Bursitis, Bacteremia, and Disseminated Infection of &lt;i&gt;Mycobacteroides&lt;/i&gt; (&lt;i&gt;Mycobacterium&lt;/i&gt;) &lt;i&gt;abscessus&lt;/i&gt; subsp. &lt;i&gt;massiliense&lt;/i&gt;

Oka, Kazuki; Morioka, Hiroshi; Eguchi, Motoki; Sato, Yoshitaka; Tetsuka, Nobuyuki; Iguchi, Mitsutaka; Kanematsu, Takeshi; Fukano, Hanako; Hoshino, Yoshihiko; Kiyoi, Hitoshi; Yagi, Tetsuya

doi:10.2169/internalmedicine.6189-20

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…Importantly, sitafloxacin exhibits antibacterial activity against M. tuberculosis and M. avium both in vitro and in vivo (Tomioka et al, 1999;Sato et al, 2003;Asakura et al, 2019). Cases of M. abscessus infection successfully treated with a drug combination that included sitafloxacin were reported (Oka et al, 2021;Takano et al, 2021). The efficacy of sitafloxacin alone in treating M. abscessus infections, however, remains to be evaluated.…”

Section: Discussionmentioning

confidence: 99%

“…Sitafloxacin is an oral quinolone, which exhibits excellent antibacterial activity by simultaneously inhibiting DNA gyrase and topoisomerase IV in a broad range of bacteria including mycobacteria (Tomioka et al, 1999;Sato et al, 2003;Amano et al, 2016;Nakajima et al, 2016;Asakura et al, 2019;Kamada et al, 2021). Reports of the successful treatment of cases of M. abscessus-associated pneumonia with drug combinations that included sitafloxacin have provoked a recent interest in using sitafloxacin for treating M. abscessus infections (Oka et al, 2021;Takano et al, 2021). Information concerning the anti-M. abscessus activity of sitafloxacin is limited, however.…”

Section: Introductionmentioning

confidence: 99%

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Sitafloxacin Expresses Potent Anti-Mycobacterium abscessus Activity

Guo

Zhao

et al. 2022

Front. Microbiol.

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Therapeutic options for treating Mycobacterium abscessus infections are extremely limited; quinolones are important. The in vitro anti-M. abscessus activities of nine quinolones, emphasizing sitafloxacin, were investigated. Antimicrobial susceptibility testing was performed on 10 non-tuberculous mycobacterium reference strains and 194 clinical, M. abscessus isolates. The activity of sitafloxacin against intracellular M. abscessus residing within macrophages was also evaluated. A checkerboard assay was conducted to determine synergy between sitafloxacin and 10 clinically important antibiotics. Among the nine quinolones tested, sitafloxacin exhibited the greatest anti-M. abscessus activity with MIC50 and MIC90 of 1 and 2 mg/L, respectively. Sitafloxacin exerted a bacteriostatic effect on M. abscessus and inhibited the intracellular growth of M. abscessus at concentrations equivalent to clarithromycin. No antagonism between sitafloxacin and 10 clinically important anti-M. abscessus antibiotics was evident. In summary, sitafloxacin exhibited a significant advantage relative to other quinolones in inhibiting the growth of M. abscessus in vitro, suggesting the potential inclusion of sitafloxacin in new strategies to treat M. abscessus infections.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sitafloxacin Expresses Potent Anti-Mycobacterium abscessus Activity

Guo

Zhao

et al. 2022

Front. Microbiol.

