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Ang CH, Lingegowda PB, Wong AWJ. Curious case of cutaneous Mycobacterium abscessus complicated by paradoxical reaction. Singapore Med J 2024:00077293-990000000-00112. [PMID: 38785452 DOI: 10.4103/singaporemedj.smj-2023-149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/14/2023] [Indexed: 05/25/2024]
Affiliation(s)
- Chuan Han Ang
- Department of Plastic, Reconstructive and Aesthetic Surgery, Sengkang General Hospital, Singapore
| | | | - Allen Wei-Jiat Wong
- Department of Plastic, Reconstructive and Aesthetic Surgery, Sengkang General Hospital, Singapore
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Tuan HT, Ngoc NA, Ai LD, Van Luat N. Complicated Surgical Site Infection with Mycobacterium Abscessus After Liposuction and Affections of Corticosteroids in the Treatment Regimen: Three Cases Report and a Systematic Review. Aesthetic Plast Surg 2024; 48:1365-1385. [PMID: 37530819 DOI: 10.1007/s00266-023-03512-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/30/2023] [Indexed: 08/03/2023]
Abstract
INTRODUCTION Mycobacterium abscessus infection after liposuction/fat grafting is a rare complication that is hard to diagnose and treat. Misdiagnosis could result in treatment failure and prolonged hospital stays. The paradoxical reaction is another complication that rarely occurs in non-HIV patients infected with nontuberculosis mycobacteria. This study reported 3 cases infected with M. abscessus complicated by the paradoxical reaction after liposuction and fat grafting. It highlighted characteristics giving clues of the paradoxical reaction and a successful strategy. Also, a systematic review was conducted to comprehensively provide varied aspects of M. abscessus infection after liposuction and/or fat grafting. METHODS Three cases were retrospectively included reporting data characteristics of patients, cosmetic procedures, and treatment strategy. PubMed, Scopus, Virtual Health Library (VHL), and Global Health Library (GHL) were searched to find and include cases with M. abscessus infection after liposuction and/or fat grafting based on defined selection criteria. Relevant data were extracted and summarized. The risk of bias in included studies was assessed using JBI critical appraisal checklists. RESULTS Twenty-four articles were included in the systematic review. Symptoms often developed approximately 1 month after the cosmetic surgery. Culture, AFB, and PCR were common methods of diagnosis of M. abscessus after liposuction and/or fat grafting. It took about 33 days on average from the presentation to isolate and detect the pathogens. Antibiotics based on susceptibility testing results along with surgical interventions were effective methods of treatment. Our three cases which were complicated by the paradox were addressed by adding methylprednisolone for 2 weeks to the macrolide-based therapy. CONCLUSIONS Awareness of this disease should be widely raised among physicians for early diagnosis and proper treatments. Cultures of specimens and AFB should be repeated many times before excluding the possibility of Mycobacterium spp. A paradoxical reaction should be suspected if the symptoms were worse after the antibiotic therapy based on susceptibility testing results and proper surgical interventions, especially if patients had taken corticosteroids before being admitted. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
| | | | - Luu Dang Ai
- Hoang Tuan Clinic, Hoang Quoc Viet, Hanoi, Vietnam
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Shen H, Zhang Q, Peng L, Ma W, Guo J. Cutaneous Mycobacterium Abscessus Infection Following Plastic Surgery: Three Case Reports. Clin Cosmet Investig Dermatol 2024; 17:637-647. [PMID: 38505806 PMCID: PMC10949168 DOI: 10.2147/ccid.s445175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
Aim Mycobacterium abscessus is ubiquitous in the environment and seldom causes infections in immunocompetent individuals. However, skin and soft tissue infections caused by M. abscessus have been reported in recent years. Additionally, the cutaneous infections or outbreaks post cosmetic surgery caused by M. abscessus have been increasing due to the popularity of plastic surgery. The main modes of transmission are through contaminated saline, disinfectants, or surgery equipment, as well as close contact between patients. This article describes three patients who were admitted to our hospital between November 2019 and October 2020. They presented with long-term non-healing wounds caused by M. abscessus infection after undergoing plastic surgery. Symptoms presented by the three patients included swelling, ulceration, secretion, and pain. After identification of M. abscessus with Ziehl-Neelsen staining and MALDI-TOF MS system, the patients were treated with surgical debridement and clarithromycin. Conclusion It is important to note that a long-term wound that does not heal, especially after plastic surgery, should raise suspicion for M. abscessus infection. The infection mechanism in these three patients may have been due to exposure to surgical equipment that was not properly sterilized or due to poor sterile technique by the plastic surgeon. To prevent such infections, it is important to ensure proper sterilization of surgical equipment and saline.
