1
|
Nguyen I, Green ON, Modahl L. Nontuberculous Mycobacterial Pulmonary Disease: A Clinical and Radiologic Update. Semin Roentgenol 2022; 57:75-89. [DOI: 10.1053/j.ro.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 11/11/2022]
|
2
|
Impact of Environmental and Pharmacologic Changes on the Upper Gastrointestinal Microbiome. Biomedicines 2021; 9:biomedicines9060617. [PMID: 34072493 PMCID: PMC8229529 DOI: 10.3390/biomedicines9060617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/23/2021] [Accepted: 05/26/2021] [Indexed: 02/08/2023] Open
Abstract
Diseases of the upper gastrointestinal tract have become more prevalent over time. Mechanisms of disease formation are still only partially understood. Recent literature has shown that the surrounding microbiome affects the propensity for disease formation in various parts of the upper gastrointestinal tract. A review was performed of any literature to our best knowledge concerning the effects of pharmacologic agents, environmental changes, and surgical intervention on the microbiome of the upper gastrointestinal tract. Searches of the literature were performed using specific keywords related to drugs, surgical procedures, and environmental factors. Many prescription and nonprescription drugs that are commonly used have varying effects on the upper gastrointestinal tract. Proton pump inhibitors may affect the relative prevalence of some organisms in the lower esophagus and have less effect in the proximal esophagus. Changes in the esophageal microbiome correlate with some esophageal diseases. Drugs that induce weight loss have also been shown to affect the microbiomes of the esophagus and stomach. Common surgical procedures are associated with shifts in the microbial community in the gastrointestinal tract. Environmental factors have been shown to affect the microbiome in the upper gastrointestinal tract, as geographic differences correlate with alterations in the microbiome of the gastrointestinal tract. Understanding the association of environmental and pharmacologic changes on the microbiome of the upper gastrointestinal tract will facilitate treatment plans to reduce morbidity from disease.
Collapse
|
3
|
Microbiome of the Aerodigestive Tract in Health and Esophageal Disease. Dig Dis Sci 2021; 66:12-18. [PMID: 33236315 PMCID: PMC8006547 DOI: 10.1007/s10620-020-06720-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/15/2020] [Indexed: 02/06/2023]
Abstract
The diverse human gut microbiome is comprised of approximately 40 trillion microorganisms representing up to 1000 different bacterial species. The human microbiome plays a critical role in gut epithelial health and disease susceptibility. While the interaction between gut microbiome and gastrointestinal pathology is increasingly understood, less is known about the interaction between the microbiome and the aerodigestive tract. This review of the microbiome of the aerodigestive tract in health, and alterations in microbiome across esophageal pathologies highlights important findings and areas for future research. First, microbiome profiles are distinct along the aerodigestive tract, spanning the oral cavity to the stomach. In patients with reflux-related disease such as gastro-esophageal reflux disease, Barrett's esophagus, and esophageal adenocarcinoma, investigators have observed an overall increase in gram negative bacteria in the esophageal microbiome compared to healthy individuals. However, whether differences in microbiome promote disease development, or if these shifts are a consequence of disease remains unknown. Interestingly, use of proton pump inhibitor therapy is also associated with shifts in the microbiome, with distinct shifts and patterns along the aerodigestive tract. The relationship between the human gut microbiome and esophageal pathology is a ripe area for investigation, and further understanding of these pathways may promote development of novel targets in prevention and therapy for esophageal diseases.
Collapse
|
4
|
Pfeuffer-Jovic E, Heyckendorf J, Reischl U, Bohle RM, Bley T, Buck A, Wilkens H, Schäfers HJ, Langen HJ, Held M. Pulmonary vasculitis due to infection with Mycobacterium goodii: A case report. Int J Infect Dis 2020; 104:178-180. [PMID: 33383220 DOI: 10.1016/j.ijid.2020.12.074] [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: 10/22/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 11/30/2022] Open
Abstract
A 57-year-old Caucasian woman suffered from dyspnea on exertion. One year following a supposed pulmonary embolism event, a chronic thromboembolic vasculopathy was diagnosed and a pulmonary thromboendarterectomy was performed. However, a granulomatous pulmonary arterial vasculitis was identified upon examination. DNA of Mycobacterium goodii was detected as the most likely causative agent. Anti-inflammatory and anti-mycobacterial therapy was initiated for more than 12 months. Regular PET-CT scans revealed improvement under therapy. The last PET-CT did not show any tracer uptake following 10 months of therapy.
