1
|
Akazawa N, Itoh N, Ishibana Y, Murakami H, Okumura S. Successful management of surgical site infection caused by Mycobacterium mageritense in a breast cancer patient. J Infect Chemother 2024; 30:800-805. [PMID: 38272263 DOI: 10.1016/j.jiac.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/14/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
Mycobacterium mageritense (M. mageritense), a nontuberculous mycobacterium, is classified as a rapidly growing mycobacterium, class IV in the Runyon Classification. This bacterium is found in soil, water, and other habitats. Infections caused by M. mageritense are relatively rare and no treatment protocol has been established. Herein, we report a case of skin and soft tissue infection caused by M. mageritense. A 49-year-old woman underwent surgery for right breast cancer. Four months after surgery, a surgical site infection was found, and M. mageritense was identified in the wound culture using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Based on the sensitivity results, the patient was treated with levofloxacin and doxycycline for 4 months. In addition to antimicrobial agents, aggressive surgical interventions led to a favorable course of treatment. In conclusion, successful treatment of skin and soft tissue infections with M. mageritense requires surgical intervention whenever possible, aggressive susceptibility testing, and appropriate antimicrobial therapy.
Collapse
Affiliation(s)
- Nana Akazawa
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
| | - Naoya Itoh
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Yuichi Ishibana
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Hiromi Murakami
- Division of Infectious Diseases, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Seiko Okumura
- Department of Plastic and Reconstructive Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| |
Collapse
|
2
|
Hu KY, Chao CT, Chen SI, Shu CC, Hung KY. Mycobacterium mageritense related peritoneal dialysis peritonitis: An antibiogram summary and successful treatment experiences. Nephrology (Carlton) 2023; 28:690-692. [PMID: 37632407 DOI: 10.1111/nep.14234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/21/2023] [Accepted: 08/10/2023] [Indexed: 08/28/2023]
Affiliation(s)
- Kai-Yu Hu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Ter Chao
- Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Toxicology, National Taiwan University College of Medicine, Taipei, Taiwan
- Nephrology Division, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital Beihu branch, Taipei, Taiwan
| | - Shih-I Chen
- Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital Beihu branch, Taipei, Taiwan
| | - Chin-Chung Shu
- Chest Medicine Division, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuan-Yu Hung
- Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Nephrology Division, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| |
Collapse
|
3
|
Pereira MMR, de Oliveira FM, da Costa AC, Junqueira-Kipnis AP, Kipnis A. Ferritin from Mycobacterium abscessus is involved in resistance to antibiotics and oxidative stress. Appl Microbiol Biotechnol 2023; 107:2577-2595. [PMID: 36862179 DOI: 10.1007/s00253-023-12420-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 03/03/2023]
Abstract
Mycobacterium abscessus subsp. massiliense (Mycma) is a rapidly growing Mycobacterium belonging to the M. abscessus complex that is often associated with lung and soft tissue infection outbreaks. Mycma is resistant to many antimicrobials, including those used for treating tuberculosis. Therefore, Mycma infections are difficult to treat and may lead to high infectious complication rates. Iron is essential for bacterial growth and establishment of infection. During infection, the host reduces iron concentrations as a defense mechanism. To counteract the host-induced iron deficiency, Mycma produces siderophores to capture iron. Mycma has two ferritins (encoded by mycma_0076 and mycma_0077) modulated by different iron concentrations, which allow the survival of this pathogen during iron scarcity. In this study, we constructed knockout (Mycma 0076KO) and complemented (Mycma 0076KOc) gene strains for mycma_0076 to understand the function of 0076 ferritin. Deletion of mycma_0076 in Mycma led to the transition in colony morphology from smooth to rough, alteration of the glycopeptidolipids spectra, increased permeability of the envelope, reduction in biofilm formation, increased susceptibility to antimicrobials and hydrogen peroxide-induced oxidative stress, and decreased internalization by macrophages. This study shows that Mycma_0076 ferritin in Mycma is involved in resistance to oxidative stress and antimicrobials, and alteration of cell envelope architecture. KEY POINTS: • Deletion of the mycma_0076 gene altered colony morphology to rough; • Mycma 0076KO changed GPL profile; • Absence of Mycma_0076 ferritin results in increased susceptibility to antimicrobials and oxidative stress in Mycma. Legend: a In wild-type M. abscessus subsp. massiliense strain, iron is captured from the environment by carboxymycobactins and mycobactins (1). Iron-dependent regulator (IdeR) proteins bind to ferrous iron (Fe+2) in the bacterial cytoplasm leading to the activation of the IdeR-Fe+2 complex (2). The activated complex binds to the promoter regions of iron-dependent genes, called iron box, which in turn help in the recruitment of RNA polymerase to promote transcription of genes such as mycma_0076 and mycma_0077 ferritin genes (3). Mycma_0076 and Mycma_0077 ferritins bind to excess iron in the medium and promote Fe2+ oxidation into ferric iron (Fe3+) and store iron molecules to be released under iron scarcity conditions. (4) Genes related to biosynthesis and transport of glycopeptidolipids (GPL) are expressed normally and the cell envelope is composed of different GPL species (colored squares represented on the cell surface (GPLs). Consequently, WT Mycma present smooth colony phenotype (5). b In Mycma 0076KO strain, the lack of ferritin 0076 causes overexpression of mycma_0077 (6), but does not restore wild-type iron homeostasis and thus may result in free intracellular iron, even in the presence of miniferritins (MaDps). The excess iron potentiates oxidative stress (7) by generating hydroxyl radicals through Fenton Reaction. During this process, through an unknown mechanism, that could involve Lsr2 (8), the expression of GPL synthesis locus is regulated positively and/or negatively, resulting in alteration of GPL composition in the membrane (as represented by different colors of squares on the cell surface), resulting in a rough colony phenotype (9). The changes of GPL can increase cell wall permeability, contributing to antimicrobial susceptibility (10).
Collapse
Affiliation(s)
- Maria Micaella Rodrigues Pereira
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, Brazil
- Tropical Medicine and Public Health Graduate Program at Federal, University of Goiás, Goiânia, GO, Brazil
| | - Fábio Muniz de Oliveira
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, Brazil
- Tropical Medicine and Public Health Graduate Program at Federal, University of Goiás, Goiânia, GO, Brazil
- Indiana Center for Regenerative Medicine and Engineering, School of Medicine, Indiana University, Indianapolis, IN, USA
| | | | | | - André Kipnis
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO, Brazil.
| |
Collapse
|
4
|
Hashimoto N, Kani N, Makino S, Naka T, Miyakawa H, Okamoto K, Uwatoko R, Bessho S, Iio R, Ueda Y, Hayashi T. Fatal peritoneal dialysis-associated peritonitis caused by Mycobacterium mageritense: a case report with review. RENAL REPLACEMENT THERAPY 2023. [DOI: 10.1186/s41100-023-00457-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Background
Peritonitis is a serious and potentially fatal complication of peritoneal dialysis. We report a case of fatal peritonitis caused by Mycobacterium mageritense that was detected for the first time in peritonitis.
Case presentation
A male patient in his 60 s undergoing peritoneal dialysis was admitted for catheter diversion with exit-site renewal. The patient had a refractory exit-site infection. Mycobacterial culture was not performed at the exit site prior to admission. After the surgery, the patient developed a fever, and a cloudy effluent was observed. Various antibiotics, including anti-tuberculosis drugs, were administered; however, his symptoms did not improve. The catheter was removed on the thirty-seventh day of admission. Bacteria positive for Ziehl–Neelsen staining were found in the peritoneal sample collected during the surgery. Since nontuberculous mycobacteria were considered the cause of peritonitis, the patient was administered imipenem/cilastatin, amikacin, and clarithromycin. However, he died of septic shock on the fifty-first day after admission. Mycobacterium mageritense was detected in the ascites culture after death.
Conclusion
This is, to our knowledge, the first report of peritonitis caused by Mycobacterium mageritense. In patients undergoing peritoneal dialysis, when a refractory exit-site infection is observed, mycobacterial culture is necessary to prevent the development of peritonitis.
Collapse
|
5
|
Maheshwari S, Parakh S, Das SM, Ahuja A, Jha SN, Agrawal R, Gupta V, Luthra S. Multifocal Serpiginoid Choroiditis Due to Mycobacterium Mageritense following Laparoscopic Hysterectomy in an Immunocompetent Host. Ocul Immunol Inflamm 2023; 31:236-241. [PMID: 35050821 DOI: 10.1080/09273948.2021.2018713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE To report nontubercular choroiditis, caused by Mycobacterium mageritense isolated using MALDI-TOF MS, following laparoscopic hysterectomy in an immunocompetent patient. CASE REPORT A 42-year-old female presented with gradual, painless diminution of vision in the right eye for six weeks. She had undergone laparoscopic hysterectomy two months back. BCVA was 2/60 OD. Clinical presentation and imaging all pointed to a diagnosis of serpiginous-like choroiditis. Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) had led to isolation of Mycobacterium mageritense. Patient was treated with systemic antibiotics. At 3 months follow up, BCVA improved to 6/60; fundus showed healed choroiditis and chorioretinal thinning. CONCLUSION Atypical mycobacterial infections associated with laparoscopic surgeries can rarely lead to debilitating systemic bacteremia resulting in profound visual impairment. The importance of timely diagnosis using specific and sophisticated methods such as MALDI-TOF MS as well as maintaining aseptic precautions perioperatively during major surgeries cannot be overemphasized.