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Affiliation(s)
- Hongwei Shen
- Clinical Laboratory, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, People’s Republic of China
| | - Qiaomin Zhang
- Clinical Laboratory, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, People’s Republic of China
| | - Liang Peng
- Department of Burns and Plastic Surgery, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, People’s Republic of China
| | - Wen Ma
- Clinical Laboratory, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, People’s Republic of China
| | - Jingdong Guo
- Department of Burns and Plastic Surgery, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, People’s Republic of China
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Ninosu N, Vogelmann R, Géraud C, Olsavszky V. Abscessed Mycobacterium fortuitum infection of the face after autologous fat transfer. J Dtsch Dermatol Ges 2024; 22:453-456. [PMID: 38185788 DOI: 10.1111/ddg.15321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/03/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Nadia Ninosu
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, Mannheim, Germany
| | - Roger Vogelmann
- Second Department of Internal Medicine, University Medical Center Mannheim and Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Cyrill Géraud
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, Mannheim, Germany
- Section of Clinical and Molecular Dermatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for Angioscience, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Victor Olsavszky
- Department of Dermatology, Venereology, and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, and Center of Excellence in Dermatology, Mannheim, Germany
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Ninosu N, Vogelmann R, Géraud C, Olsavszky V. Abszedierte Mycobacterium-fortuitum-Infektion im Gesicht nach Eigenfettinjektion: Abscessed Mycobacterium fortuitum infection of the face after autologous fat transfer. J Dtsch Dermatol Ges 2024; 22:453-456. [PMID: 38450989 DOI: 10.1111/ddg.15321_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/03/2023] [Indexed: 03/08/2024]
Affiliation(s)
- Nadia Ninosu
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, und Exzellenzzentrum für Dermatologie, Mannheim
| | - Roger Vogelmann
- II. Medizinische Klinik, Universitätsklinikum Mannheim, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim
| | - Cyrill Géraud
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, und Exzellenzzentrum für Dermatologie, Mannheim
- Sektion Klinische und Molekulare Dermatologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim
- European Center for Angioscience, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim
| | - Victor Olsavszky
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, und Exzellenzzentrum für Dermatologie, Mannheim
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Alkaelani MT, Koussayer B, Blount T, Amawi YA, Mahboob O, Le NK, Parus A, Troy J. Complications of Medical Tourism in Aesthetic Surgery: A Systematic Review. Ann Plast Surg 2023; 91:668-673. [PMID: 37962261 DOI: 10.1097/sap.0000000000003683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
INTRODUCTION As medical cost continues to rise, so has the use of medical tourism by patients as a more cost-effective alternative. While the upfront cost savings attract many unsuspecting patients from their country of origin, there are significant patient safety issues surrounding short- and long-term follow-up, as well as the management and cost of complications. METHODS A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses on complications that presented after cosmetic surgeries performed abroad. The literature search was performed on October 18, 2022, using the databases of PubMed, Google Scholar, and Embase. RESULTS From the 44 studies that were included, 589 patients were identified who presented with complications after having a cosmetic procedure abroad. Infection was the most prevalent complication in this study followed by wound dehiscence, seroma/hematoma, and tissue necrosis. Ninety-eight percent of the infectious organisms were bacterial, and 81% of them were from the Mycobacterium genus. CONCLUSIONS Cosmetic tourism is a global phenomenon. This systematic review highlights the nature of complications following cosmetic tourism, the surgeries that resulted in complications, the countries that the primary procedures took place in, and the countries of origin of the patients. To aid in reducing morbidity and mortality from cosmetic tourism, regulatory bodies should educate and empower the public to aid them in making educated medical conditions when seeking care.