Collapse
Affiliation(s)
- Elena Pfeuffer-Jovic
- Department of Internal Medicine, Respiratory Medicine and Ventilatory Support, Medical Mission Hospital, Central Clinic Würzburg, Academic Teaching Hospital of the Julius Maximilian University of Würzburg, Würzburg, Germany.
| | - Jan Heyckendorf
- German Center for Infection Research (DZIF), Borstel, Germany; University of Lübeck, Lübeck, Germany
| | - Udo Reischl
- Institute of Medical Microbiology and Hygiene, University Hospital of Regensburg, Regensburg, Germany
| | - Rainer M Bohle
- Department of Pathology, Saarland University, Homburg Saar, Germany
| | - Thorsten Bley
- Clinic for Radiology, Julius Maximilian University of Würzburg, Würzburg, Germany
| | - Andreas Buck
- Clinic for Nuclear Medicine, Julius Maximilian University of Würzburg, Würzburg, Germany
| | - Heinrike Wilkens
- Department of Internal Medicine V, Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University, Homburg Saar, Germany
| | - Hans-Joachim Schäfers
- Department of Thoracic and Cardiovascular Surgery, Saarland University, Homburg Saar, Germany
| | - Heinz-Jakob Langen
- Department of Radiology, Medical Mission Hospital, Central Clinic Würzburg, Academic Teaching Hospital of the Julius Maximilian University of Würzburg, Würzburg, Germany
| | - Matthias Held
- Department of Internal Medicine, Respiratory Medicine and Ventilatory Support, Medical Mission Hospital, Central Clinic Würzburg, Academic Teaching Hospital of the Julius Maximilian University of Würzburg, Würzburg, Germany
| |
Collapse
|
5
|
Park CH, Lee SK. Exploring Esophageal Microbiomes in Esophageal Diseases: A Systematic Review. J Neurogastroenterol Motil 2020; 26:171-179. [PMID: 32235026 PMCID: PMC7176507 DOI: 10.5056/jnm19240] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/11/2020] [Accepted: 02/27/2020] [Indexed: 12/12/2022] Open
Abstract
Studies that investigated esophageal microbiomes are limited when compared to those on intestinal microbiomes. Nevertheless, several studies have investigated the relationship between esophageal microbiomes and various esophageal diseases, owing to the advancement of next-generation sequencing techniques. Streptococcus is the most common bacterial taxon in a normal esophagus. Additionally, Haemophilus, Neisseria, Prevotella, and Veillonella are also found. However, gram-negative bacteria, including Prevotella, are more abundant in a diseased esophagus, such as in gastroesophageal reflux disease and Barrett’ esophagus. This systematic review aims to summarize current evidences on esophageal microbiomes in various esophageal diseases.
Collapse
Affiliation(s)
- Chan Hyuk Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Gyeonggi-do, Korea
| | - Sang Kil Lee
- Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
6
|
Shelton A, Giurgea L, Moshgriz M, Siegel M, Akselrod H. A case of Mycobacterium goodii infection related to an indwelling catheter placed for the treatment of chronic symptoms attributed to Lyme disease. Infect Dis Rep 2019; 11:8108. [PMID: 31579470 PMCID: PMC6761459 DOI: 10.4081/idr.2019.8108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/25/2019] [Indexed: 11/23/2022] Open
Abstract
Mycobacterium goodii has only rarely been reported to cause invasive disease in humans. Previously reported cases of M. goodii infection have included prosthetic joint infections, pacemaker pocket infections, and pneumonia. We present a case of M. goodii bacteremia with concomitant pulmonary septic emboli that developed in a 32-year-old woman with an indwelling central venous catheter (CVC). The CVC had been placed one year previously for intermittent treatment with intravenous, broadspectrum antibiotics, administered by an outside physician for the treatment of symptoms attributed to chronic Lyme disease. Despite our recommendations, the patient declined follow-up in our Infectious Diseases clinic, opting to continue care under her chronic Lyme disease physician. This case clearly demonstrates the potential for serious medical complications that can arise from the inappropriate use of longterm intravenous antibiotics using a CVC to treat non-specific symptoms attributed to Lyme disease and patients should be counseled regarding these risks.
