma
- Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002 India
| | - Lama Misba
- Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002 India
| | - Asad U. Khan
- Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002 India
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26
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Jones RS, Shier KL, Master RN, Bao JR, Clark RB. Current significance of the Mycobacterium chelonae-abscessus group. Diagn Microbiol Infect Dis 2019; 94:248-254. [PMID: 30954313 DOI: 10.1016/j.diagmicrobio.2019.01.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 02/08/2023]
Abstract
Organisms of the Mycobacterium chelonae-abscessus group can be significant pathogens in humans. They produce a number of diseases including acute, invasive and chronic infections, which may be difficult to diagnose correctly. Identification among members of this group is complicated by differentiating at least eleven (11) known species and subspecies and complexity of identification methodologies. Treatment of their infections may be problematic due to their correct species identification, antibiotic resistance, their differential susceptibility to the limited number of drugs available, and scarcity of susceptibility testing.
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Affiliation(s)
- Robert S Jones
- Infectious Disease Department, Quest Diagnostics Nichols Institute, Chantilly, VA 20131
| | - Kileen L Shier
- Infectious Disease Department, Quest Diagnostics Nichols Institute, Chantilly, VA 20131
| | - Ronald N Master
- Infectious Disease Department, Quest Diagnostics Nichols Institute, Chantilly, VA 20131
| | - Jian R Bao
- Infectious Disease Department, Quest Diagnostics Nichols Institute, Chantilly, VA 20131
| | - Richard B Clark
- Infectious Disease Department, Quest Diagnostics Nichols Institute, Chantilly, VA 20131.
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27
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Abstract
Nontuberculous mycobacteria (NTM) diseases mainly manifest as pulmonary illnesses, but 20 -30% of NTM isolates originate from extrapulmonary diseases. These diseases cause a variety of clinical syndromes, including skin and soft-tissue infections, musculoskeletal infections, lymphadenitis, and disseminated disease. In skin and soft-tissue infections, musculoskeletal infections, prolonged treatment with combinations of antibiotics is effective in the treatment of NTM diseases, with surgery as an important complementary tool. The recommended duration of therapy for skin and soft-tissue infection is usually 2 – 4 months for mild disease and 6 months for severe disease, while treatment of musculoskeletal NTM disease usually requires at least 6 - 12 months. Management options of NTM lymphadenitis include surgical intervention, medical therapy, or observation. Treatment of disseminated NTM disease generally requires 6 to 12 months after immune restoration. However, despite a considerable increase in knowledge about NTM diseases, determining optimal treatment approaches remains a complex and challenging task.
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Affiliation(s)
- Yu Mi Wi
- Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University, Changwon, Korea.
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28
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Chung J, Ince D, Ford BA, Wanat KA. Cutaneous Infections Due to Nontuberculosis Mycobacterium: Recognition and Management. Am J Clin Dermatol 2018; 19:867-878. [PMID: 30168084 DOI: 10.1007/s40257-018-0382-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Nontuberculous mycobacteria (NTM) are a diverse group of organisms that are ubiquitous in the environment, and the incidence of cutaneous infections due to NTM has been steadily increasing. Cutaneous infections due to NTM can be difficult to diagnose, due to their wide spectrum of clinical presentations and histopathological findings that are often nonspecific. A variety of modalities including tissue culture and polymerase chain reaction (PCR) assays may be necessary to identify the organism. Treatment can also be challenging, as it can depend on multiple factors, including the causative organism, the patient's immunological status, and the extent of disease involvement. In this review, we discuss the common presentations of cutaneous NTM infections, diagnostic tools, and treatment recommendations. A multi-disciplinary approach that involves good communication between the clinician, the histopathologist, the microbiologist, and infectious disease specialists can help lead to successful diagnosis and management.