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Affiliation(s)
| | - Bilal Koussayer
- Department of Plastic Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL
| | - Taylor Blount
- From the Florida State University College of Medicine
| | - Yusuf A Amawi
- From the Florida State University College of Medicine
| | - Omar Mahboob
- From the Florida State University College of Medicine
| | - Nicole K Le
- Department of Plastic Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL
| | - Anamaria Parus
- Department of Plastic Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL
| | - Jared Troy
- Department of Plastic Surgery, University of South Florida Health Morsani College of Medicine, Tampa, FL
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Guidance on the treatment of rare deep subcutaneous mycobacterium abscess following cosmetic procedures: a case series and systematic review of the literature. EUROPEAN JOURNAL OF PLASTIC SURGERY 2023. [DOI: 10.1007/s00238-023-02053-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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8
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Nontuberculosis Mycobacteria Infection After Liposuction and Fat Grafting for Augmentation Mammoplasty: A Case Report and Literature Review. Ann Plast Surg 2022; 90:S55-S59. [PMID: 36729056 DOI: 10.1097/sap.0000000000003345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Nontuberculosis mycobacteria (NTM) commonly occur in nature. Although the infection rate is low, soft tissue infection with NTM after surgical procedures is possible in both immunocompromised and normal populations. For cosmetic surgery, NTM infection has emerged as a common infection in the recent years, and this indicates the need to pay more attention, especially to those with prolonged atypical uncertain wound problems. AIM AND OBJECTIVES We aimed to report a case of NTM infection after breast augmentation to share our experience on clinical appearance and process of diagnosis and treatment, and to review the existing literature. MATERIALS AND METHODS We retrospectively review a patient who suffered from NTM infection after liposuction and fat grafting for breast augmentation between 2019 and 2021 in our hospital. The baseline characteristics, operations, bacterial culture report, medications, and outpatient information were collected from medical records. RESULTS The patient suffered from purulent skin lesions after breast augmentation and was diagnosed with NTM infection according to the culture report. The NTM infection was resolved after a long-term course of treatment for around a year, including surgical debridement, serial aspirations, and prescriptions of antituberculosis medications. CONCLUSIONS The results of our study suggest that NTM must be considered when facing refractory infections after surgeries or invasive procedures without bacterial growth on routine cultures. Acid-fast stain and mycobacterial culture are strongly recommended. Treatment modalities include localized aspiration, surgical debridement, and multidrug antibiotics based on the sensitivity of the microorganism.
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Sullivan JR, Yao J, Courtine C, Lupien A, Herrmann J, Müller R, Behr MA. Natural Products Lysobactin and Sorangicin A Show In Vitro Activity against Mycobacterium abscessus Complex. Microbiol Spectr 2022; 10:e0267222. [PMID: 36342177 PMCID: PMC9769517 DOI: 10.1128/spectrum.02672-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/08/2022] [Indexed: 11/09/2022] Open
Abstract
The prevalence of lung disease caused by Mycobacterium abscessus is increasing among patients with cystic fibrosis. M. abscessus is a multidrug resistant opportunistic pathogen that is notoriously difficult to treat due to a lack of efficacious therapeutic regimens. Currently, there are no standard regimens, and treatment guidelines are based empirically on drug susceptibility testing. Thus, novel antibiotics are required. Natural products represent a vast pool of biologically active compounds that have a history of being a good source of antibiotics. Here, we screened a library of 517 natural products purified from fermentations of various bacteria, fungi, and plants against M. abscessus ATCC 19977. Lysobactin and sorangicin A were active against the M. abscessus complex and drug resistant clinical isolates. These natural products merit further consideration to be included in the M. abscessus drug pipeline. IMPORTANCE The many thousands of people living with cystic fibrosis are at a greater risk of developing a chronic lung infection caused by Mycobacterium abscessus. Since M. abscessus is clinically resistant to most anti-TB drugs available, treatment options are limited to macrolides. Despite macrolide-based therapies, cure rates for M. abscessus lung infections are 50%. Using an in-house library of curated natural products, we identified lysobactin and sorangicin A as novel scaffolds for the future development of antimicrobials for patients with M. abscessus infections.
