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Marius M, Fernandez C. Non-Microbiological Mycobacterial Detection Techniques for Quality Control of Biological Products: A Comprehensive Review. Microorganisms 2024; 12:788. [PMID: 38674732 PMCID: PMC11052345 DOI: 10.3390/microorganisms12040788] [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: 03/14/2024] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Mycobacteria can be one of the main contaminants of biological products, and their presence can have serious consequences on patients' health. For this reason, the European Pharmacopoeia mandates the specific testing of biological products for mycobacteria, a critical regulatory requirement aimed at ensuring the safety of these products before they are released to the market. The current pharmacopeial reference, i.e., microbial culture method, cannot ensure an exhaustive detection of mycobacteria due to their growth characteristics. Additionally, the method is time consuming and requires a continuous supply of culture media, posing logistical challenges. Thus, to overcome these issues, pharmaceutical industries need to consider alternative non-microbiological techniques to detect these fastidious, slow-growing contaminating agents. This review provides an overview of alternative methods, which could be applied within a quality control environment for biological products and underlines their advantages and limitations. Nucleic acid amplification techniques or direct measurement of mycobacteria stand out as the most suitable alternatives for mycobacterial testing in biological products.
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Affiliation(s)
- Marine Marius
- Sanofi, 1541 Ave. Marcel Mérieux, 69280 Marcy l’Etoile, France;
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2
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Chow I, Chan S, Lin M, Peters L. Infection du cuir chevelu à Mycobacterium abscessus après une greffe capillaire subie en Amérique centrale. CMAJ 2023; 195:E1731-E1734. [PMID: 38110217 PMCID: PMC10727792 DOI: 10.1503/cmaj.230794-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023] Open
Affiliation(s)
- Ivy Chow
- Département de sciences pharmaceutiques (Chow), Hôpital général de Vancouver; Faculté de sciences pharmaceutiques, Université de la Colombie-Britannique, Vancouver, C.-B.; Autorité sanitaire du Fraser (Chan, Peters), Burnaby, C.-B.; Santé Covenant (Lin); Département de médecine (Lin), Division d'infectiologie, Université de l'Alberta, Edmonton, Alb.; Département de médecine (Peters), Division d'infectiologie, Université de la Colombie-Britannique, Vancouver, C.-B.
| | - Sara Chan
- Département de sciences pharmaceutiques (Chow), Hôpital général de Vancouver; Faculté de sciences pharmaceutiques, Université de la Colombie-Britannique, Vancouver, C.-B.; Autorité sanitaire du Fraser (Chan, Peters), Burnaby, C.-B.; Santé Covenant (Lin); Département de médecine (Lin), Division d'infectiologie, Université de l'Alberta, Edmonton, Alb.; Département de médecine (Peters), Division d'infectiologie, Université de la Colombie-Britannique, Vancouver, C.-B
| | - Molly Lin
- Département de sciences pharmaceutiques (Chow), Hôpital général de Vancouver; Faculté de sciences pharmaceutiques, Université de la Colombie-Britannique, Vancouver, C.-B.; Autorité sanitaire du Fraser (Chan, Peters), Burnaby, C.-B.; Santé Covenant (Lin); Département de médecine (Lin), Division d'infectiologie, Université de l'Alberta, Edmonton, Alb.; Département de médecine (Peters), Division d'infectiologie, Université de la Colombie-Britannique, Vancouver, C.-B
| | - Laurenna Peters
- Département de sciences pharmaceutiques (Chow), Hôpital général de Vancouver; Faculté de sciences pharmaceutiques, Université de la Colombie-Britannique, Vancouver, C.-B.; Autorité sanitaire du Fraser (Chan, Peters), Burnaby, C.-B.; Santé Covenant (Lin); Département de médecine (Lin), Division d'infectiologie, Université de l'Alberta, Edmonton, Alb.; Département de médecine (Peters), Division d'infectiologie, Université de la Colombie-Britannique, Vancouver, C.-B
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3
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Chow I, Chan S, Lin M, Peters L. Mycobacterium abscessus scalp infection after hair transplantation in Central America. CMAJ 2023; 195:E1440-E1442. [PMID: 37903523 PMCID: PMC10615345 DOI: 10.1503/cmaj.230794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023] Open
Affiliation(s)
- Ivy Chow
- Department of Pharmaceutical Sciences (Chow), Vancouver General Hospital; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC; Fraser Health Authority (Chan, Peters), Burnaby, BC; Covenant Health (Lin); Department of Medicine (Lin), Division of Infectious Diseases, University of Alberta, Edmonton, Alta.; Department of Medicine (Peters), Division of Infectious Diseases, University of British Columbia, Vancouver, BC
| | - Sara Chan
- Department of Pharmaceutical Sciences (Chow), Vancouver General Hospital; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC; Fraser Health Authority (Chan, Peters), Burnaby, BC; Covenant Health (Lin); Department of Medicine (Lin), Division of Infectious Diseases, University of Alberta, Edmonton, Alta.; Department of Medicine (Peters), Division of Infectious Diseases, University of British Columbia, Vancouver, BC
| | - Molly Lin
- Department of Pharmaceutical Sciences (Chow), Vancouver General Hospital; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC; Fraser Health Authority (Chan, Peters), Burnaby, BC; Covenant Health (Lin); Department of Medicine (Lin), Division of Infectious Diseases, University of Alberta, Edmonton, Alta.; Department of Medicine (Peters), Division of Infectious Diseases, University of British Columbia, Vancouver, BC
| | - Laurenna Peters
- Department of Pharmaceutical Sciences (Chow), Vancouver General Hospital; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC; Fraser Health Authority (Chan, Peters), Burnaby, BC; Covenant Health (Lin); Department of Medicine (Lin), Division of Infectious Diseases, University of Alberta, Edmonton, Alta.; Department of Medicine (Peters), Division of Infectious Diseases, University of British Columbia, Vancouver, BC
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4
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Kaur H, Reyes-Barron C, Sipprell WH, Cameron A, Louie T, Tsai PR, Scott G. Painful Purulent Nodules Caused by Mycobacterium at Site of Lipodissolve Injections. Am J Dermatopathol 2022; 44:257-259. [PMID: 34999596 DOI: 10.1097/dad.0000000000002118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT "Lipodissolve" (LD) is a non-FDA-approved solution of phosphatidylcholine in deoxycholate that was developed around 2004. A study of its safety reported minor and uncommon side effects including pain, tender nodules, pigmentary alterations, and ulceration at the site of injection. We present a 53-year-old woman who received LD injections bilaterally to her proximal arms. One week later, she developed painful nodules at each injection site. She was treated with a 10-day course of trimethoprim/sulfamethoxazole without improvement. An incisional biopsy was performed and showed deep dermal suppurative inflammation with numerous neutrophils and granulomas. Stains for bacteria, fungus, and acid-fast organisms were negative. Cultures for acid-fast bacilli grew Mycobacterium abscessus, sensitive to amikacin and clarithromycin. The patient was subsequently treated with intravenous amikacin, azithromycin, and bedaquiline with symptom resolution. Investigation revealed 3 similar infections linked to LD injections originating from the same physician's office. The most common organism implicated in injection infections is Staphylococcus aureus. Infections at injection sites caused by atypical mycobacteria have been reported to occur after tattooing, other types of injections, and implants. Of atypical mycobacteria, M. abscessus accounts for the greatest number of postinjection or iatrogenic infections. Common antitubercular drugs are not effective for treating atypical mycobacteria, making species identification and sensitivity testing imperative for treatment. This case highlights an unusual infection caused by cosmetic injections of LD, previously reported to be associated with minimal side effects, and the importance of examination for acid-fast bacilli and follow-up with culture, even in the absence of organisms identified on stained sections.
