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Fujishima C, Tahara J, Munemoto S, Hioki C, Sasaki H, Yoshida H, Matsuo H, Miyamoto Y, Ishii N, Kudo H. Cutaneous nontuberculous mycobacterial infections in Japan: Review of the Japanese literature. J Dermatol 2022; 49:1075-1084. [PMID: 35906770 DOI: 10.1111/1346-8138.16531] [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: 03/24/2022] [Revised: 07/11/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022]
Abstract
Nontuberculous mycobacteria cause a wide range of infections, including cutaneous infections, in both immunocompromised and immunocompetent patients. Although pulmonary nontuberculous mycobacterial infections have increased significantly in Japan in recent years, there is less evidence on clinical and microbiological characteristics of cutaneous nontuberculous mycobacterial infections in Japan. We reviewed 86 Japanese cases reported between July 2016 and November 2021 and analyzed them in conjunction with the eight patients from our institution who were diagnosed with cutaneous nontuberculous mycobacterial infections by culture between 2015 and 2021. In the aggregate series, the average patient age was 60 years, and the ratio of immunocompromised hosts was 53%, both of which were higher than those in previous reports from other countries. No female predominance was observed, unlike in pulmonary nontuberculous mycobacteria infections. Rapidly growing mycobacteria accounted for 58% of the cases (n = 54), whereas slowly growing mycobacteria for 43% (n = 40). Mycobacterium marinum (also known as Mycobacteroides marinum) (n = 20, 21%) was the most common cause, followed by Mycobacterium chelonae (n = 18, 19%), Mycobacterium abscessus (also known as Mycobacteroides abscessus) (n = 15, 16%), and Mycobacterium ulcerans (n = 11, 12%). While clinical appearance was variable, M ulcerans infections usually presented with ulcers, while nodules were common among infections caused by M chelonae and M marinum. Disseminated infections involving multiple organs were observed in 23 patients (24%). Thirty-two cases (30%) were preceded by exposure, including raising or handling fish, trauma, and invasive medical procedures. Most patients were treated with more than two antibiotics and responded to therapy.
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Affiliation(s)
- Chieko Fujishima
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Jumpei Tahara
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Sawa Munemoto
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Chika Hioki
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Hiroka Sasaki
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Haruka Yoshida
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Hiroo Matsuo
- Department of Infectious Diseases, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Yuji Miyamoto
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, Higashimurayama, Japan
| | - Norihisa Ishii
- National Sanatorium Tamazenshoen, Higashimurayama, Japan
| | - Hitoshi Kudo
- Department of Dermatology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
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2
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Rodriguez RR, Alhamad K, Ghosh S, Bihler E, Raj MS. Atypical Mycobacterium Abscessus Infection in Stable Chronic Lymphocytic Leukemia: A Case Report and Review of the Literature. Cureus 2021; 13:e20574. [PMID: 35103153 PMCID: PMC8776059 DOI: 10.7759/cureus.20574] [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] [Accepted: 12/21/2021] [Indexed: 11/05/2022] Open
Abstract
Chronic lymphocytic leukemia is the most common blood cancer in adults. A major cause of morbidity and mortality associated with this cancer stems from opportunistic infections. Similar to many cancers, the inherent effects of battling a raging disease along with the many treatment options causing immunosuppression to lend to the likelihood of obtaining secondary infections. As it is important for physicians to note the ever-increasing secondary complications, which can manifest in the long-term management of immunosuppressed patients, we present a case of an 86-year-old Caucasian female with stable chronic lymphocytic leukemia who developed intermittent presentation of lung abscesses due to growth of atypical Mycobacterium species. With the advent of new treatment options, there has been an increased rate of drug-resistant organisms, lending for the need for more awareness to the severity of these secondary complications and for better options in preventing their occurrence.