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Affiliation(s)
- Jina Chung
- Department of Dermatology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Dilek Ince
- Division of Infectious Disease, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Bradley A Ford
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Karolyn A Wanat
- Department of Dermatology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
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Rapidly Growing Mycobacterial Infections of the Skin and Soft Tissues Caused by M. fortuitum and M. chelonae. CURRENT TROPICAL MEDICINE REPORTS 2018. [DOI: 10.1007/s40475-018-0150-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Donohue MJ. Increasing nontuberculous mycobacteria reporting rates and species diversity identified in clinical laboratory reports. BMC Infect Dis 2018; 18:163. [PMID: 29631541 PMCID: PMC5891905 DOI: 10.1186/s12879-018-3043-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/12/2018] [Indexed: 01/15/2023] Open
Abstract
Background Nontuberculous Mycobacteria (NTM) are environmental microorganisms that can affect human health. A 2009–2010 occurrence survey of NTM in potable tap water samples indicated an increased recovery rate for many clinically significant species such as M. avium (30%) and M. abscessus (12%). To determine if these trends by species were mirrored in human infections, isolation rates of NTM species identified in clinical laboratory reports from four states were evaluated. Method Clinical laboratory reports from the Mississippi, Missouri, Ohio, and Wisconsin Health Departments were used to investigate the species of NTM isolated from human specimens in 2014. The NTM positive specimen reports were tabulated for each species and complex/group. The number of reports by month were used to investigate seasonal trends. The 2014 isolation rates were compared to historic values to examine longitudinal trends. Results The positive rate of NTM specimens increased from 8.2 per 100,000 persons in 1994 to 16 per 100,000 persons in 2014 (or 13.3 per 100,000 after excluding Mycobacterium gordonae). Changes in NTM diversity were observed in complex/groups known to be clinically significant. Between 1994 and 2014 the rate implicating M. abscesses-chelonae group and M. avium complex increased by 322 and 149%, respectively. Conclusions Based on public health data supplied by the four State’s Health Departments and the 2014 U.S. population, 50,976 positive NTM specimen reports per year were projected for the nation; serving as an indicator for the national potential disease burden that year. Electronic supplementary material The online version of this article (10.1186/s12879-018-3043-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maura J Donohue
- United States Environmental Protection Agency, 26 W. Martin Luther King Dr. Mail Stop 587, Cincinnati, Ohio, 45268, USA.
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Nho S, Kim S, Kweon O, Howard P, Moon M, Sadrieh N, Cerniglia C. Microbiological survey of commercial tattoo and permanent makeup inks available in the United States. J Appl Microbiol 2018; 124:1294-1302. [DOI: 10.1111/jam.13713] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/09/2018] [Accepted: 01/16/2018] [Indexed: 12/15/2022]
Affiliation(s)
- S.W. Nho
- Division of Microbiology National Center for Toxicological Research US FDA Jefferson AR USA
| | - S.‐J. Kim
- Division of Microbiology National Center for Toxicological Research US FDA Jefferson AR USA
| | - O. Kweon
- Division of Microbiology National Center for Toxicological Research US FDA Jefferson AR USA
| | - P.C. Howard
- Office of Scientific Coordination National Center for Toxicological Research US FDA Jefferson AR USA
| | - M.S. Moon
- Office of Cosmetics and Colors Center for Food Safety and Applied Nutrition US FDA College Park MD USA
| | - N.K. Sadrieh
- Office of Cosmetics and Colors Center for Food Safety and Applied Nutrition US FDA College Park MD USA
| | - C.E. Cerniglia
- Division of Microbiology National Center for Toxicological Research US FDA Jefferson AR USA
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González-Villanueva I, Silvestre Salvador J. Diagnostic Tools to Use When We Suspect an Allergic Reaction to a Tattoo: A Proposal Based on Cases at Our Hospital. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2017.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Mannelli VK, Rai MP, Nemakayala DR, Kadiri NP. Mycobacterium ChelonaeDeveloping Multidrug Resistance. BMJ Case Rep 2018; 2018:bcr-2017-222569. [PMID: 29472421 DOI: 10.1136/bcr-2017-222569] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Mycobacterium chelonae is a rapidly growing mycobacterium which is known to respond well to standard antibiotic treatment regimen. There are no specific guidelines for treatment. Antibiotics are chosen based on the bacterial sensitivity. Here we present a 47-year-old man with hip replacement who developed bright red papular generalised skin lesions and bilateral hip abscess. On workup, it was confirmed that M. chelonae was the causative organism. He was given 8 weeks of antibiotics; however, there was worsening of the hip abscess on interval imaging. The progression was most likely due to M. chelonae developing antibiotic resistance. Physicians should be aware of the rising resistance of this organism, and guide antibiotic therapy based on bacterial sensitivity to yield better outcomes.