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Affiliation(s)
- Harsimran Kaur
- Department of Pathology and Laboratory Medicine, URMC, Rochester, NY
| | | | | | - Andrew Cameron
- Department of Pathology and Laboratory Medicine, URMC, Rochester, NY
| | | | | | - Glynis Scott
- Department of Pathology and Laboratory Medicine, URMC, Rochester, NY
- Dermatology, URMC, Rochester, NY
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5
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Kavitha K, Ragunathan L, Elantheriyan P, Gopalakrishnan K, Gopala KA, Balamurugan ID, Navya RR, Marcella SS, Venkatachalam GK. The burden of mycobacteria species among children from postvaccination abscess in Southern India. Int J Mycobacteriol 2021; 10:358-363. [PMID: 34916452 DOI: 10.4103/ijmy.ijmy_190_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background From the time vaccines were introduced, their impact has been beyond measurable. Mycobacteria are pathogens increasingly isolated from postvaccination abscess. Identification of these pathogens plays a very crucial role in the management of these babies. We aimed to determine Mycobacterial spp occurrence from vaccination abscess, draw local antibiogram, and guide management of babies with vaccination abscess. Methods Babies with postvaccination abscess from 2016 to 2020 were included. Pus collected during incision and drainage was processed as per the standard guidelines. Mycobacterium isolates were identified by conventional methods, and all samples were confirmed by polymerase chain reaction. All babies underwent incision and drainage, and all were started with amoxicillin and clavulanic acid and changed later as per the sensitivity report. Results Mycobacterium abscessus was isolated from 17% (12) pus samples from 71 postdiphtheria pertussis and tetanus vaccination, and Mycobacterium bovis was isolated from 83.3% (10) babies with post-Bacillus Calmette-Guérin vaccination. The mean interval between injection and abscess formation was 32.75 days in case of M. abscessus, whereas it was 50.4 days in case of M. bovis. All the M. abscessus were sensitive to linezolid, amikacin, and clarithromycin, whereas no treatment except incision and drainage was required for M. bovis. Conclusion There is an increased incidence of Mycobacterial spp infection in postvaccination abscess. All babies with M abscessus responded well with combination antibiotic therapy plus drainage of abscesses, whereas M. bovis was treated by incision and drainage, and no further antibiotics were given.
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Affiliation(s)
- Kannaiyan Kavitha
- Department of Microbiology, Aarupadai Veedu Medical College and Hospital, Puducherry, India
| | - Latha Ragunathan
- Department of Microbiology, Aarupadai Veedu Medical College and Hospital, Puducherry, India
| | | | - Kuppusamy Gopalakrishnan
- Department of Anesthesiology, Sri Lakshmi Narayana Medical College and Hospital, Puducherry, India
| | | | | | - Ragunadha Reddy Navya
- Department of Microbiology, Aarupadai Veedu Medical College and Hospital, Puducherry, India
| | - Sherin Samuel Marcella
- Department of Microbiology, Aarupadai Veedu Medical College and Hospital, Puducherry, India
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van der Loo C, Bartie C, Barnard TG, Potgieter N. Detection of Free-Living Amoebae and Their Intracellular Bacteria in Borehole Water before and after a Ceramic Pot Filter Point-of-Use Intervention in Rural Communities in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3912. [PMID: 33917870 PMCID: PMC8068299 DOI: 10.3390/ijerph18083912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/26/2021] [Accepted: 04/02/2021] [Indexed: 11/21/2022]
Abstract
Free-living amoebae (FLA) are ubiquitous in nature, whereas amoeba-resistant bacteria (ARB) have evolved virulent mechanisms that allow them to resist FLA digestion mechanisms and survive inside the amoeba during hostile environmental conditions. This study assessed the prevalence of FLA and ARB species in borehole water before and after a ceramic point-of-use intervention in rural households. A total of 529 water samples were collected over a five-month period from 82 households. All water samples were subjected to amoebal enrichment, bacterial isolation on selective media, and molecular identification using 16S PCR/sequencing to determine ARB species and 18S rRNA PCR/sequencing to determine FLA species present in the water samples before and after the ceramic pot intervention. Several FLA species including Acanthamoeba spp. and Mycobacterium spp. were isolated. The ceramic pot filter removed many of these microorganisms from the borehole water. However, design flaws could have been responsible for some FLA and ARB detected in the filtered water. FLA and their associated ARB are ubiquitous in borehole water, and some of these species might be potentially harmful and a health risk to vulnerable individuals. There is a need to do more investigations into the health risk of these organisms after point-of-use treatment.
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Affiliation(s)
- Clarissa van der Loo
- Water and Health Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa; (C.v.d.L.); (T.G.B.)
| | | | - Tobias George Barnard
- Water and Health Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa; (C.v.d.L.); (T.G.B.)
| | - Natasha Potgieter
- Environmental Health, Domestic Hygiene and Microbial Pathogens Research Group, Department of Microbiology, University of Venda, Thohoyandou 1950, South Africa
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Dash A, Gupta N, Ray Y, Kodan P, Singh BK, Soneja M. Choosing the therapy for neurological infection with rapidly growing mycobacteria. Drug Discov Ther 2020; 14:211-212. [PMID: 32830168 DOI: 10.5582/ddt.2020.03026] [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: 11/05/2022]
Abstract
The management of neurological infections due to non-tubercular mycobacteria is extremely challenging because of scarce literature, issues with penetration, lack of easily available susceptibility platforms and adverse effects associated with long term therapy. We report a case of a young girl with neurological infection due to rapidly growing mycobacteria to discuss the factors that should be considered while choosing the therapy for such rare and persistent infections.
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Affiliation(s)
- Atman Dash
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Nitin Gupta
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Yogiraj Ray
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Parul Kodan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Binit Kumar Singh
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Soneja
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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8
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Joseph C, Petit C, Schmit JL, Drancourt M, Pluquet E, Lanoix JP. Community-acquired granulomatous mastitis superinfected with Mycobacterium bolletii. Med Mal Infect 2019; 50:291-292. [PMID: 31806269 DOI: 10.1016/j.medmal.2019.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/04/2019] [Indexed: 11/25/2022]
Affiliation(s)
- C Joseph
- Infectious Diseases Department, University Hospital, Amiens, France; AGIR: Microbiology Research Unit, EA4294, Jules Verne University of Picardie, Amiens, France.
| | - C Petit
- Infectious Diseases Department, University Hospital, Amiens, France
| | - J L Schmit
- Infectious Diseases Department, University Hospital, Amiens, France; AGIR: Microbiology Research Unit, EA4294, Jules Verne University of Picardie, Amiens, France
| | - M Drancourt
- Microbiology Laboratory, Hygiene, Hospital Epidemiology, La Timone Hospital, University Hospital, Marseille, France
| | - E Pluquet
- Bacteriology Laboratory, University Hospital, Amiens, France; AGIR: Microbiology Research Unit, EA4294, Jules Verne University of Picardie, Amiens, France
| | - J P Lanoix
- Infectious Diseases Department, University Hospital, Amiens, France; AGIR: Microbiology Research Unit, EA4294, Jules Verne University of Picardie, Amiens, France
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Jones RS, Shier KL, Master RN, Bao JR, Clark RB. Current significance of the Mycobacterium chelonae-abscessus group. Diagn Microbiol Infect Dis 2019; 94:248-254. [PMID: 30954313 DOI: 10.1016/j.diagmicrobio.2019.01.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 02/08/2023]
Abstract
Organisms of the Mycobacterium chelonae-abscessus group can be significant pathogens in humans. They produce a number of diseases including acute, invasive and chronic infections, which may be difficult to diagnose correctly. Identification among members of this group is complicated by differentiating at least eleven (11) known species and subspecies and complexity of identification methodologies. Treatment of their infections may be problematic due to their correct species identification, antibiotic resistance, their differential susceptibility to the limited number of drugs available, and scarcity of susceptibility testing.