Collapse
Affiliation(s)
| | - Shweta Parakh
- Drishti Eye Institute, Drishti Eye Institute, Dehradun, India
| | | | - Alok Ahuja
- Dr. Ahuja's Pathology and Imaging Centre, Dr. Ahuja's Pathology and Imaging Centre, Dehradun, India
| | - Shashi Nath Jha
- Sir Ganga Ram Hospital, Sir Ganga Ram Hospital, New Delhi, India
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Vishali Gupta
- Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Saurabh Luthra
- Drishti Eye Institute, Drishti Eye Institute, Dehradun, India
| |
Collapse
|
6
|
Suarez-Diaz E, Hubiche T, Del Giudice P. Increased incidence of cutaneous Staphylococcusaureus infections after the 2010 floods in the Var department of France: Rumour or reality? Ann Dermatol Venereol 2022; 149:176-179. [PMID: 35718576 DOI: 10.1016/j.annder.2021.12.004] [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: 04/21/2021] [Revised: 07/12/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Natural disasters are typically associated with the emergence of infectious diseases. On 15 June 2010, severe storms caused flooding in the Var department (France). A rumour about increased risk of Staphylococcusaureus skin infections after bathing in the sea began to circulate on Internet a few days after the floods. The aim of this study was to compare the rumour with the true incidence of cases of infection. METHODS Since 1999, we have been conducting a prospective survey of S. aureus skin infections in our hospital to study their clinical, laboratory and epidemiologic features. We compared data on cases of Staphylococcus skin infection recorded in our institution from 2008 to 2012. RESULTS We found that there was no increase in S. aureus skin infections after the floods compared to the previous and subsequent years. CONCLUSION We had a unique opportunity to check the rumoured increase in incidence of infectious disease with the true incidence. In our study, the fear of S. aureus skin infections following flooding proved to be unfounded.
Collapse
Affiliation(s)
- E Suarez-Diaz
- Dermatology and Infectiology Unit, hôpital Bonnet, CHI de Fréjus/Saint-Raphaël, 240, avenue de Saint-Lambert, 83600 Fréjus, France
| | - T Hubiche
- Dermatology and Infectiology Unit, hôpital Bonnet, CHI de Fréjus/Saint-Raphaël, 240, avenue de Saint-Lambert, 83600 Fréjus, France
| | - P Del Giudice
- Dermatology and Infectiology Unit, hôpital Bonnet, CHI de Fréjus/Saint-Raphaël, 240, avenue de Saint-Lambert, 83600 Fréjus, France.
| |
Collapse
|
7
|
Lao CK, Wu TS, Lin KY, Lee MH. Disseminated Mycobacterium peregrinum and Mycobacterium avium infection in a patient with AIDS: A case report and review of literature. J Clin Tuberc Other Mycobact Dis 2022; 27:100314. [PMID: 35492430 PMCID: PMC9038537 DOI: 10.1016/j.jctube.2022.100314] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Disseminated nontuberculous mycobacterial infections are frequently recognized in patients living with human immunodeficiency virus/acquired immunodeficiency syndrome (AIDS) and Mycobacterium avium-intracellulare complex (MAIC) is the most common species. Mycobacterium peregrinum is a rapidly growing mycobacterium that accounts for 1–2% of community-acquired and healthcare-associated infections. It mainly causes skin and soft tissue infection. Disseminated infection by M. peregrinum has never been reported in patients with AIDS. We describe a case of disseminated co-infection of M. peregrinum and M. avium in a 33-year-old male with newly diagnosed AIDS, and review the literature regarding M. peregrinum infection. The patient’s bone marrow culture grew M. peregrinum and his blood culture grew M. avium. The diagnosis of disseminated co-infection of M. peregrinum and M. avium was confirmed. Disseminated infection due to M. peregrinum is rare and diagnosis can be challenging. Due to limited case numbers, there is no treatment guideline for M. peregrinum nowadays. Further study is warranted for better understanding M. peregrinum related infections.
Collapse
|
8
|
García-Boyano M, Baquero-Artigao F, Toro C, Alguacil-Guillén M, Lázaro-Perona F, Calvo C. Mycobacterium mageritense Lymphadenitis in Child. Emerg Infect Dis 2022; 28:752-753. [PMID: 35202540 PMCID: PMC8888222 DOI: 10.3201/eid2803.211486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Although human infections caused by Mycobacterium mageritense are rare, there are some case reports involving sinusitis, pneumonia, and hospital-acquired infections in adults. We report a case of lymphadenitis caused by M. mageritense in a child in Spain.
Collapse
|
9
|
Morita Y, Kondo Y, Takeuchi E. Pulmonary mycobacteriosis caused by Mycobacterium peregrinum: A case report. Medicine (Baltimore) 2022; 101:e28809. [PMID: 35147117 PMCID: PMC8830817 DOI: 10.1097/md.0000000000028809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 01/25/2022] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Mycobacterium peregrinum is a member of the group of rapidly growing nontuberculous mycobacteria. It mainly causes surgical site and catheter-related infections, while pulmonary infection is rare. We herein present a case of pulmonary infection caused by M peregrinum. PATIENT CONCERNS A 62-year-old woman visited our hospital with dyspnea and was admitted for the treatment of pneumonia in July 2018. DIAGNOSIS Chest computed tomography showed patchy opacities and consolidation in the bilateral lungs and a cavity in the right upper lobe, which persisted after the treatment of bacterial pneumonia 5 years ago. She was administered ceftriaxone and azithromycin. Consolidation in the bilateral lungs improved, whereas the cavity in the right upper lobe remained and the consolidation surrounding it gradually spread. On admission, the sputum acid-fast bacillus culture was positive, and M peregrinum was identified twice by mass spectrometry. The cavity and consolidation surrounding it were diagnosed as pulmonary mycobacteriosis caused by M peregrinum. INTERVENTIONS Although we recommended treatment for mycobacteriosis, the patient refused it. OUTCOMES The patient is regularly followed up; however, the cavity wall is thickening and shadows have become mildly enhanced over the course of 3 years. LESSONS We herein present a rare case of pulmonary mycobacteriosis caused by M peregrinum and discuss the literature. Since limited information is currently available on pulmonary mycobacteriosis caused by M peregrinum, the accumulation of further case reports and the clarification of its clinical features are needed.
Collapse
Affiliation(s)
- Yutaka Morita
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi city, Kochi, Japan
- Department of Internal Medicine, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi city, Kochi, Japan
| | - Yoshihiro Kondo
- Division of Pulmonary Medicine, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi city, Kochi, Japan
| | - Eiji Takeuchi
- Department of Clinical Investigation, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishimachi, Kochi city, Kochi, Japan
| |
Collapse
|
10
|
A Case of Laryngeal Infection Secondary to Mycobacterium mageritense in an Immunocompetent Patient. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2021. [DOI: 10.1097/ipc.0000000000001054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
11
|
Joya CA, Deegan C, Gleeson TD. Mycobacterium mageritense infection following mastectomy and breast reconstruction requiring triple antibiotic therapy and surgical debridement. BMJ Case Rep 2021; 14:14/2/e237618. [PMID: 33542012 PMCID: PMC7868199 DOI: 10.1136/bcr-2020-237618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A 40-year-old woman was referred to infectious disease specialists for a Mycobacterium mageritense skin infection following mastectomy and bilateral reconstruction with deep inferior epigastric perforator flap. Her case demonstrates the difficulty in treating non-tuberculosis mycobacterial infections, especially the rarely seen species. She failed to respond to dual antibiotic therapy containing imipenem-cilastin despite reported sensitivity. Additionally, her course was complicated by intolerance to various regimens, including gastrointestinal distress, a drug rash with eosinophilia and systemic symptoms, and tendinopathy. With few published data, no treatment guidelines, and limited medications from which to choose for M. mageritense, her treatment posed a challenge. She ultimately required aggressive surgical intervention and a triple therapy antibiotic regimen. The duration of our patient's treatment and the extent of her complications suggest a potential need for early surgical intervention in postsurgical wounds infected with M. mageritense that do not respond to conventional treatment.