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Kham-Ngam I, Chetchotisakd P, Ananta P, Chaimanee P, Reechaipichitkul W, Lulitanond V, Namwat W, Faksri K. Differentiation between persistent infection/colonization and re-infection/re-colonization of Mycobacterium abscessus isolated from patients in Northeast Thailand. INFECTION GENETICS AND EVOLUTION 2018; 68:35-42. [PMID: 30521865 DOI: 10.1016/j.meegid.2018.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 11/20/2018] [Accepted: 12/01/2018] [Indexed: 01/15/2023]
Abstract
Mycobacterium abscessus can cause true infection or be present in the host as a harmless colonist. The ability of M. abscessus to cause disease and develop drug resistance is known to have a genetic basis. We aimed to differentiate between persistent infection and reinfection using multilocus sequence typing (MLST) and to study the genetic diversity of M. abscessus relative to multi-organ infection and drug resistance in Northeast Thailand. DNA was extracted from 62 M. abscessus isolates (24 cases). The following genes were sequenced: argH, cya, glpK, gnd, murC, pta, purH and rpoB. Drug susceptibility tests were performed using broth microdilution. Subspecies classification and phylogeny were determined. Among the 24 cases (62 isolates), 19 cases (49 isolates) were of true NTM infection and 5 cases (13 isolates) examples of colonization. Two subspecies, M. abscessus subsp. massiliense (12 cases, 32 isolates) and M. abscessus subsp. abscessus (12 cases, 30 isolates) were identified. The major sequence type (ST) was ST227. Two clonal groups among patients were found; clonal cluster I (5 cases, 8 isolates) and clonal cluster II (2 cases, 4 isolates) but no epidemiological link was apparent. Reinfection (2 cases with different clones of M. abscessus strains; >9 SNPs different) and persistent infection (14 cases with the same clone; <6 SNPs) were distinguished based on a phylogeny. Based on these SNP cutoff values, 3 cases of persistent colonization (same strain through time) and 2 cases of re-colonization (different strains through time) were identified. M. abscessus subsp. abscessus was significantly associated with clarithromycin resistance (p < .001) and multi-organ infection (p = .03). Molecular epidemiology based on MLST can be used to differentiate between reinfection vs persistent infection, persistent colonization vs re-colonization. ST227 was the main epidemic strain in Northeast Thailand.
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Affiliation(s)
- Irin Kham-Ngam
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand
| | | | - Pimjai Ananta
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Clinical Microbiology Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Prajaub Chaimanee
- Clinical Microbiology Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Wipa Reechaipichitkul
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Viraphong Lulitanond
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand
| | - Wises Namwat
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand
| | - Kiatichai Faksri
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand.
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Miyashita K, Matsuura S, Tajima K, Tajima S, Aoki A, Sakagami T, Koshimizu N, Toyoshima M, Suda T. Disseminated Mycobacterium avium Infection Presenting with Bladder Lesions in a Patient with Interferon-γ-neutralizing Autoantibodies. Intern Med 2018; 57:3041-3045. [PMID: 29780147 PMCID: PMC6232015 DOI: 10.2169/internalmedicine.0965-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 63-year-old woman presented with a fever, eruption, and sterile pyuria. A cystoscopic examination revealed submucosal nodular lesions in the trigone of the bladder, and a biopsy specimen showed epithelioid cell granulomas in the lamina propria of the bladder. Mycobacterium avium grew in the urine culture. Other organ involvement, such as the lungs, spleen, bones, muscles, and pelvic lymph nodes, was observed on radiological examinations, and M. avium was isolated from some organ lesions. Interferon-γ-neutralizing autoantibodies were detected in the patient's serum. Therefore, the patient was diagnosed with disseminated M. avium infection, which was resolved with antimycobacterial treatment.
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Affiliation(s)
- Koichi Miyashita
- Department of Respiratory Medicine, Fujieda City General Hospital, Japan
- Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan
| | - Shun Matsuura
- Department of Respiratory Medicine, Fujieda City General Hospital, Japan
| | - Kenichi Tajima
- Department of Urology, Fujieda City General Hospital, Japan
| | - Shogo Tajima
- Department of Pathology, Graduate School of Medicine University of Tokyo, Japan
| | - Ami Aoki
- Department of Respiratory Medicine and Infectious Disease, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Takuro Sakagami
- Department of Respiratory Medicine and Infectious Disease, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Naoki Koshimizu
- Department of Respiratory Medicine, Fujieda City General Hospital, Japan
| | - Mikio Toyoshima
- Department of Respiratory Medicine, Hamamatsu Rosai Hospital, Japan
| | - Takafumi Suda
- Second Department of Internal Medicine, Hamamatsu University School of Medicine, Japan
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Mycobacterium abscessus Complex Cutaneous Infection. CURRENT TROPICAL MEDICINE REPORTS 2018. [DOI: 10.1007/s40475-018-0151-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Abstract
ABSTRACT
Rapidly growing mycobacteria (RGM) compose approximately one-half of the currently validated mycobacterial species and are divided into six major groups, including the
Mycobacterium fortuitum
group,
M. chelonae/M. abscessus
complex,
M. smegmatis
group,
M. mucogenicum
group,
M. mageritense
/
M. wolinskyi
, and the pigmented RGM. This review discusses each group and highlights the major types of infections associated with each group. Additionally, phenotypic and molecular laboratory identification methods, including gene sequencing, mass spectrometry, and the newly emerging whole-genome sequencing, are detailed, along with a discussion of the current antimicrobial susceptibility methods and patterns of the most common pathogenic species.
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