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Affiliation(s)
- Robert S Jones
- Infectious Disease Department, Quest Diagnostics Nichols Institute, Chantilly, VA 20131
| | - Kileen L Shier
- Infectious Disease Department, Quest Diagnostics Nichols Institute, Chantilly, VA 20131
| | - Ronald N Master
- Infectious Disease Department, Quest Diagnostics Nichols Institute, Chantilly, VA 20131
| | - Jian R Bao
- Infectious Disease Department, Quest Diagnostics Nichols Institute, Chantilly, VA 20131
| | - Richard B Clark
- Infectious Disease Department, Quest Diagnostics Nichols Institute, Chantilly, VA 20131.
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10
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Lamb GS, Starke JR. Mycobacterium abscessus Infections in Children: A Review of Current Literature. J Pediatric Infect Dis Soc 2018; 7:e131-e144. [PMID: 29897511 DOI: 10.1093/jpids/piy047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 05/02/2018] [Indexed: 12/12/2022]
Abstract
There is limited literature on Mycobacterium abscessus infections in children and limited data about its diagnosis and management. The incidence of infections due to M abscessus appears to be increasing in certain populations and can be a significant cause of morbidity and mortality.Management of these infections is challenging and relies on combination antimicrobial therapy and debridement of diseased tissue, depending on the site and extent of disease. Treatment regimens often are difficult to tolerate, and the antimicrobials used can cause significant adverse effects, particularly given the long duration of therapy needed.This review summarizes the literature and includes information from our own institution's experience on pediatric M abscessus infections including the epidemiology, transmission, clinical manifestations, and the management of these infections. Adult data have been used where there are limited pediatric data. Further studies regarding epidemiology and risk factors, clinical presentation, optimal treatment, and outcomes in children are necessary.
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Abstract
Nontuberculous mycobacteria (NTM) include species that colonize human epithelia, as well as species that are ubiquitous in soil and aquatic environments. NTM that primarily inhabit soil and aquatic environments include the Mycobacterium avium complex (MAC, M. avium and Mycobacterium intracellulare) and the Mycobacterium abscessus complex (MABSC, M. abscessus subspecies abscessus, massiliense, and bolletii), and can be free-living, biofilm-associated, or amoeba-associated. Although NTM are rarely pathogenic in immunocompetent individuals, those who are immunocompromised - due to either an inherited or acquired immunodeficiency - are highly susceptible to NTM infection (NTMI). Several characteristics such as biofilm formation and the ability of select NTM species to form distinct colony morphotypes all may play a role in pathogenesis not observed in the related, well-characterized pathogen Mycobacterium tuberculosis The recognition of different morphotypes of NTM has been established and characterized since the 1950s, but the mechanisms that underlie colony phenotype change and subsequent differences in pathogenicity are just beginning to be explored. Advances in genomic analysis have led to progress in identifying genes important to the pathogenesis and persistence of MAC disease as well as illuminating genetic aspects of different colony morphotypes. Here we review recent literature regarding NTM ecology and transmission, as well as the factors which regulate colony morphotype and pathogenicity.
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Affiliation(s)
- Tiffany A Claeys
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Richard T Robinson
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
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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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Tang P, Walsh S, Murray C, Alterman C, Varia M, Broukhanski G, Chedore P, DeKoven J, Assaad D, Gold WL, Ghazarian D, Finkelstein M, Pritchard M, Yaffe B, Jamieson F, Henry B, Phillips E. Outbreak of Acupuncture-Associated Cutaneous Mycobacterium Abscessus Infections. J Cutan Med Surg 2016; 10:166-9. [PMID: 17234114 DOI: 10.2310/7750.2006.00041] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Cutaneous atypical mycobacterial infections have been increasingly described in association with cosmetic and alternative procedures. Objective: We report an outbreak of acupuncture-associated mycobacteriosis. Between April and December 2002, 32 patients developed cutaneous mycobacteriosis after visiting an acupuncture practice in Toronto, Canada. Results: Of 23 patients whose lesions were biopsied, 6 (26.1%) had culture-confirmed infection with Mycobacterium abscessus. These isolates were genetically indistinguishable by amplified fragment length polymorphism. The median incubation period was 1 month. Of 24 patients for whom clinical information was available, 23 (95.8%) had resolution of their infection. All patients developed residual scarring or hyperpigmentation. Conclusion: Nontuberculous mycobacteria should be recognized as an emerging, but preventable, cause of acupuncture-associated infections.
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Affiliation(s)
- Patrick Tang
- Department of Laboratory Medicine, Toronto, ON, Canada
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Subinhibitory Doses of Aminoglycoside Antibiotics Induce Changes in the Phenotype of Mycobacterium abscessus. Antimicrob Agents Chemother 2015. [PMID: 26195529 DOI: 10.1128/aac.01132-15] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Subinhibitory doses of antibiotics have been shown to cause changes in bacterial morphology, adherence ability, and resistance to antibiotics. In this study, the effects of subinhibitory doses of aminoglycoside antibiotics on Mycobacterium abscessus were investigated. The treatment of M. abscessus cells with subinhibitory doses of amikacin was found to change their colony from a smooth to a rough morphotype and increase their ability to adhere to a polyvinylchloride plate, aggregate in culture, and resist phagocytosis and killing by macrophages. M. abscessus cells treated with a subinhibitory dose of amikacin also became more potent in Toll-like receptor 2 (TLR-2) stimulation, leading to increased tumor necrosis factor alpha (TNF-α) production by macrophages. The MAB_3508c gene was shown to play a role in mediating these phenotypic changes, as its expression in M. abscessus cells was increased when they were treated with a subinhibitory dose of amikacin. In addition, overexpression of MAB_3508c in M. abscessus cells caused changes similar to those induced by subinhibitory doses of amikacin, including a switch from smooth to rough colony morphology, increased ability to aggregate in liquid culture, decreased motility, and increased resistance to killing by macrophages. These findings suggest the importance of using sufficient doses of antibiotics for the treatment of M. abscessus infections.
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15
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Bacterial phospholipases C as vaccine candidate antigens against cystic fibrosis respiratory pathogens: the Mycobacterium abscessus model. Vaccine 2015; 33:2118-24. [PMID: 25804706 DOI: 10.1016/j.vaccine.2015.03.030] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 03/05/2015] [Accepted: 03/11/2015] [Indexed: 01/16/2023]
Abstract
BACKGROUND Vaccine strategies represent one of the fighting answers against multiresistant bacteria in a number of clinical settings like cystic fibrosis (CF). Mycobacterium abscessus, an emerging CF pathogen, raises difficult therapeutic problems due to its intrinsic antibiotic multiresistance. METHODS By reverse vaccinology, we identified M. abscessus phospholipase C (MA-PLC) as a potential vaccine target. We deciphered here the protective response generated by vaccination with plasmid DNA encoding the MA-PLC formulated with a tetra functional block copolymer 704, in CF (ΔF508) mice. Protection was tested against aerosolized smooth and rough (hypervirulent) variants of M. abscessus. RESULTS MA-PLC DNA vaccination (days 0, 21, 42) elicited a strong antibody response. A significant protective effect was obtained against aerosolized M. abscessus (S variant) in ΔF508 mice, but not in wild-type FVB littermates; similar results were observed when: (i) challenging mice with the "hypervirulent" R variant, and; (ii) immunizing mice with purified MA-PLC protein. High IgG titers against MA-PLC protein were measured in CF patients with M. abscessus infection; interestingly, significant titers were also detected in CF patients positive for Pseudomonas aeruginosa versus P. aeruginosa-negative controls. CONCLUSIONS MA-PLC DNA- and PLC protein-vaccinated mice cleared more rapidly M. abscessus than β-galactosidase DNA- or PBS- vaccinated mice in the context of CF. PLCs could constitute interesting vaccine targets against common PLC-producing CF pathogens like P. aeruginosa.