Collapse
Affiliation(s)
- Christie Alyce Joya
- Parasitology, Naval Medical Research Unit No 6, Callao, Peru,Infectious Disease, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Cara Deegan
- School of Medicine, USUHS, Bethesda, Maryland, USA
| | - Todd D Gleeson
- Infectious Disease, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| |
Collapse
|
12
|
Pérez-Alfonzo R, Poleo Brito LE, Vergara MS, Ruiz Damasco A, Meneses Rodríguez PL, Kannee Quintero CE, Carrera Martinez C, Rivera-Oliver IA, Da Mata Jardin OJ, Rodríguez-Castillo BA, de Waard JH. Odontogenic cutaneous sinus tracts due to infection with nontuberculous mycobacteria: a report of three cases. BMC Infect Dis 2020; 20:295. [PMID: 32316920 PMCID: PMC7171849 DOI: 10.1186/s12879-020-05015-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 04/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background Soft tissue or skin infections due to nontuberculous mycobacteria (NTM) have been reported frequently and are mostly associated with trauma or cosmetic interventions like plastic surgery. However, infection with NTM as a result of a dental procedure have rarely been described and the lack of clinical suspicion and a clear clinical manifestation makes diagnosis challenging. Case presentation We report on three patients with a facial cutaneous sinus tract of dental origin, due to an infection with respectively Mycobacterium fortuitum, M. abscessus and M. peregrinum. The infection source was the dental unit waterlines (DUWLs), which were colonized with NTM. Conclusions Water of the DUWL can pose a health risk. This report emphasizes the need for quality control and certification of water flowing through DUWLs, including the absence of NTM. Our report also shows the need for a rapid recognition of NTM infections and accurate laboratory diagnosis in order to avoid long-term ineffective antibiotic treatment.
Collapse
Affiliation(s)
- Ricardo Pérez-Alfonzo
- Centro Clínico de Dermatología y Enfermedades Tropicales, Instituto de Biomedicina Dr. Jacinto Convit, Caracas, Venezuela
| | - Luisa Elena Poleo Brito
- Servicio de Dermatología, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | - Marialejandra Solano Vergara
- Servicio de Dermatología, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | - Angela Ruiz Damasco
- Servicio de Dermatología, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | | | - Carmen Elena Kannee Quintero
- Centro Clínico de Dermatología y Enfermedades Tropicales, Instituto de Biomedicina Dr. Jacinto Convit, Caracas, Venezuela
| | - Carolina Carrera Martinez
- Centro Clínico de Dermatología y Enfermedades Tropicales, Instituto de Biomedicina Dr. Jacinto Convit, Caracas, Venezuela
| | - Ismar Alejandra Rivera-Oliver
- Departamento Laboratorio de Tuberculosis. Instituto de Biomedicina "Dr. Jacinto Convit", Universidad Central de Venezuela, Caracas, Venezuela.,One Health Research Group. Facultad de Ciencias de la Salud, Universidad de las Américas, Sede Queri, Quito, Ecuador
| | - Omaira J Da Mata Jardin
- Departamento Laboratorio de Tuberculosis. Instituto de Biomedicina "Dr. Jacinto Convit", Universidad Central de Venezuela, Caracas, Venezuela
| | - Bárbara A Rodríguez-Castillo
- Departamento Laboratorio de Tuberculosis. Instituto de Biomedicina "Dr. Jacinto Convit", Universidad Central de Venezuela, Caracas, Venezuela
| | - Jacobus H de Waard
- Departamento Laboratorio de Tuberculosis. Instituto de Biomedicina "Dr. Jacinto Convit", Universidad Central de Venezuela, Caracas, Venezuela. .,One Health Research Group. Facultad de Ciencias de la Salud, Universidad de las Américas, Sede Queri, Quito, Ecuador.
| |
Collapse
|
13
|
A review of melioidosis cases imported into Europe. Eur J Clin Microbiol Infect Dis 2019; 38:1395-1408. [PMID: 30949898 DOI: 10.1007/s10096-019-03548-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 03/25/2019] [Indexed: 12/31/2022]
Abstract
Melioidosis is a tropical bacterial infection, rarely encountered, and poorly known by clinicians. In non-endemic areas, a misdiagnosis can lead to a fatal outcome. This study aims to identify the main characteristics of imported and diagnosed melioidosis cases in Europe to increase clinician's awareness of this diagnosis. A literature review of imported and diagnosed human melioidosis cases in Europe was performed. PubMed and Web of Science search engines were used for retrieving articles from 2000 to November 2018. Seventy-seven cases of imported melioidosis into Europe described in the literature were identified. More than half of the cases were acquired in Thailand (53%) by men (73%). Patients were usually exposed to Burkholderia pseudomallei during a holiday stay (58%) of less than 1 month (23%) and were hospitalized during the month following their return to Europe (58%). Among travelers, melioidosis is less often associated with risk factor (16%), diabetes being the most frequently comorbidity related (19%). The clinical presentation was multifaceted, pneumonia being the most common symptom (52%), followed by cardiovascular form (45%) and skin and soft tissues damages (35%). The diagnosis was obtained by culture (92%), often supplemented by morphological, biochemical, and molecular identification (23%). Misdiagnoses were common (21%). Over half of the patients received a complete and adapted treatment (56%). Mortality is lower for returning traveler (6%). Imported melioidosis cases into Europe have their own characteristics. This possibility should be considered in patients with pneumonia, fever, and/or abscess returning from endemic areas even years after.
Collapse
|
14
|
Lopeman RC, Harrison J, Desai M, Cox JAG. Mycobacterium abscessus: Environmental Bacterium Turned Clinical Nightmare. Microorganisms 2019; 7:microorganisms7030090. [PMID: 30909391 PMCID: PMC6463083 DOI: 10.3390/microorganisms7030090] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/15/2019] [Accepted: 03/19/2019] [Indexed: 12/19/2022] Open
Abstract
Mycobacteria are a large family of over 100 species, most of which do not cause diseases in humans. The majority of the mycobacterial species are referred to as nontuberculous mycobacteria (NTM), meaning they are not the causative agent of tuberculous (TB) or leprosy, i.e., Mycobacterium tuberculous complex and Mycobacterium leprae, respectively. The latter group is undoubtedly the most infamous, with TB infecting an estimated 10 million people and causing over 1.2 million deaths in 2017 alone TB and leprosy also differ from NTM in that they are only transmitted from person to person and have no environmental reservoir, whereas NTM infections are commonly acquired from the environment. It took until the 1950′s for NTM to be recognised as a potential lung pathogen in people with underlying pulmonary disease and another three decades for NTM to be widely regarded by the medical community when Mycobacterium avium complex was identified as the most common group of opportunistic pathogens in AIDS patients. This review focuses on an emerging NTM called Mycobacterium abscessus (M. abs). M. abs is a rapidly growing NTM that is responsible for opportunistic pulmonary infections in patients with structural lung disorders such as cystic fibrosis and bronchiectasis, as well as a wide range of skin and soft tissue infections in humans. In this review, we discuss how we came to understand the pathogen, how it is currently treated and examine drug resistance mechanisms and novel treatments currently in development. We highlight the urgent need for new and effective treatments for M. abs infection as well as improved in vivo methods of efficacy testing.
Collapse
Affiliation(s)
- Rose C Lopeman
- School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK.
| | - James Harrison
- School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK.
| | - Maya Desai
- Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK.
| | - Jonathan A G Cox
- School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK.
| |
Collapse
|
15
|
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.
Collapse
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.
| |
Collapse
|
16
|
Emigh B, Trust MD. Contaminated Wounds: Fresh Water, Salt Water, and Agricultural Contamination. CURRENT TRAUMA REPORTS 2018. [DOI: 10.1007/s40719-018-0144-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
17
|
Abstract
Hydrologic disasters, including hurricanes, tsunamis, and severe flooding, have been associated with infectious diseases, particularly among vulnerable and displaced populations in resource-poor settings. Skin and soft tissue infections, gastrointestinal infections, respiratory infections, zoonotic infections, and vector-borne diseases each present unique threats to human health in this setting. Increased emergency physician awareness of these infectious diseases and their diagnosis and management helps optimize medical care for survivors after a hydrologic disaster and safeguard the health of disaster responders.