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Prednisolone

2021

Reactions Weekly

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Disseminated Mycobacterium abscessus subsp. massiliense infection: case reportA 59-year-old woman developed disseminated Mycobacterium abscessus subsp. massiliense infection following treatment with prednisolone for autoimmune haemolytic anaemia and idiopathic thrombocytopenic purpura.The woman presented to a hospital with a mass on the back of her right hand. Her medical history was significant for autoimmune haemolytic anaemia (AIHA), idiopathic thrombocytopenic purpura (ITP) with splenectomy, and antiphospholipid antibody syndrome. She had been treated with prednisolone 50 mg/day [route not stated], rituximab and eltrombopag. Later, she noted a swelling on her right opisthenar and had difficulty stretching her ring finger. Her WBC count was 12 600 /µL and serum CRP level was 0.41 mg/dL. The swollen right opisthenar was suspected as benign tumour including the ganglion. Later, the mass was enlarged gradually.The woman underwent drainage and incision of the bursa at an outpatient ward. Acid-fast staining of the specimen was positive, but she was tested negative for tuberculosis and Mycobacterium avium complex. She was admitted and underwent additional curettage of the mass. Significant rice body formation was also removed. From the drainage specimens Mycobacteria was isolated. The two blood culture samples grew Gram-positive rods after 5 days. The DNA-DNA hybridization test identified the Mycobacteria as Mycobacterium abscessus complex. The bursitis were considered to due to the caused by the M. abscessus. Thus, she again hospitalised. Her right hand was swollen and reddish, and the mass measured ~40mm. Laboratory findings were as follows: elevated serum CRP, decreased haemoglobin level and thrombocytopenia. CT scan did not show any disseminated lesions. She started receiving clarithromycin, imipenem/cilastatin and amikacin. Subsequently, her right hand findings were improved. One month later, she strongly requested to be discharged. Later, she was discharged without any antibiotic therapy. Later, her blood cultures once again revealed M. abscessus complex. She underwent whole-body imaging and the following new abnormalities were noted including bilateral multiple nodular lung lesions, high signal nodules of the posterior mitral valve, lumbar disc destruction and bilateral popliteal cysts. Endocarditis was suspected. However, a clear consensus of endocarditis was not identified. Multiplex PCR revealed M. abscessus subspecies. massiliense. She again received clarithromycin, imipenem/cilastatin and amikacin for eight weeks and her blood culture was tested negative for the Mycobacterium. Her treatment was later switched to clarithromycin, sitafloxacin and faropenem. Later, faropenem was stopped and discharged with clarithromycin and sitafloxacin. In the next year, she again hospitalised with heart failure due to worsening AIHA. During admission blood culture and mycobacterial blood culture was collected. Two weeks following the admission, she died with gastrointestinal bleeding and respiratory failure. Her mycobact...

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Disseminated Mycobacterium abscessus infection with osteoarticular manifestations as an important differential diagnosis of inflammatory arthritis: A case report and literature review

Watanabe,

Yoshida,

Kidoguchi

et al. 2023

Modern Rheumatology Case Reports

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This case report describes a 52-year-old immunocompromised man diagnosed with disseminated Mycobacterium abscessus complex (MABC) infection. The patient had a history of malignant lymphoma and presented with fever and polyarthritis that lasted 3 weeks. Upon initial evaluation, blood and synovial fluid cultures from the swollen joints were negative. Reactive arthritis or rheumatoid arthritis was suspected as the cause of inflammatory synovitis in multiple joints. Administration of prednisolone followed by an interleukin-6 inhibitor improved the fever, but polyarthritis persisted, and destruction of the left hip joint was observed. Two months later, Mycobacterium abscessus was detected in a blood culture and right shoulder joint synovium, leading to a final diagnosis of disseminated MABC infection. The joint symptoms resolved with combined antimicrobial therapy using amikacin, azithromycin, and imipenem/cilastatin. To date, 12 cases of disseminated MABC infection with osteoarticular manifestations have been reported. A total of 13 cases, including the present case, were reviewed. Seven patients had bone involvements, five had joint involvement, and the remaining one had bursa involvement. All the cases with joint involvement, except for our case, presented with monoarthritis. MABC infection is diagnosed based on the demonstration of MABC itself. Clinicians should keep disseminated MABC infection in mind as a possible cause of persistent arthritis. As demonstrated in our case, multiple replicate cultures of blood or specimens from the affected sites may be needed to detect it.

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Bursitis, Bacteremia, and Disseminated Infection of <i>Mycobacteroides</i> (<i>Mycobacterium</i>) <i>abscessus</i> subsp. <i>massiliense</i>

Cited by 3 publications

References 12 publications

Sitafloxacin Expresses Potent Anti-Mycobacterium abscessus Activity

Sitafloxacin Expresses Potent Anti-Mycobacterium abscessus Activity

Prednisolone

Disseminated Mycobacterium abscessus infection with osteoarticular manifestations as an important differential diagnosis of inflammatory arthritis: A case report and literature review

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