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Affiliation(s)
- Jaryd R. Sullivan
- Department of Microbiology & Immunology, McGill University, Montréal, Québec, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- McGill International TB Centre, Montréal, Québec, Canada
| | - Jacqueline Yao
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Christophe Courtine
- Department of Microbiology & Immunology, McGill University, Montréal, Québec, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Andréanne Lupien
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- McGill International TB Centre, Montréal, Québec, Canada
| | - Jennifer Herrmann
- Department of Microbial Natural Products, Helmholtz-Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI),Saarbrücken, Germany
| | - Rolf Müller
- Department of Microbial Natural Products, Helmholtz-Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI),Saarbrücken, Germany
- Department of Pharmacy, Saarland University, Saarbrücken, Germany
| | - Marcel A. Behr
- Department of Microbiology & Immunology, McGill University, Montréal, Québec, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- McGill International TB Centre, Montréal, Québec, Canada
- Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada
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10
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High Morbidity of Mycobacterial Infections Following Cosmetic Surgery Tourism. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2022. [DOI: 10.1097/ipc.0000000000001142] [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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11
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Cardenas DD, Yasmin T, Ahmed S. A Rare Insidious Case of Skin and Soft Tissue Infection Due to Mycobacterium abscessus: A Case Report. Cureus 2022; 14:e25725. [PMID: 35812535 PMCID: PMC9270099 DOI: 10.7759/cureus.25725] [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: 06/07/2022] [Indexed: 12/02/2022] Open
Abstract
Mycobacterium abscessus complex (MABc) is part of the rapid-growing non-tuberculous mycobacteria group that usually resides in natural water sources. When it affects humans, it can be highly resistant and difficult to manage. The most common presentation is localized, mainly in the lungs and soft tissue, but can be generalized in immunocompromised patients. Here we present a case report of a 40-year-old female with a chronic infection of the abdominal wall after abdominoplasty.
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Lee JM, Park J, Reed SG, Coler RN, Hong JJ, Kim LH, Lee W, Kwon KW, Shin SJ. Vaccination inducing durable and robust antigen-specific Th1/Th17 immune responses contributes to prophylactic protection against Mycobacterium avium infection but is ineffective as an adjunct to antibiotic treatment in chronic disease. Virulence 2022; 13:808-832. [PMID: 35499090 PMCID: PMC9067471 DOI: 10.1080/21505594.2022.2068489] [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] [Indexed: 11/13/2022] Open
Abstract
Mycobacterium avium complex (MAC) causing pulmonary disease in humanshas emerged worldwide. Thus, effective strategies simultaneously aiming to prevent MAC infection and accelerate therapeutic efficacy are required. To this end, subunit vaccine-induced protection against a well-defined virulent Mycobacterium avium (Mav) isolate was assessed as a preventative and therapeutic modality in murine models. Mav-derived culture filtrate antigen (CFA) was used as a vaccine antigen with glucopyranosyl lipid A stable emulsion (GLA-SE) or GLA-SE plus cyclic-di-GMP (GLA-SE/CDG), and we compared the immunogenicities, protective efficacies and immune correlates. Interestingly, CFA+GLA-SE/CDG immunization induced greater CFA-specific Th1/Th17 responses in both the lung and spleen than among the tested groups. Consequently, protective efficacy was optimally achieved with CFA+GLA-SE/CDG by significantly reducing bacterial loads along with long-lasting maintenance of antigen-specific Th1/Th17 cytokine-producing multifunctional T cell responses and relevant cytokine productions. Thus, we employed this subunit vaccine as an adjunct to antibiotic treatment. However, this vaccine was ineffective in further reducing bacterial loads. Collectively, our study demonstrates that strong Mav CFA-specific Th1/Th17 responses are critical for preventative protection against Mav infection but may be ineffective or even detrimental in an established and progressive chronic disease, indicating that different approaches to combating Mav infection are necessary according to vaccination purposes.