Collapse
Affiliation(s)
- Stephen Y Liang
- Division of Emergency Medicine, Washington University School of Medicine, St Louis, MO, USA; Division of Infectious Diseases, Washington University School of Medicine, St Louis, MO, USA.
| | - Nicole Messenger
- Division of Emergency Medicine, Washington University School of Medicine, St Louis, MO, USA
| |
Collapse
|
18
|
Mycobacterium abscessus Soft Tissue Disease of the Abdominal Wall. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2018. [DOI: 10.1097/ipc.0000000000000646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Summers NA, Kempker R, Palacio F. Mycobacterium abscessus subspecies massiliense infection after skin graft and cholecystectomy in a burn patient. Int J Infect Dis 2018; 76:29-31. [PMID: 30170154 PMCID: PMC6248876 DOI: 10.1016/j.ijid.2018.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 11/20/2022] Open
Abstract
Diagnosing skin and soft tissue infections due to rapidly growing mycobacteria (RGM) can often prove difficult, leading to delays in treatment. Postoperative infections caused by RGM are increasingly recognized both within and outside the USA, but are rarely encountered in burn units. We report a case of postoperative skin and soft tissue infection along a cholecystectomy incision in a burn patient caused by Mycobacterium abscessus subsp. massiliense. Postoperative infections caused by RGM require a high index of suspicion, often necessitating biopsy for definitive diagnosis. Physicians should consider this diagnosis when postoperative infections arise later than typically seen for routine bacterial infections and fail to respond to first-line therapy.
Collapse
Affiliation(s)
- Nathan A Summers
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
| | - Russell Kempker
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Federico Palacio
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| |
Collapse
|
20
|
Bhalla GS, Sarao MS, Kalra D, Bandyopadhyay K, John AR. Methods of phenotypic identification of non-tuberculous mycobacteria. Pract Lab Med 2018; 12:e00107. [PMID: 30094310 PMCID: PMC6074605 DOI: 10.1016/j.plabm.2018.e00107] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 03/10/2018] [Accepted: 07/17/2018] [Indexed: 12/22/2022] Open
Abstract
Non-tuberculous mycobacteria (NTM) are composed of mycobacterial species other than the Mycobacterium tuberculosis complex. Initially thought to be mere contaminants when isolated from clinical specimens, literature is increasing by the day showing NTM as proven pathogens. Due to the difference in antimicrobial susceptibility of different species, it becomes imperative for the microbiology laboratory to identify them to the species level. Molecular methods are available for rapid and accurate identification, but in a resource limited nation, phenotypic methods, albeit time consuming, are of paramount importance. By means of this article, the authors intend provide a concise summary of the basic biochemical reactions which can be done to identify most commonly isolated NTM.
Collapse
Affiliation(s)
- Gurpreet S. Bhalla
- Department of Lab Sciences, Army Hospital (R&R), New Delhi 110010, India
- Corresponding author.
| | - Manbeer S. Sarao
- Div of Infectious Diseases, Detroit Medical Centre, Michigan, United States
| | - Dinesh Kalra
- Department of Microbiology, Command Hospital (WC), Chandimandir, India
| | | | | |
Collapse
|
21
|
Paterson DL, Wright H, Harris PNA. Health Risks of Flood Disasters. Clin Infect Dis 2018; 67:1450-1454. [DOI: 10.1093/cid/ciy227] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 03/20/2018] [Indexed: 12/31/2022] Open
Affiliation(s)
- David L Paterson
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Hugh Wright
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Patrick N A Harris
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Brisbane, Australia
| |
Collapse
|
22
|
Field Wound Care: Prophylactic Antibiotics. Wilderness Environ Med 2018; 28:S90-S102. [PMID: 28601215 DOI: 10.1016/j.wem.2016.12.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 12/19/2016] [Accepted: 12/20/2016] [Indexed: 12/28/2022]
Abstract
Adequate management of wounds requires numerous interventions, one of which is the appropriate use of antimicrobials to attempt to minimize the risk of excess morbidity or mortality without increasing toxicity or multidrug resistant bacterial acquisition. There are numerous recommendations and opinions for not only the use of systemic prophylactic antimicrobials, but also the agent, dose, route, and duration. To best address the implementation of systemic antimicrobials in a field scenario, one must weigh the factors that go into that decision and then determine the best agents possible. The epidemiologic triangle (ie, the host, the agent, and the environment) forms the basis for selecting the correct prophylactic antibiotic for field wound care. Extreme conditions can be encountered in both military and nonmilitary systems, requiring a unique selection process to make the right antibiotic choice. A modifiable weighted matrix, recommended previously for point of injury combat casualty care, assists in selecting the best oral and intravenous/intramuscular agent based on the epidemiologic risk determination.
Collapse
|
23
|
Okabe T, Sasahara T, Suzuki J, Onishi T, Komura M, Hagiwara S, Suzuki H, Morisawa Y. Mycobacterium mageritense Parotitis in an Immunocompetent Adult. Indian J Microbiol 2017; 58:28-32. [PMID: 29434394 DOI: 10.1007/s12088-017-0692-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/10/2017] [Indexed: 11/29/2022] Open
Abstract
Mycobacterium mageritense, a rapidly growing mycobacterium, is a rare clinical pathogen. Furthermore, parotitis due to non-tuberculosis mycobacterium is very rare in adults. Herein, we report the first case of M. mageritense parotitis in an immunocompetent adult. A 40-year-old man presented with swelling in a left parotid lesion. He was diagnosed with parotitis. The culture from the parotid abscess grew M. mageritense. He was unsuccessfully treated with levofloxacin monotherapy. Trimethoprim-sulfamethoxazole was added, leading to some clinical response; however, the erythema persisted despite 14 months of antibiotic therapy. Subsequently, the skin lesion was surgically removed. The antibiotic treatment was ceased a week after surgery as the postoperative course was uneventful and the lesion had improved. No recurrence was noted at 7 months after surgery. Although extremely rare, M. mageritense can cause parotitis in immunocompetent adults, and may not be sufficiently treated with antibiotics alone.
Collapse
Affiliation(s)
- Taro Okabe
- 1Division of Infectious Diseases, Jichi Medical University Hospital, Shimotsuke, Tochigi Japan
| | - Teppei Sasahara
- 1Division of Infectious Diseases, Jichi Medical University Hospital, Shimotsuke, Tochigi Japan.,2Department of Infection and Immunity, School of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498 Japan
| | - Jun Suzuki
- 1Division of Infectious Diseases, Jichi Medical University Hospital, Shimotsuke, Tochigi Japan
| | - Tsubasa Onishi
- 1Division of Infectious Diseases, Jichi Medical University Hospital, Shimotsuke, Tochigi Japan
| | - Masayoshi Komura
- 3Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi Japan
| | - Shigehiro Hagiwara
- 4Department of Clinical Laboratory, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi Japan
| | - Hiromichi Suzuki
- 5Clinical Laboratory Center, Dokkyo Medical University Hospital, Mibu, Tochigi Japan
| | - Yuji Morisawa
- 1Division of Infectious Diseases, Jichi Medical University Hospital, Shimotsuke, Tochigi Japan
| |
Collapse
|
24
|
Mycobacterium abscessus Displays Fitness for Fomite Transmission. Appl Environ Microbiol 2017; 83:AEM.00562-17. [PMID: 28754702 DOI: 10.1128/aem.00562-17] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/20/2017] [Indexed: 11/20/2022] Open
Abstract
Mycobacterium abscessus is a rapidly growing nontuberculous mycobacterium (NTM) increasingly reported in soft tissue infections and chronic lung diseases, including cystic fibrosis. The environmental source of M. abscessus has not been definitively identified, but NTM have been detected in soil and water. To determine the potential of soil-derived M. abscessus as an infectious source, we explored the association, growth, and survival of M. abscessus with defined mineral particulates, including kaolin, halloysite, and silicone dioxide, and house dust as possible M. abscessus fomites. M. abscessus physically associated with particulates, and the growth of M. abscessus was enhanced in the presence of both kaolin and house dust. M. abscessus survived desiccation for 2 weeks but was not viable after 3 weeks. The rate of decline of M. abscessus viability during desiccation was reduced in the presence of house dust. The evidence for enhanced growth and survival of M. abscessus during alternating growth and drying periods suggests that dissemination could occur when in wet or dry environments. These studies are important to understand environmental survival and acquisition of NTM.IMPORTANCE The environmental source of pulmonary Mycobacterium abscessus infections is not known. Fomites are nonliving carriers of infectious agents and may contribute to acquisition of M. abscessus This study provides evidence that M. abscessus growth is enhanced in the presence of particulates, using kaolin, an abundant natural clay mineral, and house dust as experimental fomites. Moreover, M. abscessus survived desiccation for up to 2 weeks in the presence of house dust, kaolin, and several chemically defined mineral particulates; mycobacterial viability during extended periods of dessication was enhanced by the presence of house dust. The growth characteristics of M. abscessus with particulates suggest that a fomite mechanism of transmission may contribute to M. abscessus acquisition, which may lead to strategies to better control infections by M. abscessus and related organisms.