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Affiliation(s)
- Vinod Kumar Mannelli
- Department of Internal Medicine, Michigan State University, Lansing, Michigan, USA
| | - Manoj P Rai
- Department of Internal Medicine, Michigan State University, Lansing, Michigan, USA
| | | | - Naga Preethi Kadiri
- Department of Internal Medicine, Michigan State University, Lansing, Michigan, USA
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Abstract
The genus Mycobacterium includes human pathogens (Mycobacterium tuberculosis and Mycobacterium leprae) and environmental organisms known as non-tuberculous mycobacteria (NTM) that, when associated with biomaterials and chronic disease, can cause human infections. A common pathogenic factor of mycobacteria is the formation of biofilms. Various molecules are involved in this process, including glycopeptidolipids, shorter-chain mycolic acids, and GroEL1 chaperone. Nutrients, ions, and carbon sources influence bacterial behavior and have a regulatory role in biofilm formation. The ultrastructure of mycobacterial biofilms can be studied by confocal laser scanning microscopy, a technique that reveals different phenotypic characteristics. Cording is associated with NTM pathogenicity, and is also considered an important property of M. tuberculosis strains. Mycobacterial biofilms are more resistant to environmental aggressions and disinfectants than the planktonic form. Biofilm-forming mycobacteria have been reported in many environmental studies, especially in water systems. NTM cause respiratory disease in patients with underlying diseases, such as old tuberculosis scars, bronchiectasis, and cystic fibrosis. Pathogens can be either slowly growing mycobacteria, such as Mycobacterium avium complex, or rapidly growing species, such as Mycobacterium abscessus. Another important biofilm-related group of infections are those associated with biomaterials, and in this setting the most frequently isolated organisms are rapidly growing mycobacteria. M. tuberculosis can develop a biofilm which plays a role in the process of casseous necrosis and cavity formation in lung tissue. M. tuberculosis also develops biofilms on clinical biomaterials. Biofilm development is an important factor for antimicrobial resistance, as it affords protection against antibiotics that are normally active against the same bacteria in the planktonic state. This antibiotic resistance of biofilm-forming microorganisms may result in treatment failure, and biofilms have to be physically eradicated to resolve the infection. New strategies with potential antibiofilm molecules that improve treatment efficacy have been developed. A novel antibiofilm approach focuses on Methylobacterium sp. An understanding of biofilm is essential for the appropriate management of patients with many NTM diseases, while the recent discovery of M. tuberculosis biofilms opens a new research field.
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Affiliation(s)
- Jaime Esteban
- Department of Clinical Microbiology, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Madrid, Spain
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Jaén-Luchoro D, Aliaga-Lozano F, Gomila RM, Gomila M, Salvà-Serra F, Lalucat J, Bennasar-Figueras A. First insights into a type II toxin-antitoxin system from the clinical isolate Mycobacterium sp. MHSD3, similar to epsilon/zeta systems. PLoS One 2017; 12:e0189459. [PMID: 29236773 PMCID: PMC5728571 DOI: 10.1371/journal.pone.0189459] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 11/28/2017] [Indexed: 01/21/2023] Open
Abstract
A putative type II toxin-antitoxin (TA) system was found in the clinical isolate Mycobacterium sp. MHSD3, a strain closely related to Mycobacterium chelonae. Further analyses of the protein sequences of the two genes revealed the presence of domains related to a TA system. BLAST analyses indicated the presence of closely related proteins in the genomes of other recently published M. chelonae strains. The functionality of both elements of the TA system was demonstrated when expressed in Escherichia coli cells, and the predicted structure of the toxin is very similar to those of well-known zeta-toxins, leading to the definition of a type II TA system similar to epsilon/zeta TA systems in strains that are closely related to M. chelonae.