Collapse
Affiliation(s)
- Andrew Shelton
- Department of Internal Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Luca Giurgea
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Mahdi Moshgriz
- Department of Pathology, George Washington University Medical Center, Washington, DC
| | - Marc Siegel
- Department of Medicine, George Washington University Medical Faculty Associates, Washington, DC, USA
| | - Hana Akselrod
- Department of Medicine, George Washington University Medical Faculty Associates, Washington, DC, USA
| |
Collapse
|
7
|
Waldron R, Waldron D, McMahon E, Reilly L, Riain UN, Fleming C, O'Regan A. Mycobacterium goodii pneumonia: An unusual presentation of nontuberculous mycobacterial infection requiring a novel multidisciplinary approach to management. Respir Med Case Rep 2019; 26:307-309. [PMID: 30891397 PMCID: PMC6404650 DOI: 10.1016/j.rmcr.2019.02.022] [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: 02/13/2019] [Revised: 02/27/2019] [Accepted: 02/27/2019] [Indexed: 12/01/2022] Open
Abstract
Background Mycobacterium goodii is a rapidly growing nontuberculous mycobacterium which has been associated with several infections including cellulitis, osteomyelitis, lymphadenitis, infected pacemakers and bursitis but it is a rare cause of respiratory infection. Case presentation In this case report we describe a 51-year-old woman who presented with a 6-week history of non-productive cough, pleuritic chest pain and weight loss. She had a history of gastric adenocarcinoma managed with a distal oesophagectomy and total gastrectomy and consequentially suffered severe post-operative gastric reflux. Initial cultures were negative but following a VATS lung biopsy Mycobacterium goodii was cultured and histology revealed an organising pneumonia. Treatment was with a prolonged course of steroids, amikacin and meropenem followed by oral ciprofloxacin and doxycycline. Ongoing gastric dysmotility and weight loss showed clinical improvement with a novel approach of a combination of prokinetics and somatostatin analogues controlling risk of repeat aspiration and improving symptom control. Conclusions This is an unusual case of organising pneumonia related to Mycobacterium goodii infection and highlights the importance of mycobacterial culture in unusual and unresolving cases of organising pneumonia. The importance of controlling symptoms related to gastric dysmotility and aspiration is also addressed.
Collapse
Affiliation(s)
- Ruth Waldron
- Department of Clinical Microbiology, Galway University Hospital, Ireland
- Corresponding author. Department of Clinical Microbiology, Galway University Hospital, Newcastle Rd, Galway, H91 YR71, Ireland.
| | - Dympna Waldron
- Department of Palliative Medicine, Galway University Hospital, Ireland
| | - Eileen McMahon
- Department of Respiratory Medicine, Galway University Hospital, Ireland
| | - Leona Reilly
- Department of Palliative Medicine, Galway University Hospital, Ireland
| | - Una Ni Riain
- Department of Clinical Microbiology, Galway University Hospital, Ireland
| | - Catherine Fleming
- Department of Infectious Diseases, Galway University Hospital, Ireland
| | - Anthony O'Regan
- Department of Respiratory Medicine, Galway University Hospital, Ireland
| |
Collapse
|
8
|
Parikh RB, Grant M. Mycobacterium goodii endocarditis following mitral valve ring annuloplasty. Ann Clin Microbiol Antimicrob 2017; 16:14. [PMID: 28327156 PMCID: PMC5361780 DOI: 10.1186/s12941-017-0190-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 03/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mycobacterium goodii is an infrequent human pathogen which has been implicated in prosthesis related infections and penetrating injuries. It is often initially misidentified as a gram-positive rod by clinical microbiologic laboratories and should be considered in the differential diagnosis. CASE PRESENTATION We describe here the second reported case of M. goodii endocarditis. Species level identification was performed by 16S rDNA (ribosomal deoxyribonucleic acid) gene sequencing. The patient was successfully treated with mitral valve replacement and a prolonged combination of ciprofloxacin and trimethoprim/sulfamethoxazole. CONCLUSION Confirmation of the diagnosis utilizing molecular techniques and drug susceptibility testing allowed for successful treatment of this prosthetic infection.