Collapse
|
25
|
Liu X, Liang J, Zao J, Quan L, Jia X, Li M, Tao K. Vacuum Sealing Drainage Treatment Combined with Antibiotic-Impregnated Bone Cement for Treatment of Soft Tissue Defects and Infection. Med Sci Monit 2016; 22:1959-65. [PMID: 27281233 PMCID: PMC4917306 DOI: 10.12659/msm.896108] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background This study aimed to evaluate the combined effect of vacuum sealing drainage (VSD) and antibiotic-loaded bone cement on soft tissue defects and infection. Material/Methods This prospective non-blinded study recruited 46 patients with soft tissue defects and infection from January 2010 to May 2014 and randomly divided them into experimental and control groups (n=23). Patients in the experimental group were treated with VSD and antibiotic-loaded bone cement, while the patients in the control group were treated with VSD only. Results In the experimental group, the wound was healed in 23 cases at 4 weeks postoperatively, of which direct suture was performed in 12 cases, and additional free flap transplantation or skin grafting was performed in 6 cases and 5 cases, respectively. No infection reoccurred in 1-year follow-up. In the control group, the wound was healed in 15 cases at 6 weeks postoperatively, of which direct suture was performed in 8 cases, and additional free flap transplantation or skin grafting was performed in 3 cases and 4 cases, respectively. In the other 8 cases the wound was healed at 8 weeks postoperatively. Infection reoccurred in 3 cases during the follow-up. The experimental group had significantly fewer VSD dressing renewals, shorter time needed until the wound was ready for surgery, shorter duration of antibiotic administration, faster wound healing, and shorter hospital stay than the control group (p<0.01). Conclusions The combination of VSD and antibiotic bone cement might be a better method for treatment of soft tissue defects and infection.
Collapse
Affiliation(s)
- Xin Liu
- 7th Department of Orthopedics Ward, The First Hospital of Harbin City, Harbin, Heilongjiang, China (mainland)
| | - Jiulong Liang
- Department of Plastic Surgery, General Hospital of Shenyang Military Area Command PLA, Shenyang, Liaoning, China (mainland)
| | - Jun Zao
- 7th Department of Orthopedics Ward, The First Hospital of Harbin City, Harbin, Heilongjiang, China (mainland)
| | - Liangliang Quan
- Department of Plastic Surgery, General Hospital of Shenyang Military Area Command PLA, Shenyang, Liaoning, China (mainland)
| | - Xunyuan Jia
- 7th Department of Orthopedics Ward, The First Hospital of Harbin City, Harbin, Heilongjiang, China (mainland)
| | - Mingchao Li
- 7th Department of Orthopedics Ward, The First Hospital of Harbin City, Harbin, Heilongjiang, China (mainland)
| | - Kai Tao
- Department of Plastic Surgery, General Hospital of Shenyang Military Area Command PLA, Shenyang, Liaoning, China (mainland)
| |
Collapse
|
26
|
Fukunaga M, Goya M, Ogawa M, Fukuda K, Taniguchi H, Ando K, Iwabuchi M, Miyazaki H. Implantable cardioverter defibrillator infection due to Mycobacterium mageritense. J Infect Chemother 2016; 22:180-3. [DOI: 10.1016/j.jiac.2015.09.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 08/27/2015] [Accepted: 09/14/2015] [Indexed: 11/27/2022]
|
27
|
Wachholz PA, Sette CS, Caitano do Nascimento D, Soares CT, Diório SM, Masuda PY. Mycobacterium peregrinum Skin Infection: Case Report. J Cutan Med Surg 2015; 20:249-51. [PMID: 26627593 DOI: 10.1177/1203475415616963] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mycobacterium peregrinum is a rapidly growing mycobacterium (RGM) that rarely causes skin infections. The correct identification of the specific RGM infecting the skin will enhance therapeutic success. OBJECTIVE To highlight the importance of rapid and precise identification of the Mycobacterium involved in skin infections in order to enhance therapeutic success. METHODS We describe an RGM skin infection in an immunocompetent patient. RESULTS Classic methods (biochemical tests and culture) of RGM identification are time-consuming, and the histopathological features are not specific. Some molecular methods are reliable but expensive. The PRAhsp-65 is a simple procedure that is helpful in identifying the specific agent of an RGM. CONCLUSION Although skin infections caused by M peregrinum are rare, they represent a substantial clinical challenge. Specific and more effective treatment options depend on the development of precise and rapid methods for identifying mycobacterial species.
Collapse
|
28
|
Bandino JP, Hang A, Norton SA. The Infectious and Noninfectious Dermatological Consequences of Flooding: A Field Manual for the Responding Provider. Am J Clin Dermatol 2015; 16:399-424. [PMID: 26159354 DOI: 10.1007/s40257-015-0138-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Meteorological data show that disastrous floods are increasingly frequent and more severe in recent years, perhaps due to climatic changes such as global warming. During and after a flood disaster, traumatic injuries, communicable diseases, chemical exposures, malnutrition, decreased access to care, and even mental health disorders dramatically increase, and many of these have dermatological manifestations. Numerous case reports document typical and atypical cutaneous infections, percutaneous trauma, immersion injuries, noninfectious contact exposures, exposure to wildlife, and exacerbation of underlying skin diseases after such disasters as the 2004 Asian tsunami, Hurricane Katrina in 2005, and the 2010 Pakistan floods. This review attempts to provide a basic field manual of sorts to providers who are engaged in care after a flooding event, with particular focus on the infectious consequences. Bacterial pathogens such as Staphylococcus and Streptococcus are still common causes of skin infections after floods, with atypical bacteria also greatly increased. Vibrio vulnificus is classically associated with exposure to saltwater or brackish water. It may present as necrotizing fasciitis with hemorrhagic bullae, and treatment consists of doxycycline or a quinolone, plus a third-generation cephalosporin and surgical debridement. Atypical mycobacterial infections typically produce indolent cutaneous infections, possibly showing sporotrichoid spread. A unique nontuberculous infection called spam has recently been identified in Satowan Pacific Islanders; combination antibiotic therapy is recommended. Aeromonas infection is typically associated with freshwater exposure and, like Vibrio infections, immunocompromised or cirrhotic patients are at highest risk for severe disease, such as necrotizing fasciitis and sepsis. Various antibiotics can be used to treat Aeromonas infections. Melioidosis is seen mainly in Southeast Asia and Australia, particularly in rice farmers, and can remain latent for many years before presenting as the host's immunocompetence wanes. It can present with a variety of skin findings or as a nonspecific febrile illness, and preferred treatment consists of ceftazidime or a carbapenem with trimethoprim/sulfamethoxazole (TMP/SMX) for 2 weeks, then continuing TMP/SMX for at least 3 months. Leptospirosis is a waterborne zoonosis that is often prevalent after heavy rains or flooding. Different forms exist, including Fort Bragg fever, which produces a distinctive erythematous papular rash on the shins. Doxycycline is often sufficient; however, volume and potassium repletion may be necessary if renal involvement exists. Chromobacterium violaceum infection may occur after open skin is exposed to stagnant or muddy water. Cultured colonies produce a unique violacein pigment, and treatment typically consists of a carbapenem. Both typical and atypical fungal infections are increased in the flooding disaster scenario, such as dermatophytosis, chromoblastomycosis, blastomycosis, and mucormycosis. Appropriate antifungals should be used. In addition, land inundated with water expands the habitat for parasites and/or vectors, thus increased vigilance for regional parasitic infections is necessary after a flood. Lastly, noninfectious consequences of a flooding disaster are also common and include miliaria, immersion foot syndromes, irritant and allergic contact dermatitis, traumatic wounds and animal bites, and arthropod assault, as well as exacerbation of existing skin conditions such as atopic dermatitis, psoriasis, and alopecia areata due to increased stress or nonavailability of daily medications.
Collapse
Affiliation(s)
- Justin P Bandino
- Dermatology, USAF Hospital Langley, Hampton, VA, USA.
- , Yorktown, VA, 23693, USA.
| | - Anna Hang
- University of North Carolina, Chapel Hill, NC, USA
| | - Scott A Norton
- Dermatology Division, Children's National Medical Center, Washington, DC, USA
| |
Collapse
|
29
|
Skin, soft tissue and systemic bacterial infections following aquatic injuries and exposures. Am J Med Sci 2015; 349:269-75. [PMID: 25374398 DOI: 10.1097/maj.0000000000000366] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
: Bacterial infections following aquatic injuries occur commonly in fishermen and vacationers after freshwater and saltwater exposures. Internet search engines were queried with the key words to describe the epidemiology, clinical manifestations, diagnostic and treatment strategies and outcomes of both the superficial and the deeper invasive infections caused by more common, newly emerging and unusual aquatic bacterial pathogens. Main findings included the following: (1) aquatic injuries often result in gram-negative polymicrobial infections with marine bacteria; (2) most marine bacteria are resistant to 1st- and 2nd-generation penicillins and cephalosporins; (3) nontuberculous, mycobacterial infections should be considered in late-onset, culture-negative and antibiotic-resistant marine infections; (4) superficial marine infections and pre-existing wounds exposed to seawater may result in deeply invasive infections and sepsis in immunocompromised patients. With the exception of minor marine wounds demonstrating localized cellulitis, most other marine infections and all gram-negative and mycobacterial marine infections will require therapy with antibiotic combinations.