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Affiliation(s)
- Ju Mi Lee
- Department of Microbiology, Institute for Immunology and Immunological Disease, Graduate School of Medical science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Jiyun Park
- Department of Microbiology, Institute for Immunology and Immunological Disease, Graduate School of Medical science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Rhea N Coler
- Seattle Children’s Research Institute, Center for Global Infectious Disease Research, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Jung Joo Hong
- National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju, South Korea
| | - Lee-Han Kim
- Department of Microbiology, Institute for Immunology and Immunological Disease, Graduate School of Medical science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Wonsik Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Kee Woong Kwon
- Department of Microbiology, Institute for Immunology and Immunological Disease, Graduate School of Medical science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Jae Shin
- Department of Microbiology, Institute for Immunology and Immunological Disease, Graduate School of Medical science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
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Cutaneous Mycobacterial Infections in Returning Travelers. CURRENT TROPICAL MEDICINE REPORTS 2021. [DOI: 10.1007/s40475-021-00228-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pavli A, Maltezou HC. Infectious complications related to medical tourism. J Travel Med 2021; 28:5959955. [PMID: 33159509 DOI: 10.1093/jtm/taaa210] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Medical tourism has been increasing dramatically globally, with people travelling from developed countries to low-income or middle-income countries, often to avoid high costs or long delays associated with seeking healthcare in their countries of origin. The current review summarizes healthcare-related infections associated with medical tourism, focusing on cosmetic surgery and organ transplantation. METHODS A systematic MEDLINE and PubMed search from January 2010 to December 2019 yielded 80 relevant articles, including 49 articles on medical tourism-related infections focusing on cosmetic surgery and organ transplantation, which were included in this reviews. RESULTS The literature reveals specific types of cross-border, healthcare-related infections depending on medical intervention. Destinations include low-income countries such as countries of Asia and the Indian subcontinent, middle-income countries including Central and South America, and high-income countries such as the United States and Europe. In terms of type of infections, in 36 (68%) and 15 (28.3%) studies, wound and blood-borne infections were documented, respectively, while in 21 studies (58.3%) non-tuberculous mycobacteria were isolated, including Mycobacterium abscessus, Mycobacterium chelonae, Mycobacterium senegalense and Mycobacterium fortuitum. The choices of medical tourists could have significant consequences for them and their home countries, including infectious complications and importation of pathogens, particularly antibiotic-resistant microorganisms, with public health implications. CONCLUSIONS There is a need for public health strategies in order to prevent morbidity and mortality as well as future management and education of patients engaging in medical tourism.