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Non-tuberculous mycobacterial infection in hospitalized children: a case series. Epidemiol Infect 2015; 143:3173-81. [DOI: 10.1017/s0950268815000333] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
SUMMARYNon-tuberculous mycobacteria (NTM) illness is an emerging life-threatening infection, and paediatric features have not been well studied. The objective of our study was to review the NTM isolates of hospitalized paediatric patients identified at our institution and to describe the characteristics of these cases. Our retrospective chart review from 2010 to 2013 identified 45 patients with 46 positive NTM cultures. Fifteen (33%) patients had received haematopoietic cell transplant, 13 (29%) had cystic fibrosis, and six (13%) were previously healthy. Twenty-seven (59%) NTM isolates were Mycobacterium chelonae/abscessus, 14 (30%) were M. avium intracellulare, and four (9%) were M. immunogenum. The majority (65%) of cases were community-acquired, and 20 (43%) patients were treated as infection. This case series identified a predominance of M. chelonae/abscessus, and includes a substantial number of haematopoietic cell transplant patients, which reflects the changing spectrum of NTM disease as molecular diagnostics improve and quaternary care facilities provide for a larger immunocompromised population.
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Blossom DB, Alelis KA, Chang DC, Flores AH, Gill J, Beall D, Peterson AM, Jensen B, Noble-Wang J, Williams M, Yakrus MA, Arduino MJ, Srinivasan A. Pseudo-outbreak ofMycobacterium abscessusInfection Caused by Laboratory Contamination. Infect Control Hosp Epidemiol 2015; 29:57-62. [DOI: 10.1086/524328] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective.To investigate the cause(s) of an increased incidence of clinical cultures growingMycobacterium abscessusat a hospital in Florida.Design.Outbreak investigation.Setting.University-affiliated, tertiary-care hospital.Methods.A site visit was done during the first week of September 2006. We reviewed the medical records of patients from whomM. abscessuswas recovered during the period from January 1, 2003, through June 30, 2006. We collected environmental samples from various sites and evaluated specimen processing procedures in the microbiology laboratory. Isolates ofM. abscessusrecovered from the environment and from 12 randomly selected patients who sought medical care in 2006 were compared by pulsed-field gel electrophoresis (PFGE). Follow-up case surveillance was continued through March 31, 2007.Results.Specimens from 143 patients obtained from various anatomical sites grewM. abscessuson culture in 2005-2006, compared with specimens from 21 patients in 2003-2004. The 12 isolates from patients that were selected for molecular typing had indistinguishable PFGE patterns. Observations revealed no major breaches in the processing of mycobacterial specimens in the laboratory. Isolates grew only after prolonged incubation (mean ± SD, 45 ± 15 days) in test tubes containing diagonally oriented Middlebrook and Cohn 7H10 agar or Lowenstein-Jensen medium. Environmental samples obtained from the inside of the specimen incubator grewM. abscessuson culture. A test tube containing diagonally oriented, uninoculated Middlebrook and Cohn 7H10 agar that was incubated in the same incubator as clinical specimens grewM. abscessuswith a PFGE pattern that matched the pattern of the patient isolates. Cases ofM. abscessusinfection decreased to baseline after the hospital changed suppliers of mycobacterial media and cleaned the incubator.Conclusions.Although the source was never confirmed, our investigation suggests that this was a pseudo-outbreak ofM. abscessusinfection that resulted from contamination of mycobacterial cultures during incubation. Our findings emphasize the need for guidance on the disinfection of specimen incubators.
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Rapidly growing mycobacteria among pediatric hematopoietic cell transplant patients traced to the hospital water supply. Pediatr Infect Dis J 2014; 33:1043-6. [PMID: 24781138 DOI: 10.1097/inf.0000000000000391] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rapidly growing mycobacteria (RGM) have a predilection for those with immunocompromised states. We report increased isolation of RGM among pediatric hematopoietic cell transplant patients that was traced to the hospital water supply. METHODS Cases of RGM-positive patients were differentiated based on whether they were community-acquired or nosocomial, colonized or infected based on predefined criteria. Medical records of all RGM-positive patients were reviewed and data extracted. Infection control outbreak measures were instituted and an environmental investigation was conducted. RESULTS Between July 2011 and April 2012, 16 RGM isolates were identified among 15 hematopoietic cell transplant patients, compared with none in the preceding year. After environmental samples were initially grown on media for heterotrophic counts and further speciated, RGM species were identified in the hospital water supply. CONCLUSIONS This outbreak of RGM was traced to an environmental source and was successfully controlled through institution of infection control measures.
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Outbreak of primary inoculation tuberculosis in an acupuncture clinic in southeastern China. Epidemiol Infect 2014; 143:943-8. [PMID: 25148461 DOI: 10.1017/s0950268814002039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Outbreak of Mycobacterium tuberculosis infections associated with acupuncture has not been reported. Thirteen patients with a painful swollen lump were referred to our hospital. The index patient received acupuncture and paraspinal muscular injection at a local acupuncture clinic in April 2011 and was diagnosed with M. tuberculosis 1 month later. From May 2011 to August 2011, 12 more patients with a swollen lump on the nuchal region or in the lower back or the buttocks region were referred to our hospital. Tuberculin skin test (TST), T-SPOT.TB, acid-fast stain, M. tuberculosis culture, chest radiograph, and lump magnetic resonance imaging (MRI) were performed and the patients were diagnosed with tuberculous abscess of the lump. All 13 patients received intramuscular injection at the paraspinal muscle by two acupuncturists at a local clinic and reported a swollen lump at the injection site. The needles and syringes were reused after autoclave sterilization. The TST was positive in all patients. Twelve patients had positive acid-fast stains. Mycobacterial cultures of abscess specimens were positive in all 13 patients. T-SPOT.TB tests were positive in all patients who underwent the test. The lesions and biopsies were subjected to polymerase chain reaction (PCR) and gene sequencing by the Disease Control Center of Zhejiang Province, China and the causative agent was identified as M. tuberculosis, Beijing type. In conclusion, physicians should consider the possibility of mycobacterial infections, apart from other bacterial agents, in patients with a swollen paraspinal lump following intramuscular injection.
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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.
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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.
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Kreutzfeldt KM, McAdam PR, Claxton P, Holmes A, Seagar AL, Laurenson IF, Fitzgerald JR. Molecular longitudinal tracking of Mycobacterium abscessus spp. during chronic infection of the human lung. PLoS One 2013; 8:e63237. [PMID: 23696800 PMCID: PMC3655965 DOI: 10.1371/journal.pone.0063237] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 04/02/2013] [Indexed: 11/21/2022] Open
Abstract
The Mycobacterium abscessus complex is an emerging cause of chronic pulmonary infection in patients with underlying lung disease. The M. abscessus complex is regarded as an environmental pathogen but its molecular adaptation to the human lung during long-term infection is poorly understood. Here we carried out a longitudinal molecular epidemiological analysis of 178 M. abscessus spp. isolates obtained from 10 cystic fibrosis (CF) and 2 non CF patients over a 13 year period. Multi-locus sequence and molecular typing analysis revealed that 11 of 12 patients were persistently colonized with the same genotype during the course of the infection while replacement of a M. abscessus sensu stricto strain with a Mycobacterium massiliense strain was observed for a single patient. Of note, several patients including a pair of siblings were colonized with closely-related strains consistent with intra-familial transmission or a common infection reservoir. In general, a switch from smooth to rough colony morphology was observed during the course of long-term infection, which in some cases correlated with an increasing severity of clinical symptoms. To examine evolution during long-term infection of the CF lung we compared the genome sequences of 6 sequential isolates of Mycobacterium bolletii obtained from a single patient over an 11 year period, revealing a heterogeneous clonal infecting population with mutations in regulators controlling the expression of virulence factors and complex lipids. Taken together, these data provide new insights into the epidemiology of M. abscessus spp. during long-term infection of the CF lung, and the molecular transition from saprophytic organism to human pathogen.