Collapse
|
30
|
Honda JR, Bernhard JN, Chan ED. Natural disasters and nontuberculous mycobacteria: a recipe for increased disease? Chest 2015; 147:304-308. [PMID: 25644904 DOI: 10.1378/chest.14-0974] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Infectious diseases acquired by survivors of large-scale natural disasters complicate the recovery process. During events such as tsunamis, hurricanes, earthquakes, and tornados and well into the recovery period, victims often are exposed to water-soil mixtures that have relocated with indigenous microbes. Because nontuberculous mycobacteria (NTM) are ubiquitous in water and soil, there is potential for increased exposure to these organisms during natural disasters. In this hypothesis-driven commentary, we discuss the rise in NTM lung disease and natural disasters and examine the geographic overlap of NTM infections and disaster frequencies in the United States. Moreover, we show an increased number of positive NTM cultures from Louisiana residents in the years following three of the relatively recent epic hurricanes and posit that such natural disasters may help to drive the increased number of NTM infections. Finally, we advocate for increased environmental studies and surveillance of NTM infections before and after natural disasters.
Collapse
Affiliation(s)
- Jennifer R Honda
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora; National Jewish Health, Denver Veterans Affairs Medical Center, Denver, CO.
| | - Jon N Bernhard
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Edward D Chan
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora; National Jewish Health, Denver Veterans Affairs Medical Center, Denver, CO
| |
Collapse
|
31
|
Mansour A, Jordan K. Disseminated Cladophialophora bantiana disease in a patient with prediabetes. BMJ Case Rep 2014; 2014:bcr-2014-206426. [PMID: 25398915 DOI: 10.1136/bcr-2014-206426] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Cladophialophora bantiana, a dematiaceous fungus from the family Phaeohyphomycetes, is highly neurotropic and primarily reported as a rare cause of brain abscess. Pulmonary infection and disease outside the central nervous system is extremely rare, particularly in immunocompetent patients. We report an unusual case of disseminated cladosporiosis in a young man with a new diagnosis of prediabetes but no other identifiable risk factors for disease. Fungal cultures were positive for C. bantiana from brain abscess aspiration, vertebral bone cultures and subcarinal lymph node biopsy. Although the patient demonstrated initial good response to surgical debridement of brain abscesses plus antifungal therapy, he eventually expired from septic shock secondary to C. bantiana pneumonia and recurrent brain abscesses 2 years after initial diagnosis.
Collapse
Affiliation(s)
- Anas Mansour
- Department of Internal Medicine, Riverside Methodist Hospital, Columbus, Ohio, USA
| | - Kim Jordan
- Department of Internal Medicine, Riverside Methodist Hospital, Columbus, Ohio, USA
| |
Collapse
|
32
|
Longworth SA, Blumberg EA, Barton TD, Vinnard C. Non-tuberculous mycobacterial infections after solid organ transplantation: a survival analysis. Clin Microbiol Infect 2014; 21:43-7. [PMID: 25636926 DOI: 10.1016/j.cmi.2014.07.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 07/10/2014] [Accepted: 07/16/2014] [Indexed: 11/20/2022]
Abstract
The relationship of non-tuberculous mycobacterial (NTM) infections and survival among solid organ transplant recipients is unknown. We conducted a retrospective cohort study to measure the impact of NTM infection on survival in this patient population, comparing the effect of Mycobacterium abscessus infection with that of infections due to other pathogenic NTM species. We identified 33 patients with NTM infection post-transplantation, 18 with infection that was diagnosed within the first year. Although drug resistance was common among M. abscessus isolates, patients with M. abscessus infection did not have increased mortality compared with patients with other types of NTM infections (p 0.64). In contrast, we observed a significant association overall between early NTM infection and 3-year mortality post-transplantation (hazard ratio 8.76, 95% CI 2.69-28.57). The mortality burden of NTM infection following transplantation may be due to factors other than the virulence of the organisms. Multicentre studies are needed to identify the optimal approach for diagnosing and treating these uncommon but serious infections.
Collapse
Affiliation(s)
- S A Longworth
- Department of Medicine, Division of Infectious Diseases, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - E A Blumberg
- Department of Medicine, Division of Infectious Diseases, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - T D Barton
- Department of Medicine, Division of Infectious Diseases, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - C Vinnard
- Department of Medicine, Division of Infectious Diseases & HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, USA.
| |
Collapse
|
33
|
Draft Genome Sequence of Mycobacterium mageritense DSM 44476
T. GENOME ANNOUNCEMENTS 2014; 2:2/2/e00354-14. [PMID: 24786954 PMCID: PMC4007989 DOI: 10.1128/genomea.00354-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
ABSTRACT
We report the draft genome sequence of
Mycobacterium mageritense
strain DSM 44476
T
(CIP 104973), a nontuberculosis species responsible for various infections. The genome described here is composed of 7,966,608 bp, with a G+C content of 66.95%, and contains 7,675 protein-coding genes and 120 predicted RNA genes.
Collapse
|
34
|
Seddon P, Fidler K, Raman S, Wyatt H, Ruiz G, Elston C, Perrin F, Gyi K, Bilton D, Drobniewski F, Newport M. Prevalence of nontuberculous mycobacteria in cystic fibrosis clinics, United Kingdom, 2009. Emerg Infect Dis 2014; 19:1128-30. [PMID: 23764198 DOI: 10.3201/eid/1907.120615] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Incidence of pulmonary infection with nontuberculous mycobacteria (NTM) is increasing among persons with cystic fibrosis (CF). We assessed prevalence and management in CF centers in the United Kingdom and found 5.0% of 3,805 adults and 3.3% of 3,317 children had recently been diagnosed with NTM. Of those, 44% of adults and 47% of children received treatment.
Collapse
Affiliation(s)
- Paul Seddon
- Royal Alexandra Children’s Hospital, Brighton, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Seddon P, Fidler K, Raman S, Wyatt H, Ruiz G, Elston C, Perrin F, Gyi K, Bilton D, Drobniewski F, Newport M. Prevalence of nontuberculous mycobacteria in cystic fibrosis clinics, United Kingdom, 2009. Emerg Infect Dis 2014. [PMID: 23764198 PMCID: PMC3713964 DOI: 10.3201/eid1907.120615] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Incidence of pulmonary infection with nontuberculous mycobacteria (NTM) is increasing among persons with cystic fibrosis (CF). We assessed prevalence and management in CF centers in the United Kingdom and found 5.0% of 3,805 adults and 3.3% of 3,317 children had recently been diagnosed with NTM. Of those, 44% of adults and 47% of children received treatment.
Collapse
Affiliation(s)
- Paul Seddon
- Royal Alexandra Children’s Hospital, Brighton, UK.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Balato N, Megna M, Ayala F, Balato A, Napolitano M, Patruno C. Effects of climate changes on skin diseases. Expert Rev Anti Infect Ther 2014; 12:171-81. [PMID: 24404995 DOI: 10.1586/14787210.2014.875855] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Global climate is changing at an extraordinary rate. Climate change (CC) can be caused by several factors including variations in solar radiation, oceanic processes, and also human activities. The degree of this change and its impact on ecological, social, and economical systems have become important matters of debate worldwide, representing CC as one of the greatest challenges of the modern age. Moreover, studies based on observations and predictive models show how CC could affect human health. On the other hand, only a few studies focus on how this change may affect human skin. However, the skin is the most exposed organ to environment; therefore, it is not surprising that cutaneous diseases are inclined to have a high sensitivity to climate. The current review focuses on the effects of CC on skin diseases showing the numerous factors that are contributing to modify the incidence, clinical pattern and natural course of some dermatoses.
Collapse
Affiliation(s)
- Nicola Balato
- Department of Dermatology, University of Naples Federico II, Via Pansini, 5, 80131 Napoli, Italy
| | | | | | | | | | | |
Collapse
|
37
|
Macheras E, Konjek J, Roux AL, Thiberge JM, Bastian S, Leão SC, Palaci M, Sivadon-Tardy V, Gutierrez C, Richter E, Rüsch-Gerdes S, Pfyffer GE, Bodmer T, Jarlier V, Cambau E, Brisse S, Caro V, Rastogi N, Gaillard JL, Heym B. Multilocus sequence typing scheme for the Mycobacterium abscessus complex. Res Microbiol 2013; 165:82-90. [PMID: 24384536 DOI: 10.1016/j.resmic.2013.12.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 12/19/2013] [Indexed: 11/29/2022]
Abstract
We developed a multilocus sequence typing (MLST) scheme for Mycobacterium abscessus sensu lato, based on the partial sequencing of seven housekeeping genes: argH, cya, glpK, gnd, murC, pta and purH. This scheme was used to characterize a collection of 227 isolates recovered between 1994 and 2010 in France, Germany, Switzerland and Brazil. We identified 100 different sequence types (STs), which were distributed into three groups on the tree obtained by concatenating the sequences of the seven housekeeping gene fragments (3576bp): the M. abscessus sensu stricto group (44 STs), the "M. massiliense" group (31 STs) and the "M. bolletii" group (25 STs). SplitTree analysis showed a degree of intergroup lateral transfers. There was also evidence of lateral transfer events involving rpoB. The most prevalent STs in our collection were ST1 (CC5; 20 isolates) and ST23 (CC3; 31 isolates). Both STs were found in Europe and Brazil, and the latter was implicated in a large post-surgical procedure outbreak in Brazil. Respiratory isolates from patients with cystic fibrosis belonged to a large variety of STs; however, ST2 was predominant in this group of patients. Our MLST scheme, publicly available at www.pasteur.fr/mlst, offers investigators a valuable typing tool for M. abscessus sensu lato in future epidemiological studies throughout the world.