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Affiliation(s)
- Daniel Jaén-Luchoro
- Microbiologia, Departament de Biologia, Universitat de les Illes Balears, Palma de Mallorca, Spain
- Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe) at University of Gothenburg, Gothenburg, Sweden
- * E-mail:
| | - Francisco Aliaga-Lozano
- Microbiologia, Departament de Biologia, Universitat de les Illes Balears, Palma de Mallorca, Spain
- Laboratorio de Biología Molecular, Clínica Rotger, Palma de Mallorca, Spain
| | - Rosa Maria Gomila
- Serveis Cientifico-Tècnics, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - Margarita Gomila
- Microbiologia, Departament de Biologia, Universitat de les Illes Balears, Palma de Mallorca, Spain
| | - Francisco Salvà-Serra
- Microbiologia, Departament de Biologia, Universitat de les Illes Balears, Palma de Mallorca, Spain
- Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe) at University of Gothenburg, Gothenburg, Sweden
| | - Jorge Lalucat
- Microbiologia, Departament de Biologia, Universitat de les Illes Balears, Palma de Mallorca, Spain
- Institut Mediterrani d’Estudis Avançats (IMEDEA, CSIC-UIB), Esporles, Spain
| | - Antoni Bennasar-Figueras
- Microbiologia, Departament de Biologia, Universitat de les Illes Balears, Palma de Mallorca, Spain
- Area de Enfermedades Infecciosas, Instituto Universitario de Investigaciones en Ciencias de la Salud (IUNICS-UIB), Universitat de les Illes Balears, Palma de Mallorca, Spain
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Diagnostic Tools to Use When We Suspect an Allergic Reaction to a Tattoo: A Proposal Based on Cases at Our Hospital. ACTAS DERMO-SIFILIOGRAFICAS 2017; 109:162-172. [PMID: 29197467 DOI: 10.1016/j.ad.2017.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/10/2017] [Accepted: 10/30/2017] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Tattooing has become a popular practice in western countries, particularly among younger populations. Tattoos, however, can cause complications, such as infections, allergic or foreign-body reactions, and even systemic inflammatory responses. PATIENTS AND METHODS We conducted a retrospective study of all patients seen for tattoo-related complications at our skin allergy unit between January 2002 and December 2016. RESULTS We studied 23 patients. Nine of these experienced early complications, all related to infection. The other 14 patients developed late reactions. Ten were diagnosed with probable allergic contact dermatitis to ink, but the suspect allergen was identified in just 3 cases and confirmed in just 1 of these. There were 2 cases of cutaneous sarcoidosis, 1 case of foreign body granuloma, and 1 case of neuropathy. CONCLUSIONS Complications resulting from tattoos are relatively common dermatology complaints. Drawing from our experience, we propose a diagnostic algorithm designed to guide dermatologists in evaluating different reactions to tattoos and prescribing appropriate treatment.
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Breuner CC, Levine DA, Breuner CC, Alderman EM, Garofalo R, Grubb LK, Powers ME, Upadhya KK, Wallace SB. Adolescent and Young Adult Tattooing, Piercing, and Scarification. Pediatrics 2017; 140:peds.2017-1962. [PMID: 28924063 DOI: 10.1542/peds.2017-1962] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Tattoos, piercing, and scarification are now commonplace among adolescents and young adults. This first clinical report from the American Academy of Pediatrics on voluntary body modification will review the methods used to perform the modifications. Complications resulting from body modification methods, although not common, are discussed to provide the pediatrician with management information. Body modification will be contrasted with nonsuicidal self-injury. When available, information also is presented on societal perceptions of body modification.