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Affiliation(s)
- Kaj M. Kreutzfeldt
- The Roslin Institute and Edinburgh Infectious Diseases, University of Edinburgh, Easter Bush Campus, Edinburgh, United Kingdom
| | - Paul R. McAdam
- The Roslin Institute and Edinburgh Infectious Diseases, University of Edinburgh, Easter Bush Campus, Edinburgh, United Kingdom
| | - Pauline Claxton
- Scottish Mycobacteria Reference Laboratory (SMRL), Clinical Microbiology, Royal Infirmary of Edinburgh, Little France, Edinburgh, United Kingdom
| | - Anne Holmes
- The Roslin Institute and Edinburgh Infectious Diseases, University of Edinburgh, Easter Bush Campus, Edinburgh, United Kingdom
| | - A. Louise Seagar
- Scottish Mycobacteria Reference Laboratory (SMRL), Clinical Microbiology, Royal Infirmary of Edinburgh, Little France, Edinburgh, United Kingdom
| | - Ian F. Laurenson
- Scottish Mycobacteria Reference Laboratory (SMRL), Clinical Microbiology, Royal Infirmary of Edinburgh, Little France, Edinburgh, United Kingdom
| | - J. Ross Fitzgerald
- The Roslin Institute and Edinburgh Infectious Diseases, University of Edinburgh, Easter Bush Campus, Edinburgh, United Kingdom
- * E-mail:
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Kang SJ, Kim H, Park KU, Lim YA, Lee WG. A Case Report ofMycobacterium abscessusPeritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis. ANNALS OF CLINICAL MICROBIOLOGY 2013. [DOI: 10.5145/acm.2013.16.2.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Seon Joo Kang
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Heungsoo Kim
- Department of Nephrology, Ajou University School of Medicine, Suwon, Korea
| | - Kyoung Un Park
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Ae Lim
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Wee Gyo Lee
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea
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Senna SG, Marsico AG, Vieira GBDO, Sobral LF, Suffys PN, Fonseca LDS. Identification of nontuberculous mycobacteria isolated from clinical sterile sites in patients at a university hospital in the city of Rio de Janeiro, Brazil. J Bras Pneumol 2012; 37:521-6. [PMID: 21881743 DOI: 10.1590/s1806-37132011000400015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 05/02/2011] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify nontuberculous mycobacteria (NTM) isolated from sterile sites in patients hospitalized between 2001 and 2006 at the Clementino Fraga Filho University Hospital, located in the city of Rio de Janeiro, Brazil. METHODS During the study period, 34 NTM isolates from sterile sites of 14 patients, most of whom were HIV-positive, were submitted to phenotypic identification and hsp65 PCR-restriction enzyme analysis (PRA). RESULTS Most isolates were identified as Mycobacterium avium, followed by M. monacense, M. kansasii, and M. abscessus. CONCLUSIONS The combination of PRA, a relatively simple and inexpensive method, with the evaluation of a few phenotypic characteristics can allow NTM to be accurately identified in the routine of clinical laboratories.
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Yasar KK, Pehlivanoglu F, Sengoz G, Cabioglu N. Successfully treated Mycobacterium abscessus mastitis: a rare cause of breast masses. Indian J Med Microbiol 2012; 29:425-7. [PMID: 22120809 DOI: 10.4103/0255-0857.90187] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Rapidly growing mycobacteria are pathogens responsible for cutaneous or subcutaneous infections especially occurring after injection, trauma or surgery. We describe a patient with Mycobacterium abscessus mastitis that presented as a mass lesion and haemorrhagical discharge. It was initially diagnosed and treated as fibrocystic disease and non-specific abscess. Full recovery was obtained with combination therapy of clarithromycin, linezolid and amikacin without surgical debridement followed by several abscess aspirations. Atypical mycobacteria should be considered in diagnosis of chronic breast lesions in endemic areas. This is the first reported case of mastitis due to M. abscessus in Turkey.
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Affiliation(s)
- K K Yasar
- Department of Clinical Microbiology and Infectious Diseases, Haseki Training and Research Hospital, Adnan Adivar Cad. Aksaray, Istanbul 343, Turkey.
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Song JY, Son JB, Lee MK, Gwack J, Lee KS, Park JY. Case series of mycobacterium abscessus infections associated with a trigger point injection and epidural block at a rural clinic. Epidemiol Health 2012; 34:e2012001. [PMID: 22323979 PMCID: PMC3272546 DOI: 10.4178/epih/e2012001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 12/28/2011] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The aim of this report is to investigate Mycobacterium abscessus infections at a rural clinic and carry out a surveillance program to determine the extent and source of these infections. METHODS The authors conducted an active surveillance investigation of 36 patients who had visited the clinic since 1 July 2008. Clinical specimens were collected from the patients and an envirnmental investigation. Pulsed-field gel elctrophoresis (PFGE) was performed for comparing with M. abscessus isolates from the patients. RESULTS Six specimens were obtained from the 6 patients respectively and 22 environmental samples were obtained. M. abscessus was isolated from the wounds of two patients, and various nosocomial pathogens, but not M. abscessus, were isolated from the surrounding environment. Two strains of M. abscessus from patients were identical as a result of PFGE. CONCLUSION Infection control education including proper hand hygiene should be emphasized for physicians performing invasive procedures. There also needs to be more attention for invasive procedures management, including trigger point injection and epidural block in rural clinics.
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Affiliation(s)
- Jun Young Song
- Epidemic Intelligence Service, Division of Public Health Administration, Gyeongnam Provincial Office, Changwon, Korea
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Satyanarayana S, Kalghatgi AT, Varghese A. Atypical Mycobacterial Injection Abscess. Med J Armed Forces India 2011; 59:246-7. [PMID: 27407528 DOI: 10.1016/s0377-1237(03)80020-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- S Satyanarayana
- Associate Professor, Department of Pathology, Armed Forces Medical College. Pune 411 040
| | - A T Kalghatgi
- Associate Professor, Department of Microbiology, Armed Forces Medical College. Pune 411 040
| | - A Varghese
- Resident, Department of Pathology, Armed Forces Medical College. Pune 411 040
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Ricciardo B, Weedon D, Butler G. Mycobacterium abscessus infection complicating a professional tattoo. Australas J Dermatol 2011; 51:287-9. [PMID: 21198529 DOI: 10.1111/j.1440-0960.2010.00659.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A healthy 23-year-old man presented with a tender papular eruption confined to the grey pigment of a recently acquired professional tattoo. Atypical mycobacterial infection was suspected and culture of a tissue specimen grew Mycobacterium abscessus. He was successfully treated with minocycline and subsequently, clarithromycin. We present a brief review of M. abscessus infection, with a particular focus on its role in nosocomial infections and in the post-tattoo setting.
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Affiliation(s)
- Bernadette Ricciardo
- Department of Dermatology, Royal Perth Hospital, East Perth, Western Australia, Australia.