Collapse
Affiliation(s)
- Edouard Macheras
- APHP Hôpitaux universitaires Paris Ile-de-France Ouest, Service de Microbiologie, Hôpital Ambroise Paré, 9 avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France; EA 3647, Université de Versailles Saint-Quentin-en-Yvelines, 2 avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux, France.
| | - Julie Konjek
- EA 3647, Université de Versailles Saint-Quentin-en-Yvelines, 2 avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux, France.
| | - Anne-Laure Roux
- APHP Hôpitaux universitaires Paris Ile-de-France Ouest, Laboratoire de Microbiologie, Hôpital Raymond Poincaré, AP-HP, Garches, France; EA 3647, Université de Versailles Saint-Quentin-en-Yvelines, 2 avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux, France.
| | - Jean-Michel Thiberge
- Institut Pasteur, Genotyping of Pathogens and Public Health, 25 rue du Docteur Roux, 75015 Paris, France.
| | - Sylvaine Bastian
- Centre national de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, 47-83 Boulevard de l'Hôpital, 75013 Paris, France; APHP, Groupe Hospitalier Pitié-Salpêtrière, Laboratoire de Bactériologie - Hygiène, 47-83 Boulevard de l'Hôpital, 75013 Paris, France.
| | - Sylvia Cardoso Leão
- Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, Rua Botucatu, 862, Vila Clementino, São Paulo SP CEP 04023-062, Brazil.
| | - Moises Palaci
- Nucleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Av. Fernando Ferrari, 514, Goiabeiras Vitória - ES, CEP 29075-910, Brazil.
| | - Valérie Sivadon-Tardy
- APHP Hôpitaux universitaires Paris Ile-de-France Ouest, Service de Microbiologie, Hôpital Ambroise Paré, 9 avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France.
| | - Cristina Gutierrez
- Caribbean Public Health Agency (CARPHA), 16-18 Jamaica Boulevard, Federation Park, Port of Spain, Trinidad and Tobago.
| | - Elvira Richter
- National Reference Center for Mycobacteria, Forschungszentrum Borstel, Parkalle 18, 23845 Borstel, Germany.
| | - Sabine Rüsch-Gerdes
- National Reference Center for Mycobacteria, Forschungszentrum Borstel, Parkalle 18, 23845 Borstel, Germany.
| | - Gaby E Pfyffer
- Institut für Medizinische Mikrobiologie, Zentrum für LaborMedizin, Luzerner Kantonsspital, Spitalstrasse, 6004 Luzern, Switzerland.
| | - Thomas Bodmer
- Institut für Infektionskrankheiten, Universität Bern, Hochschulstrasse 4, 3010 Bern, Switzerland.
| | - Vincent Jarlier
- Centre national de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, 47-83 Boulevard de l'Hôpital, 75013 Paris, France; APHP, Groupe Hospitalier Pitié-Salpêtrière, Laboratoire de Bactériologie - Hygiène, 47-83 Boulevard de l'Hôpital, 75013 Paris, France.
| | - Emmanuelle Cambau
- APHP, Groupe hospitalier Lariboisière-Fernand Widal, Laboratoire de Microbiologie, 2 rue Ambroise Paré, 75010 Paris, France.
| | - Sylvain Brisse
- Institut Pasteur, Genotyping of Pathogens and Public Health, 25 rue du Docteur Roux, 75015 Paris, France.
| | - Valérie Caro
- Institut Pasteur, Genotyping of Pathogens and Public Health, 25 rue du Docteur Roux, 75015 Paris, France.
| | - Nalin Rastogi
- Institut Pasteur, Laboratoire de Recherche et de Référence sur la Tuberculose et les Mycobactéries, BP 484 Morne Jolivière, Les Abymes 97183 Cedex, Guadeloupe, France.
| | - Jean-Louis Gaillard
- APHP Hôpitaux universitaires Paris Ile-de-France Ouest, Service de Microbiologie, Hôpital Ambroise Paré, 9 avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France; APHP Hôpitaux universitaires Paris Ile-de-France Ouest, Laboratoire de Microbiologie, Hôpital Raymond Poincaré, AP-HP, Garches, France; EA 3647, Université de Versailles Saint-Quentin-en-Yvelines, 2 avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux, France.
| | - Beate Heym
- APHP Hôpitaux universitaires Paris Ile-de-France Ouest, Service de Microbiologie, Hôpital Ambroise Paré, 9 avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France; EA 3647, Université de Versailles Saint-Quentin-en-Yvelines, 2 avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux, France.
| |
Collapse
|
38
|
Mycobacterium mageritense meningitis in an immunocompetent patient with an intrathecal catheter. Enferm Infecc Microbiol Clin 2013; 31:59-60. [DOI: 10.1016/j.eimc.2012.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 05/17/2012] [Accepted: 05/20/2012] [Indexed: 10/27/2022]
|
39
|
Kothavade RJ, Dhurat RS, Mishra SN, Kothavade UR. Clinical and laboratory aspects of the diagnosis and management of cutaneous and subcutaneous infections caused by rapidly growing mycobacteria. Eur J Clin Microbiol Infect Dis 2012; 32:161-88. [PMID: 23139042 DOI: 10.1007/s10096-012-1766-8] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2012] [Accepted: 10/15/2012] [Indexed: 10/27/2022]
Abstract
Rapidly growing mycobacteria (RGM) are known to cause pulmonary, extra-pulmonary, systemic/disseminated, and cutaneous and subcutaneous infections. The erroneous detection of RGM that is based solely on microscopy, solid and liquid cultures, Bactec systems, and species-specific polymerase chain reaction (PCR) may produce misleading results. Thus, inappropriate therapeutic measures may be used in dermatologic settings, leading to increased numbers of skin deformity cases or recurrent infections. Molecular tools such as the sequence analyses of 16S rRNA, rpoB and hsp65 or PCR restriction enzyme analyses, and the alternate gene sequencing of the superoxide dismutase (SOD) gene, dnaJ, the 16S-23S rRNA internal transcribed spacers (ITS), secA, recA1, dnaK, and the 32-kDa protein gene have shown promising results in the detection of RGM species. PCR restriction enzyme analyses (PRA) work better than conventional methods at identifying species that are closely related. Recently introduced molecular tools such as matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), pyrosequencing, DNA chip technology, and Beacon probes-combined PCR probes have shown comparable results in the detection of various species of RGM. Closely related RGM species (e.g., Mycobacterium fortuitum, M. chelonae, and M. abscessus) must be clearly differentiated using accurate molecular techniques because their therapeutic responses are species-specific. Hence, this paper reviews the following aspects of RGM: (i) its sources, predisposing factors, clinical manifestations, and concomitant fungal infections; (ii) the risks of misdiagnoses in the management of RGM infections in dermatological settings; (iii) the diagnoses and outcomes of treatment responses in common and uncommon infections in immunocompromised and immunocompetent patients; (iv) conventional versus current molecular methods for the detection of RGM; (v) the basic principles of a promising MALDI-TOF MS, sampling protocol for cutaneous or subcutaneous lesions and its potential for the precise differentiation of M. fortuitum, M. chelonae, and M. abscessus; and (vi) improvements in RGM infection management as described in the recent 2011 Clinical and Laboratory Standards Institute (CLSI) guidelines, including interpretation criteria of molecular methods and antimicrobial drug panels and their break points [minimum inhibitory concentrations (MICs)], which have been highlighted for the initiation of antimicrobial therapy.