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Affiliation(s)
- Cora C. Breuner
- Adolescent Medicine Division, Department of Pediatrics, Orthopedics and Sports Medicine, Seattle Children’s Hospital, University of Washington, Seattle, Washington; and
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Painsi C, Lange-Asschenfeldt B. Image Gallery: Pink papules within a tattoo linked to Mycobacterium chelonae infection. Br J Dermatol 2017; 177:e1. [PMID: 28731256 DOI: 10.1111/bjd.15481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C Painsi
- Department of Dermatology, State Hospital Klagenfurt, Klagenfurt am Wörthersee, Feschnigstraße 11, A-9020, Klagenfurt, Austria
| | - B Lange-Asschenfeldt
- Department of Dermatology, State Hospital Klagenfurt, Klagenfurt am Wörthersee, Feschnigstraße 11, A-9020, Klagenfurt, Austria.,Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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40
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Gherman-Ciolac C, Patel A, Budha S, Macve J, Buch H. A Case of Disseminated Sepsis Caused by an Unusual Microorganism in a Patient With Diabetes. Clin Diabetes 2017; 35:112-115. [PMID: 28442828 PMCID: PMC5391810 DOI: 10.2337/cd16-0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | | | | | - Joanna Macve
- Microbiology, New Cross Hospital, Wolverhampton, West Midlands, UK
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41
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Orrin E, Worsnop F, Natkunarajah J. Sporotrichoid Mycobacterium chelonae. Australas J Dermatol 2016; 57:244-5. [PMID: 27469486 DOI: 10.1111/ajd.12327] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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42
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Frew JW, Nguyen RTD. Tattoo-associated mycobacterial infections: an emerging public health issue. Med J Aust 2016; 203:223-3e.1. [PMID: 26852055 DOI: 10.5694/mja15.00098] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 07/17/2015] [Indexed: 11/17/2022]
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Complete Genome Sequence of Mycobacterium chelonae Type Strain CCUG 47445, a Rapidly Growing Species of Nontuberculous Mycobacteria. GENOME ANNOUNCEMENTS 2016; 4:4/3/e00550-16. [PMID: 27284158 PMCID: PMC4901242 DOI: 10.1128/genomea.00550-16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mycobacterium chelonae strains are ubiquitous rapidly growing mycobacteria associated with skin and soft tissue infections, cellulitis, abscesses, osteomyelitis, catheter infections, disseminated diseases, and postsurgical infections after implants with prostheses, transplants, and even hemodialysis procedures. Here, we report the complete genome sequence of M. chelonae type strain CCUG 47445.
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Saiman L, Siegel JD, LiPuma JJ, Brown RF, Bryson EA, Chambers MJ, Downer VS, Fliege J, Hazle LA, Jain M, Marshall BC, O’Malley C, Pattee SR, Potter-Bynoe G, Reid S, Robinson KA, Sabadosa KA, Schmidt HJ, Tullis E, Webber J, Weber DJ. Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update. Infect Control Hosp Epidemiol 2016; 35 Suppl 1:S1-S67. [DOI: 10.1086/676882] [Citation(s) in RCA: 270] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population:1.The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF. These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations.2.Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF. These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistantStaphylococcus aureus(MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF.
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45
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Kluger N. Cutaneous and systemic complications associated with tattooing. Presse Med 2016; 45:567-76. [PMID: 27160631 DOI: 10.1016/j.lpm.2016.02.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/28/2016] [Accepted: 02/08/2016] [Indexed: 12/31/2022] Open
Abstract
Tattooing can result in a wide variety of complications, whose prevalence and incidence remain still unclear. Hypersensitivity reactions (or allergies) to tattoo pigments are currently the most common complication on a tattoo, however they are not predictable. Infections are nowadays directly related to the lack of asepsis and hygiene during the tattooing procedure or during the healing phase. Patients with a known cutaneous disease should be warned of a potential risk of localization of their disease to the tattoo. A skin eruption restricted to a tattoo may reveal sarcoidosis. Patients with chronic conditions and/or impaired immunity should discuss with their physician about the possibility and when to have a tattoo.