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Choi WS, Kim MJ, Park DW, Son SW, Yoon YK, Song T, Bae SM, Sohn JW, Cheong HJ, Kim MJ. Clarithromycin and amikacin vs. clarithromycin and moxifloxacin for the treatment of post-acupuncture cutaneous infections due to Mycobacterium abscessus: a prospective observational study. Clin Microbiol Infect 2010; 17:1084-90. [PMID: 20946409 DOI: 10.1111/j.1469-0691.2010.03395.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
An outbreak of post-acupuncture cutaneous infections due to Mycobacterium abscessus occurred in Ansan, Korea, from November 2007 through to May 2008. During this time a prospective, observational, non-randomized study was conducted involving 52 patients that were diagnosed with cutaneous M. abscessus infection. We compared the clinical response between patients treated with clarithromycin plus amikacin regimen and those treated with clarithromycin plus moxifloxacin regimens with regard to time to resolution of the cutaneous lesions. Among the 52 study patients, 33 were treated with clarithromycin plus amikacin, and 19 were treated with clarithromycin plus moxifloxacin. The baseline characteristics for the treatment groups were not significantly different, except for initial surgical excision (n = 27 vs. 6, respectively, p = 0.001). The median time (weeks) to resolution of the lesions in the clarithromycin plus moxifloxacin-treated subjects was significantly shorter than that in the clarithromycin plus amikacin-treated subjects (17 ± 1.1 vs. 20 ± 0.9, respectively, p = 0.017). With adjustments for age, location of lesions, prior incision and drainage, and excision during medical therapy, clarithromycin plus moxifloxacin-treated subjects were more likely to have resolved lesions (hazard ratio, 0.387; 95% confidence interval, 0.165-0.907; p = 0.029). The frequency of drug-related adverse events in the two treatment groups was not significantly different (n = 18 vs. 14, respectively; p = 0.240). The most common adverse event was gastrointestinal discomfort. The results of our study showed that the combination regimen of clarithromycin and moxifloxacin resulted in a better clinical response than a regimen of clarithromycin plus amikacin when used for treatment of cutaneous M. abscessus infection.
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Affiliation(s)
- W S Choi
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea
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Kim WJ, Shin KH, Hwang JM, Kim KH, Choi HK, Lee SH, Lee SJ. Knee Joint Osteomyelitis due to Mycobacterium abscessus: A Case Report. Infect Chemother 2010. [DOI: 10.3947/ic.2010.42.5.315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Won Jin Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kyung Hwa Shin
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Jong Min Hwang
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kye-Hyung Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Hee Kyoung Choi
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Sun Hee Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Su Jin Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
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Yuan J, Liu Y, Yang Z, Cai Y, Deng Z, Qin P, Li T, Dong Z, Yan Z, Zhou D, Luo H, Ma H, Pang X, Fontaine RE. Mycobacterium abscessus post-injection abscesses from extrinsic contamination of multiple-dose bottles of normal saline in a rural clinic. Int J Infect Dis 2009; 13:537-42. [DOI: 10.1016/j.ijid.2008.11.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Revised: 10/27/2008] [Accepted: 11/08/2008] [Indexed: 11/29/2022] Open
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Non mycobacterial virulence genes in the genome of the emerging pathogen Mycobacterium abscessus. PLoS One 2009; 4:e5660. [PMID: 19543527 PMCID: PMC2694998 DOI: 10.1371/journal.pone.0005660] [Citation(s) in RCA: 268] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2008] [Accepted: 04/28/2009] [Indexed: 11/19/2022] Open
Abstract
Mycobacterium abscessus is an emerging rapidly growing mycobacterium (RGM) causing a pseudotuberculous lung disease to which patients with cystic fibrosis (CF) are particularly susceptible. We report here its complete genome sequence. The genome of M. abscessus (CIP 104536T) consists of a 5,067,172-bp circular chromosome including 4920 predicted coding sequences (CDS), an 81-kb full-length prophage and 5 IS elements, and a 23-kb mercury resistance plasmid almost identical to pMM23 from Mycobacterium marinum. The chromosome encodes many virulence proteins and virulence protein families absent or present in only small numbers in the model RGM species Mycobacterium smegmatis. Many of these proteins are encoded by genes belonging to a “mycobacterial” gene pool (e.g. PE and PPE proteins, MCE and YrbE proteins, lipoprotein LpqH precursors). However, many others (e.g. phospholipase C, MgtC, MsrA, ABC Fe(3+) transporter) appear to have been horizontally acquired from distantly related environmental bacteria with a high G+C content, mostly actinobacteria (e.g. Rhodococcus sp., Streptomyces sp.) and pseudomonads. We also identified several metabolic regions acquired from actinobacteria and pseudomonads (relating to phenazine biosynthesis, homogentisate catabolism, phenylacetic acid degradation, DNA degradation) not present in the M. smegmatis genome. Many of the “non mycobacterial” factors detected in M. abscessus are also present in two of the pathogens most frequently isolated from CF patients, Pseudomonas aeruginosa and Burkholderia cepacia. This study elucidates the genetic basis of the unique pathogenicity of M. abscessus among RGM, and raises the question of similar mechanisms of pathogenicity shared by unrelated organisms in CF patients.
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Kwon YH, Lee GY, Kim WS, Kim KJ. A Case of Skin and Soft Tissue Infection Caused by Mycobacterium abscessus. Ann Dermatol 2009; 21:84-7. [PMID: 20548866 DOI: 10.5021/ad.2009.21.1.84] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Accepted: 09/08/2008] [Indexed: 11/08/2022] Open
Abstract
Mycobacterium abscessus (M. abscessus) is an acid-fast bacillus that's classified as a pathogenic "rapid growing" nontuberculous mycobacteria. It is an uncommon cause of human disease, but it can cause skin and soft tissue infection after skin injury following inoculation, minor trauma and surgery. The single most important factor for determining the course and prognosis of a M. abscessus infection is the underlying immune status of the host. We report here on a 71-year-old female who presented with multiple painful erythematous cutaneous nodules on her left forearm. She had diabetes mellitus and had taken oral steroid by herself for two years because of her osteoarthritis. Histologically, granulomas and inflammatory cell infiltration were observed and M. abscessus was identified via the mycobacterial culture. We performed curettage and drainage, followed by 6 months of oral clarithromycin and the patient's disease completely healed.
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Affiliation(s)
- Yong Hyun Kwon
- Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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33
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Meningococcal Injection Abscess. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2008. [DOI: 10.1097/ipc.0b013e318168ffcb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Talati NJ, Rouphael N, Kuppalli K, Franco-Paredes C. Spectrum of CNS disease caused by rapidly growing mycobacteria. THE LANCET. INFECTIOUS DISEASES 2008; 8:390-8. [PMID: 18501854 DOI: 10.1016/s1473-3099(08)70127-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We present a case of a patient with chronic meningoencephalitis caused by Mycobacterium abscessus. We also summarise the clinical features and outcomes of cases of CNS infection caused by rapidly growing mycobacteria that have been described in the literature. Rapidly growing mycobacteria are notorious for causing skin and soft-tissue infections after trauma or surgery, pulmonary disease in patients with cystic fibrosis, and disseminated disease in immunocompromised patients. CNS infection with this organism is extremely rare. Patients usually present with subacute to chronic meningitis, neutrophilic pleocytosis, and have a history of trauma or neurosurgery. The smears are often negative for acid-fast organisms, but may show Gram-positive rods. Treatment requires a long course of two or more antibiotics that have the ability to penetrate the blood-brain barrier, and possibly of steroids as immunomodulatory agents, such as those used in tuberculous meningitis.