Collapse
Affiliation(s)
- Rohan B Parikh
- Texas Heart Institute, 6770 Bertner Avenue, Houston, Tx, 77030, USA
| | - Matthew Grant
- Yale School of Medicine, 333 Cedar St, New Haven, CT, 06510, USA.
| |
Collapse
|
9
|
Yoo DK, Hosseini-Moghaddam SM. Pacemaker pocket infection due to Mycobacterium goodii, a rapidly growing mycobacteria. BMJ Case Rep 2017; 2017:bcr-2016-218323. [PMID: 28073877 DOI: 10.1136/bcr-2016-218323] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A woman aged 74 years with an implanted dual-chamber pacemaker presented with pacemaker site infection after failing empiric antimicrobial therapy. The pathogen was later identified as Mycobacterium goodii, a rapidly growing mycobacteria species. The pacemaker was subsequently removed and the patient was treated with oral ciprofloxacin and doxycycline with clinical improvement. In this article, we describe a rare case of pacemaker site infection by M. goodii.
Collapse
Affiliation(s)
- David K Yoo
- Department of Medicine, Western University, Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | | |
Collapse
|
10
|
Abstract
The authors present a successfully treated case of Mycobacterium goodii cardiac device pocket infection, complicated by inherent resistance and drug reactions. This case highlights the complexity of treating these infections. This article outlines treatment approaches and caveats, including duration of therapy and when device reimplantation is appropriate. Mycobacterium goodii, a rapidly growing nontuberculous mycobacterium, is an emerging pathogen in nosocomial infections. Its inherent resistance patterns make it a challenging organism to treat, and delays in identification can lead to poor outcomes. We present a case of cardiac device pocket infection with M. goodii, complicated by both antibiotic resistance and drug reactions that highlight the challenges faced by clinicians trying to eradicate these infections. We also present a brief review of the English literature surrounding this disease, including a table of all reported cases of M. goodii infections and their outcomes to act as guide for clinicians formulating treatment plans for these infections. A clear understanding of diagnostic methods and treatment caveats is essential to curing infections caused by these organisms.
Collapse
|
11
|
Kim J, Seong MW, Kim EC, Han SK, Yim JJ. Frequency and clinical implications of the isolation of rare nontuberculous mycobacteria. BMC Infect Dis 2015; 15:9. [PMID: 25572753 PMCID: PMC4297383 DOI: 10.1186/s12879-014-0741-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 12/23/2014] [Indexed: 11/28/2022] Open
Abstract
Background To date, more than 125 species of nontuberculous mycobacteria (NTM) have been identified. In this study, we investigated the frequency and clinical implication of the rarely isolated NTM from respiratory specimens. Methods Patients with NTM isolated from their respiratory specimens between July 1, 2010 and June 31, 2012 were screened for inclusion. Rare NTM were defined as those NTM not falling within the group of eight NTM species commonly identified at our institution: Mycobacterium avium, M. intracellulare, M. abscessus, M. massiliense, M. fortuitum, M. kansasii, M. gordonae, and M. peregrinum. Clinical, radiographic and microbiological data from patients with rare NTM were reviewed and analyzed. Results During the study period, 73 rare NTM were isolated from the respiratory specimens of 68 patients. Among these, M. conceptionense was the most common (nine patients, 12.3%). The median age of the 68 patients with rare NTM was 68 years, while 39 of the patients were male. Rare NTM were isolated only once in majority of patient (64 patients, 94.1%). Among the four patients from whom rare NTM were isolated two or more times, only two showed radiographic aggravation caused by rare NTM during the follow-up period. Conclusions Most of the rarely identified NTM species were isolated from respiratory specimens only once per patient, without concomitant clinical aggravation. Clinicians could therefore observe such patients closely without invasive work-ups or treatment, provided the patients do not have decreased host immunity towards mycobacteria.
Collapse
Affiliation(s)
- Junghyun Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.
| | - Eui-Chong Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.
| | - Sung Koo Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.
| | - Jae-Joon Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.
| |
Collapse
|