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Affiliation(s)
- Nicolas Kluger
- University of Helsinki, Helsinki University Central Hospital, dermatology, allergology and venereology, Meilahdentie 2, P.O. Box 160, FI-00029 HUS, Finland.
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The Demographics and Rates of Tattoo Complications, Regret, and Unsafe Tattooing Practices: A Cross-Sectional Study. Dermatol Surg 2016; 41:1283-9. [PMID: 26509942 DOI: 10.1097/dss.0000000000000500] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Tattoos have become increasingly common in the United States; however, there are limited data on the rates of tattoo complications and tattoo regret. OBJECTIVE To determine the rates of infectious and allergic complications after tattooing, rates of tattoo regret, the perception of dermatologists among people with tattoos, and the demographics of people with tattoos. MATERIALS AND METHODS An 18-question cross-sectional survey was fielded in New Orleans in January 2015. Participants had to be at least 18 years old, have at least 1 tattoo, and reside within the United States. RESULTS In total, 501 participants from 38 American states were enrolled. Of all participants, 3.2% had a history of an infected tattoo, 3.8% had a history of a painful tattoo, and 21.2% had a history of a pruritic tattoo; 16.2% of participants regret a current tattoo and 21.2% are interested in having 1 or more tattoos removed; 21.2% received a tattoo while intoxicated and 17.6% had a tattoo placed somewhere other than at a tattoo parlor; and 78.9% believe dermatologists are knowledgeable about the infectious and allergic complications of tattoos. CONCLUSION Given the rates of pruritic tattoos and tattoo regret, there is an opportunity, and trust among people with tattoos, for dermatologists to manage these complications.
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Laux P, Tralau T, Tentschert J, Blume A, Dahouk SA, Bäumler W, Bernstein E, Bocca B, Alimonti A, Colebrook H, de Cuyper C, Dähne L, Hauri U, Howard PC, Janssen P, Katz L, Klitzman B, Kluger N, Krutak L, Platzek T, Scott-Lang V, Serup J, Teubner W, Schreiver I, Wilkniß E, Luch A. A medical-toxicological view of tattooing. Lancet 2016. [PMID: 26211826 DOI: 10.1016/s0140-6736(15)60215-x] [Citation(s) in RCA: 130] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Long perceived as a form of exotic self-expression in some social fringe groups, tattoos have left their maverick image behind and become mainstream, particularly for young people. Historically, tattoo-related health and safety regulations have focused on rules of hygiene and prevention of infections. Meanwhile, the increasing popularity of tattooing has led to the development of many new colours, allowing tattoos to be more spectacular than ever before. However, little is known about the toxicological risks of the ingredients used. For risk assessment, safe intradermal application of these pigments needs data for toxicity and biokinetics and increased knowledge about the removal of tattoos. Other concerns are the potential for phototoxicity, substance migration, and the possible metabolic conversion of tattoo ink ingredients into toxic substances. Similar considerations apply to cleavage products that are formed during laser-assisted tattoo removal. In this Review, we summarise the issues of concern, putting them into context, and provide perspectives for the assessment of the acute and chronic health effects associated with tattooing.