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Affiliation(s)
- Naasha J Talati
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
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35
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Antimicrobial Resistance of Rapidly Growing Mycobacteria in Western Taiwan: SMART Program 2002. J Formos Med Assoc 2008; 107:281-7. [DOI: 10.1016/s0929-6646(08)60088-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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36
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Morales P, Ros JA, Blanes M, Pérez-Enguix D, Saiz V, Santos M. Successful recovery after disseminated infection due to mycobacterium abscessus in a lung transplant patient: subcutaneous nodule as first manifestation--a case report. Transplant Proc 2007; 39:2413-5. [PMID: 17889205 DOI: 10.1016/j.transproceed.2007.07.053] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Mycobacterium abscessus infection following lung transplantation (LT) has been described in a few cases. It is characterized by a variable initial location and subsequent course in this special risk group of patients, particularly those with cystic fibrosis (CF). Herein we have presented the case of a patient subjected to LT due to CF, who 1 year after transplantation developed a subcutaneous nodule produced by M abscessus, with subsequent hematogenous spread as well as bronchial and bone marrow involvement. Antecedents prior to LT included Staphylococcus aureus colonization and sputum positivity for Aspergillus fumigatus and Scedosporium apioespermum. Treatment with ciprofloxacin and linezolid was started on the basis of the antibiogram findings. The latter antibiotic was replaced by clarithromycin for 6 months. Two years later, the patient remains asymptomatic with respiratory function parameters in the normal range. The infected patient described herein was our only case with sepsis and multisystemic spread. The important mortality among such cases reported in the literature makes early diagnosis and treatment essential.
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Affiliation(s)
- P Morales
- Unidad de Trasplante Pulmonar, Hospital Universitario la Fe, Valencia, Spain.
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Nenoff P, Uhlemann R, Grünewald T, Nenning H, Grunewald S, Paasch U. Atypische Mykobakteriose der Haut durch Mycobacterium abscessus bei einer immunkompetenten Frau. Hautarzt 2007; 58:1051-7. [PMID: 17429583 DOI: 10.1007/s00105-007-1321-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Mycobacterium abscessus is the most pathogenic of the fast-growing mycobacteria, and it is resistant to most of the antimicrobial and tuberculostatic drugs available. This non-tuberculous mycobacterium is significant in medicine because it can contaminate post-traumatic wounds and be a causative agent in chronic skin and soft tissue infection after surgical procedures.A 60-year-old immunocompetent woman was suffering from chronic ulcers and abscesses on the heels and malleoli of both feet. Histological examination revealed a granulomatous inflammation with detection of acid-fast rods, albeit without fibrinoid necrosis. The repeated detection of atypical mycobacteria, which were ultimately identified as Mycobacterium abscessus, allowed the diagnosis of an atypical mycobacteriosis of the skin. This was successfully treated first with clarithromycin and rifabutin and later with a combination of ethambutol, minocycline, clofazimine and azithromycin.
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Affiliation(s)
- P Nenoff
- Laboratorium für medizinische Mikrobiologie, Strasse des Friedens 8, 04579, Mölbis, Germany.
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Affiliation(s)
- Angela C S Hutcheson
- Department of Dermatology, Medical University of South Carolina, Charleston, South Carolina 29425, USA
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39
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Atypical Mycobacterial Infections Following Cutaneous Surgery. Dermatol Surg 2007. [DOI: 10.1097/00042728-200701000-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Adékambi T, Ben Salah S, Khlif M, Raoult D, Drancourt M. Survival of environmental mycobacteria in Acanthamoeba polyphaga. Appl Environ Microbiol 2006; 72:5974-81. [PMID: 16957218 PMCID: PMC1563627 DOI: 10.1128/aem.03075-05] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2005] [Accepted: 06/16/2006] [Indexed: 11/20/2022] Open
Abstract
Free-living amoebae in water are hosts to many bacterial species living in such an environment. Such an association enables bacteria to select virulence factors and survive in adverse conditions. Waterborne mycobacteria (WBM) are important sources of community- and hospital-acquired outbreaks of nontuberculosis mycobacterial infections. However, the interactions between WBM and free-living amoebae in water have been demonstrated for only few Mycobacterium spp. We investigated the ability of a number (n = 26) of Mycobacterium spp. to survive in the trophozoites and cysts of Acanthamoeba polyphaga. All the species tested entered the trophozoites of A. polyphaga and survived at this location over a period of 5 days. Moreover, all Mycobacterium spp. survived inside cysts for a period of 15 days. Intracellular Mycobacterium spp. within amoeba cysts survived when exposed to free chlorine (15 mg/liter) for 24 h. These data document the interactions between free-living amoebae and the majority of waterborne Mycobacterium spp. Further studies are required to examine the effects of various germicidal agents on the survival of WBM in an aquatic environment.
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Affiliation(s)
- Toïdi Adékambi
- Unité des Rickettsies, Faculté de Médecine, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
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Abstract
Mycobacterium abscessus is the most pathogenic and chemotherapy-resistant rapid-growing mycobacterium. It is commonly associated with contaminated traumatic skin wounds and with post-surgical soft tissue infections. It is also one of the mycobacteria that are most often isolated from cystic fibrosis patients. It is essential to differentiate this species from the formerly indistinct "M. chelonae-complex", as chemotherapy is especially difficult in M. abscessussenso strictu. Clarithromycin or azithromycin are the only regular oral antimycobacterial agents with an effect on M. abscessus, and should preferably be supplemented with other drugs since long-term monotherapy may cause resistance. Amikacin is a major parenteral drug against M. abscessus that should also be given in combination with another drug. The recently introduced drug tigecycline may prove to be an important addition to chemotherapy, but has yet to be fully clinically evaluated as an antimycobacterial agent. Surgery can be curative, or at least helpful, in the healing of M. abscessus infection, and if conducted, it should include the removal of all foreign or necrotic material. There is increasing awareness of M. abscessus as an emerging pathogen.
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Affiliation(s)
- Björn Petrini
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
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Dytoc MT, Honish L, Shandro C, Ting PT, Chui L, Fiorillo L, Robinson J, Fanning A, Predy G, Rennie RP. Clinical, microbiological, and epidemiological findings of an outbreak of Mycobacterium abscessus hand-and-foot disease. Diagn Microbiol Infect Dis 2006; 53:39-45. [PMID: 16054324 DOI: 10.1016/j.diagmicrobio.2005.03.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2005] [Accepted: 03/25/2005] [Indexed: 11/16/2022]
Abstract
In 2003, we identified an outbreak of clinically distinct lesions involving the hands and feet associated with a public wading pool in Edmonton, Alberta, Canada. A total of 85 cases were identified. The management and follow-up of 41 children and 1 adult patients is presented. Skin lesions occurred within a median incubation period of 29 days and approximately 88 days for the adult patient. Lesions resolved within a median of 58 days and approximately 150 days for the adult patient. Patients were treated with clarithromycin, topical antibiotic dressings, and/or incision and drainage of pustules or followed without treatment. All resolved without complication. The pool was closed and cleaned. The M. abscessus hand-and-foot disease is characterized by the onset, mainly in children, of tender, erythematous papules, pustules, and abscesses with a self-limited course. This is the first documented M. abscessus outbreak associated with wading pool exposure.
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Affiliation(s)
- Marlene T Dytoc
- Division of Dermatology and Cutaneous Sciences, University of Alberta, Edmonton, Alberta, Canada T6G 2G3.
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Song JY, Sohn JW, Jeong HW, Cheong HJ, Kim WJ, Kim MJ. An outbreak of post-acupuncture cutaneous infection due to Mycobacterium abscessus. BMC Infect Dis 2006; 6:6. [PMID: 16412228 PMCID: PMC1361796 DOI: 10.1186/1471-2334-6-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2005] [Accepted: 01/13/2006] [Indexed: 11/24/2022] Open
Abstract
Background Despite the increasing popularity of acupuncture, the importance of infection control is not adequately emphasized in Oriental medicine. In December 2001, an Oriental medical doctor in Seoul, South Korea, encountered several patients with persistent, culture-negative skin lesions on the trunk and extremities at the sites of prior acupuncture treatment. We identified and investigated an outbreak of Mycobacterium abscessus cutaneous infection among the patients who attended this Oriental medicine clinic. Methods Patients were defined as clinic patients with persistent cutaneous infections at the acupuncture sites. Medical records for the previous 7 months were reviewed. Clinical specimens were obtained from the patients and an environmental investigation was performed. M. abscessus isolates, cultured from patients, were compared by pulsed-field gel electrophoresis (PFGE). Results Forty patients who attended the Oriental medicine clinic and experienced persistent cutaneous wound infections were identified. Cultures from five of these patients proved positive, and all other diagnoses were based on clinical and histopathologic examinations. All environmental objects tested were negative for M. abscessus, however, most were contaminated by various nosocomial pathogens. Molecular analysis using PFGE found all wound isolates to be identical. Conclusion We have identified a large outbreak of rapidly growing mycobacterial infection among patients who received acupuncture at a single Oriental medicine clinic. Physicians should suspect mycobacterial infections in patients with persistent cutaneous infections following acupuncture, and infection control education including hygienic practice, should be emphasized for Oriental medical doctors practicing acupuncture.