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Affiliation(s)
- Androula Pavli
- Department of Travel Medicine, National Public Health Organization, Athens, Greece
| | - Helena C Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece
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Kalimulina KR, Ismatullin DD, Lyamin AV, Kondratenko OV, Kozlov AV, Zhestkov AV. [Mycobacterium abscessus complex representatives in patients with bronchopulmonary pathology: prevalence, peculiarities of cultivation and identification.]. Klin Lab Diagn 2020; 65:316-320. [PMID: 32298549 DOI: 10.18821/0869-2084-2020-65-5-316-320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 03/02/2020] [Indexed: 11/17/2022]
Abstract
More and more publications appear in the modern literature on the increase in the prevalence of non-tuberculous mycobacteria (NTMs), in particular, representatives of M. chelonae / Mycobacterium abscessus complex (MABSc). The paper presents data on the current classification of M. chelonae / Mycobacterium abscessus complex and its main representatives. The main data on the possible sources and ways of infection of MABSc patients in hospital are presented. The main features of cultivation on various nutrient media and their possible identification using modern methods are also indicated. The main risk factors for the development of mycobacteriosis in patients and the possible clinical picture are described. The prevalence of MABSc representatives in the structure of non-tuberculous mycobacteria isolated from clinical material from 483 patients from the Samara region was assessed for examination for tuberculosis, and the prevalence from 933 patients with cystic fibrosis (CF) from 55 regions of the Russian Federation from 2016 to 2019 was estimated. In total, as a result of the study, 316 NTM strains (65.4%) were isolated and identified in the first group of patients. M.abscessus was isolated and identified 10 strains and 5 strains - M.chelonae, which amounted to 3.2% and 1.6%, respectively, of all NTMs. In general, MABSc representatives were isolated in 3.1% of the examined patients. As a result of a screening study of patients with CF, 14194 microorganism strains from 933 patients were isolated and identified. Altogether M. abscessus was isolated and confirmed from 14 patients of different ages. Thus, the prevalence of MABSc among the examined patients with CF in the Russian Federation was 1.5%.
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Affiliation(s)
| | | | - A V Lyamin
- Samara State Medical University, 443099, Samara, Russia
| | | | - A V Kozlov
- Samara State Medical University, 443099, Samara, Russia
| | - A V Zhestkov
- Samara State Medical University, 443099, Samara, Russia
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Abstract
The increasing popularity of medical tourism among US citizens has led to the rising incidence of nontuberculous mycobacteria (NTM) infections from cosmetic surgery performed in other countries. Clinicians must be aware of these infections and the potential difficulties in treating them. The most common NTM species isolated from cutaneous infections in medical tourists is Mycobacterium abscessus. Because many NTM species are antibiotic resistant, combination therapy is needed to combat skin and soft-tissue NTM infections in patients who had cosmetic procedures performed in foreign countries.
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Pereira RT, Malone CM, Flaherty GT. Aesthetic journeys: a review of cosmetic surgery tourism. J Travel Med 2018; 25:5039932. [PMID: 29924349 DOI: 10.1093/jtm/tay042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/23/2018] [Indexed: 11/14/2022]
Abstract
BACKGROUND Medical tourism has witnessed significant growth in recent years. The emerging trend towards international travel for cosmetic surgical interventions has not previously been reviewed. The current review aims to critically address the scale and impact of cosmetic surgical tourism and to delineate the complication profile of this form of medical tourism. METHODS Articles published in the English language on the PubMed database that were relevant to surgical tourism and the complications of elective surgical procedures abroad were examined. Reference lists of articles identified were further scrutinized. The search terms used included combinations of 'surgery abroad', 'cosmetic surgery abroad', 'cosmetic surgery tourism', 'cosmetic surgery complications' and 'aesthetic tourism'. RESULTS This article critically reviews the epidemiology of cosmetic surgical tourism and its associated economic factors. Surgical complications of selected procedures, including perioperative complications, are described. The implications for travel medicine practice are considered and recommendations for further research are proposed. CONCLUSION This narrative literature review focuses on the issues affecting travellers who obtain cosmetic surgical treatment overseas. There is a lack of focus in the travel medicine literature on the non-surgery-related morbidity of this special group of travellers. Original research exploring the motivation and pre-travel preparation, including the psychological counselling, of cosmetic surgical tourists is indicated.
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Affiliation(s)
| | - Carmel M Malone
- School of Medicine, National University of Ireland Galway, Galway, Ireland.,Department of Breast Surgery, University Hospital Galway, Galway, Ireland
| | - Gerard T Flaherty
- School of Medicine, National University of Ireland Galway, Galway, Ireland.,School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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