Collapse
Affiliation(s)
- R J Kothavade
- Microbiology Lab, Epcor, 10065 Jasper Ave NW, Edmonton, AB, T5J 3B1, Canada.
| | | | | | | |
Collapse
|
40
|
Molecular typing of Mycobacterium abscessus based on tandem-repeat polymorphism. J Clin Microbiol 2012; 50:3084-8. [PMID: 22760048 DOI: 10.1128/jcm.00753-12] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A variable-number tandem-repeat (VNTR) typing assay for the differentiation of Mycobacterium abscessus strains was developed. This assay showed complete reproducibility, locus stability, and a discriminatory power (Hunter-Gaston discriminatory index [HGDI] of 0.9563) that is superior to that of multilocus sequencing. It is a promising tool for the investigation of Mycobacterium abscessus epidemiology and nosocomial outbreaks.
Collapse
|
41
|
Andersen LK, Hercogová J, Wollina U, Davis MDP. Climate change and skin disease: a review of the English-language literature. Int J Dermatol 2012; 51:656-61; quiz 659, 661. [DOI: 10.1111/j.1365-4632.2011.05258.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
42
|
Kyselková M, Chroňáková A, Volná L, Nĕmec J, Ulmann V, Scharfen J, Elhottová D. Tetracycline resistance and presence of tetracycline resistance determinants tet(V) and tap in rapidly growing mycobacteria from agricultural soils and clinical isolates. Microbes Environ 2012; 27:413-22. [PMID: 22673307 PMCID: PMC4103549 DOI: 10.1264/jsme2.me12028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Rapidly growing mycobacteria (RGM) inhabit soil and water but certain strains represent a health risk for human and animals. Both clinical and soil RGM may be under selection pressure for resistance to tetracycline (TET) antibiotics, since tetracyclines are administrated to humans and farm animals, and TET residues enter soil through manuring; however, resistance to TET and the presence of TET-resistance genes have been assessed only in clinical isolates. We were therefore interested in comparing soil and clinical RGM in terms of TET resistance and the presence of TET-resistance genes. We used 44 RGM from grasslands with different exposure to animal manure, and 38 clinical RGM from Czech hospitals. There was no difference between the clinical and soil isolates in TET resistance, with >50% resistant isolates in both groups. otr(A), otr(B), tet(K), tet(L) or tet(M) were not detected in any soil or clinical isolate. In contrast, most isolates harbored tet(V) and tap, both encoding mycobacterial efflux pumps, including species where these genes have never been evidenced before. The phylogeny of tet(V) correlated with isolates’ BOX-PCR profiles, suggesting that this gene evolved along with mycobacterial genomes as a part of the intrinsic resistome. In certain cases, tet(V) and/or tap were found in TET-sensitive isolates, or inversely, were not found in resistant strains. Concluding, intrinsic efflux pumps may be more important for TET resistance than horizontally transferred genes in both soil and clinical RGM. Their simple presence, however, does not attest to resistance, and therefore their diversity, function and expression merit further research.
Collapse
Affiliation(s)
- Martina Kyselková
- Biology Centre of the Academy of Sciences of the Czech Republic, Institute of Soil Biology, České Budějovice, Czech Republic.
| | | | | | | | | | | | | |
Collapse
|
43
|
Kamijo F, Uhara H, Kubo H, Nakanaga K, Hoshino Y, Ishii N, Okuyama R. A Case of Mycobacterial Skin Disease Caused by Mycobacterium peregrinum, and a Review of Cutaneous Infection. Case Rep Dermatol 2012; 4:76-9. [PMID: 22548041 PMCID: PMC3339662 DOI: 10.1159/000337825] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
An 83-year-old Japanese man presented with a 2-month history of symptomatic nodules on the left hand. He was not in an immunocompromised condition and reported no causal events. A biopsy specimen demonstrated granulomatous tissue with mixed cell infiltration consisting of neutrophils, histiocytes, lymphocytes, and multinuclear giant cells. No bacillus was detected by PAS, acid-fast stain, immunofluorescent stain or polymerase chain reaction analysis. The isolate was found to be a rapidly growing mycobacterium after 4 weeks of incubation at 25°C on an Ogawa egg slant. Mycobacterium peregrinum was isolated by DNA-DNA hybridization analysis, 16S rRNA gene sequence, and by its production of 3-day arylsulfatase. The patient received 200 mg oral minocycline for 28 weeks. The lesion disappeared after 10 weeks of this treatment.
Collapse
Affiliation(s)
- Fuminao Kamijo
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Tokyo, Japan
| | | | | | | | | | | | | |
Collapse
|
44
|
Gordon Huth R, Brown-Elliott BA, Wallace RJ. Mycobacterium mageritense pulmonary disease in patient with compromised immune system. Emerg Infect Dis 2011; 17:556-8. [PMID: 21392461 PMCID: PMC3166017 DOI: 10.3201/eid1703.101279] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
|
45
|
|
46
|
Multilocus sequence analysis and rpoB sequencing of Mycobacterium abscessus (sensu lato) strains. J Clin Microbiol 2010; 49:491-9. [PMID: 21106786 DOI: 10.1128/jcm.01274-10] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mycobacterium abscessus, Mycobacterium bolletii, and Mycobacterium massiliense (Mycobacterium abscessus sensu lato) are closely related species that currently are identified by the sequencing of the rpoB gene. However, recent studies show that rpoB sequencing alone is insufficient to discriminate between these species, and some authors have questioned their current taxonomic classification. We studied here a large collection of M. abscessus (sensu lato) strains by partial rpoB sequencing (752 bp) and multilocus sequence analysis (MLSA). The final MLSA scheme developed was based on the partial sequences of eight housekeeping genes: argH, cya, glpK, gnd, murC, pgm, pta, and purH. The strains studied included the three type strains (M. abscessus CIP 104536(T), M. massiliense CIP 108297(T), and M. bolletii CIP 108541(T)) and 120 isolates recovered between 1997 and 2007 in France, Germany, Switzerland, and Brazil. The rpoB phylogenetic tree confirmed the existence of three main clusters, each comprising the type strain of one species. However, divergence values between the M. massiliense and M. bolletii clusters all were below 3% and between the M. abscessus and M. massiliense clusters were from 2.66 to 3.59%. The tree produced using the concatenated MLSA gene sequences (4,071 bp) also showed three main clusters, each comprising the type strain of one species. The M. abscessus cluster had a bootstrap value of 100% and was mostly compact. Bootstrap values for the M. massiliense and M. bolletii branches were much lower (71 and 61%, respectively), with the M. massiliense cluster having a fuzzy aspect. Mean (range) divergence values were 2.17% (1.13 to 2.58%) between the M. abscessus and M. massiliense clusters, 2.37% (1.5 to 2.85%) between the M. abscessus and M. bolletii clusters, and 2.28% (0.86 to 2.68%) between the M. massiliense and M. bolletii clusters. Adding the rpoB sequence to the MLSA-concatenated sequence (total sequence, 4,823 bp) had little effect on the clustering of strains. We found 10/120 (8.3%) isolates for which the concatenated MLSA gene sequence and rpoB sequence were discordant (e.g., M. massiliense MLSA sequence and M. abscessus rpoB sequence), suggesting the intergroup lateral transfers of rpoB. In conclusion, our study strongly supports the recent proposal that M. abscessus, M. massiliense, and M. bolletii should constitute a single species. Our findings also indicate that there has been a horizontal transfer of rpoB sequences between these subgroups, precluding the use of rpoB sequencing alone for the accurate identification of the two proposed M. abscessus subspecies.
Collapse
|
47
|
Mycobacterium abscessus: a new player in the mycobacterial field. Trends Microbiol 2010; 18:117-23. [PMID: 20060723 DOI: 10.1016/j.tim.2009.12.007] [Citation(s) in RCA: 133] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 11/25/2009] [Accepted: 12/09/2009] [Indexed: 11/24/2022]
Abstract
Mycobacterium abscessus, a relative of Koch's bacillus (the bacterium that causes tuberculosis), has recently emerged as the cause of an increasing number of both community- and hospital-acquired infections in humans; it also constitutes a serious threat for cystic fibrosis patients. This situation is worsened by its exceptionally high natural and acquired antibiotic resistance that complicates treatment. Although a rapid grower, it shares some traits with Koch's bacillus, including the ability to induce a persistent lung disease associated with caseous lesions, a landmark of Mycobacterium tuberculosis infection. Its genome sequence and microarrays are now available, and efficient genetic tools have recently been developed. Here we consider the various advantages of using this species as an experimental model to study tuberculosis and other related mycobacterial diseases.
Collapse
|
48
|
van Ingen J, Boeree M, Dekhuijzen PR, van Soolingen D. Environmental sources of rapid growing nontuberculous mycobacteria causing disease in humans. Clin Microbiol Infect 2009; 15:888-93. [DOI: 10.1111/j.1469-0691.2009.03013.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
49
|
Kaewlai R, Meennuch W, Srisuwan T, Prasitvoranant W, Yenarkarn P, Chuapetcharasopon C. Imaging in Tsunami Trauma. J Med Ultrasound 2009. [DOI: 10.1016/s0929-6441(09)60009-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|