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Affiliation(s)
- Joon Young Song
- Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jang Wook Sohn
- Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hye Won Jeong
- Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hee Jin Cheong
- Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo Joo Kim
- Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Min Ja Kim
- Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
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Newman MI, Camberos AE, Ascherman J. Mycobacteria abscessus outbreak in US patients linked to offshore surgicenter. Ann Plast Surg 2006; 55:107-10; discussion 110. [PMID: 15985802 DOI: 10.1097/01.sap.0000168030.87804.93] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We recently encountered 5 patients with Mycobacterium abscessus infection following cosmetic procedures performed at a surgicenter located off the United States coastline which, by report, actively recruits domestic patients. Additional patients with similar clinical histories and presentation have been identified at other practices along the Eastern seaboard as well. A recent Centers for Disease Control and Prevention investigation has confirmed a common link. All procedures were performed in Santo Domingo, Dominican Republic, between 2003 and 2004. More than half were performed at the same facility. We report herein a series of patients presenting with M. abscessus infections who underwent cosmetic surgery offshore. The goal of this manuscript is to heighten awareness among physicians who may encounter such patients in their practices. The indolent clinical presentation, laboratory studies utilizing acid-fast stains and cultures, and treatment including surgical debridement and pharmacologic regimens in the ultimate diagnosis and therapy for M. abscessus infections are discussed.
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Affiliation(s)
- Martin I Newman
- Department of Plastic and Reconstructive Surgery, Cleveland Clinic Florida, Weston, FL 33331, USA.
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Ryu HJ, Kim WJ, Oh CH, Song HJ. Iatrogenic Mycobacterium abscessus infection associated with acupuncture: clinical manifestations and its treatment. Int J Dermatol 2005; 44:846-50. [PMID: 16207187 DOI: 10.1111/j.1365-4632.2005.02241.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Mycobacterial infections transmitted by acupuncture are an emerging problem. There have been two reports of mycobacterial infections complicating acupuncture in the English literature. AIM To describe the clinical manifestations and treatment of patients who acquired localized Mycobacterium abscessus infection in the process of acupuncture. METHODS Clinical manifestations and responses to different methods of treatment were reviewed in 40 patients who developed various skin lesions after acupuncture at a Korean oriental medicine clinic. Results The morphology of the lesions which developed at the acupuncture sites varied. Although the lesions disappeared with the combined administration of clarithromycin and amikacin for 3 months in most cases, five out of 25 patients (20%) showed residual lesions at the end of treatment, and had to be treated with a higher dosage of clarithromycin or alternative antibiotics based on sensitivity tests. CONCLUSIONS We recommend at least 3 months of treatment with clarithromycin for treating skin infections caused by M. abscessus, with supplementary antibiotics selected based on patients' drug sensitivity tests.
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Affiliation(s)
- Hwa Jung Ryu
- Department of Dermatology and Internal Medicine, Korea University Medical Center, Seoul, South Korea
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Cloud JL, Hoggan K, Belousov E, Cohen S, Brown-Elliott BA, Mann L, Wilson R, Aldous W, Wallace RJ, Woods GL. Use of the MGB Eclipse system and SmartCycler PCR for differentiation of Mycobacterium chelonae and M. abscessus. J Clin Microbiol 2005; 43:4205-7. [PMID: 16081979 PMCID: PMC1233948 DOI: 10.1128/jcm.43.8.4205-4207.2005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Although accurate in the identification of Mycobacterium species, partial 16S rRNA gene sequencing does not distinguish Mycobacterium chelonae from M. abscessus. Thus, we designed a SmartCycler PCR assay targeting the 16S-to-23S internal transcribed spacer (ITS) region with use of MGB Eclipse probes to distinguish each species. Comparison with PCR-restriction enzyme analysis of a 441-bp fragment of the hsp65 gene resulted in 100% correlation with 25 isolates of M. chelonae and 25 isolates of M. abscessus. ITS PCR performed on 90 consecutive isolates identified by partial 16S rRNA gene sequencing (26 isolates of the M. chelonae-M. abscessus complex and 64 remaining isolates, including Mycobacterium species, Nocardia species, and other aerobic actinomycetes) showed 100% specificity and sensitivity. The ITS PCR assay is accurate and specific, easy to perform, and a good supplemental test when using partial 16S rRNA gene sequencing to identify M. chelonae and M. abscessus.
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Affiliation(s)
- Joann L Cloud
- ARUP Institute for Clinical and Experimental Pathology, 500 Chipeta Way, Salt Lake City, UT 84108, USA.
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September SM, Brözel VS, Venter SN. Diversity of nontuberculoid Mycobacterium species in biofilms of urban and semiurban drinking water distribution systems. Appl Environ Microbiol 2005; 70:7571-3. [PMID: 15574964 PMCID: PMC535200 DOI: 10.1128/aem.70.12.7571-7573.2004] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Nontuberculous mycobacteria (NTM) are ubiquitous and have been isolated from a variety of environmental sources, including water. Various NTM were isolated from biofilms in drinking water distribution systems in two urban and two semiurban areas in South Africa. Most of the isolates belonged to opportunistic pathogenic species of the NTM group, but none belonged to the Mycobacterium avium complex.
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Affiliation(s)
- S M September
- Department of Microbiology and Plant Pathology, University of Pretoria, Pretoria 0002, South Africa
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48
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Ryu HJ, Kim WJ, Oh CH, Song HJ. Iatrogenic Mycobacterium abscessus infection associated with acupuncture: clinical manifestations and its treatment. Int J Dermatol 2004. [DOI: 10.1111/j.1365-4632.2004.02241.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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49
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Fox LP, Geyer AS, Husain S, Della-Latta P, Grossman ME. Mycobacterium abscessus cellulitis and multifocal abscesses of the breasts in a transsexual from illicit intramammary injections of silicone. J Am Acad Dermatol 2004; 50:450-4. [PMID: 14988690 DOI: 10.1016/j.jaad.2003.09.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We report the case of a 29-year-old transsexual who developed Mycobacterium abscessus infection after receiving intramammary liquid silicone injections in the nonphysician office setting. Our patient represents 1 of 14 confirmed and 11 suspected cases in New York City of M abscessus infection after illicit cosmetic procedures. As injectable cosmetic procedures are becoming increasingly popular, dermatologists should be aware of both the common and unusual complications. Furthermore, all physicians should be alerted to the current cluster of M abscessus infections after injections for cosmetic purposes by nonmedical practitioners in New York City.
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Affiliation(s)
- Lindy Peta Fox
- Department of Dermatology, College of Physicians and Surgeons, Columbia University, New York City, NY, USA
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Ara M, de Santamaría CS, Zaballos P, Yus C, Lezcano MA. Mycobacterium chelonae infection with multiple cutaneous lesions after treatment with acupuncture. Int J Dermatol 2003; 42:642-4. [PMID: 12890112 DOI: 10.1046/j.1365-4362.2003.01639_3.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Mariano Ara
- Department of Dermatology, Hospital Miguel Servet, Zaragoza, Spain.
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