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Affiliation(s)
- Peter Laux
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Tewes Tralau
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Jutta Tentschert
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Annegret Blume
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Sascha Al Dahouk
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Wolfgang Bäumler
- Klinik und Poliklinik für Dermatologie, Universität Regensburg, Regensburg, Germany
| | | | | | | | | | | | | | - Urs Hauri
- Kantonales Laboratorium Basel-Stadt, Basel, Switzerland
| | - Paul C Howard
- US Food and Drug Administration, National Center for Toxicological Research, Jefferson, AR, USA
| | - Paul Janssen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Linda Katz
- US Food and Drug Administration, College Park, MD, USA
| | - Bruce Klitzman
- Duke University Medical Center, Research Park, Durham, NC, USA
| | - Nicolas Kluger
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Lars Krutak
- Smithsonian Institution, Washington, DC, USA
| | - Thomas Platzek
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | | | - Jørgen Serup
- Bispebjerg University Hospital, Department of Dermatology, The Tattoo Clinic, Copenhagen, Denmark
| | | | - Ines Schreiver
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Elena Wilkniß
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany
| | - Andreas Luch
- German Federal Institute for Risk Assessment (BfR), Department of Product Safety, Berlin, Germany.
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Yoshimoto A, Nakamura-Uchiyama F, Sato M, Fukumori T, Yamada Y, Hishiya N, Shiraishi N, Ogawa T, Uno K, Kasahara K, Maeda K, Konishi M, Yoshikawa M, Mikasa K. [A Case of Disseminated Cutaneous Mycobacterium chelonae Infection Successfully Improved with Thermal Therapy]. ACTA ACUST UNITED AC 2016; 89:410-5. [PMID: 26552135 DOI: 10.11150/kansenshogakuzasshi.89.410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A 54-year-old female with dermatomyositis treated with cyclosporine and methylprednisolone presented with multiple subcutaneous nodules on her upper and lower extremities on December 2011. The number of lesions gradually increased. She had a history of surgical intervention such as debridement, skin graft of right lower leg due to trauma and subsequent bacterial infection on August 2011. Culture from a skin lesion on June 2012 confirmed Mycobacterium chelonae, which was susceptible to clarithromycin (CAM). We started treatment with CAM, imipenem/cilastatin (IPM/CS) and tobramycin (TOB) for 2 weeks. Then CAM monotherapy was continued, however CAM was discontinued because of liver dysfunction. In September 2012 new nodular lesions were observed on the left arm and right leg. We administrated azithromycin, IPM/CS and TOB. Subcutaneous nodules were partially improved, but new lesions appeared on her right leg. A culture of skin lesion yielded M. chelonae, which was highly resistant to CAM and IPM/CS. Based on the sensitivity test, moxifloxacin was used. However, there was no significant improvement in her skin lesions, so we started thermal therapy on day 57 after admission. She showed an excellent response to thermal therapy, and there has been no recurrence.
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49
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Nunes-Costa D, Alarico S, Dalcolmo MP, Correia-Neves M, Empadinhas N. The looming tide of nontuberculous mycobacterial infections in Portugal and Brazil. Tuberculosis (Edinb) 2015; 96:107-19. [PMID: 26560840 DOI: 10.1016/j.tube.2015.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 08/27/2015] [Accepted: 09/16/2015] [Indexed: 01/15/2023]
Abstract
Nontuberculous mycobacteria (NTM) are widely disseminated in the environment and an emerging cause of infectious diseases worldwide. Their remarkable natural resistance to disinfectants and antibiotics and an ability to survive under low-nutrient conditions allows NTM to colonize and persist in man-made environments such as household and hospital water distribution systems. This overlap between human and NTM environments afforded new opportunities for human exposure, and for expression of their often neglected and underestimated pathogenic potential. Some risk factors predisposing to NTM disease have been identified and are mainly associated with immune fragilities of the human host. However, infections in apparently immunocompetent persons are also increasingly reported. The purpose of this review is to bring attention to this emerging health problem in Portugal and Brazil and to emphasize the urgent need for increased surveillance and more comprehensive epidemiological data in both countries, where such information is scarce and seriously thwarts the adoption of proper preventive strategies and therapeutic options.
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Affiliation(s)
- Daniela Nunes-Costa
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Susana Alarico
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | | | - Margarida Correia-Neves
- ICVS - Health and Life Sciences Research Institute, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Nuno Empadinhas
- CNC - Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal; IIIUC - Institute for Interdisciplinary Research, University of Coimbra, Coimbra, Portugal.
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