Mycobacterium senegalense Infection after Implant-Based Breast Reconstruction, Spain

Abstract

with primers NG1 (5′-ACCGACCACAAGGGGG-3′) and NG2 (5′-GGTTGTAAACCTCTTTCGA-3′). We obtained positive results with this PCR and a resistance-to-lysozyme test, and confirmed the presence of Nocardia species. For accurate identification, we PCR amplified 16S rRNA and partial DNA gyrase B (gyrB) genes (4) and subjected PCR products to direct sequencing (GenBank accession nos. KY817987.1 for 16S rRNA and MN159177 for gyrB). We performed a BLAST analysis (https://blast. ncbi.nlm.nih.gov/Blast.cgi) by using the megablast algorithm. This analysis confirmed the identity as N. ignorata (16S rRNA coverage 100% and 99% identity with GenBank accession no. KM113026.1; gyrB coverage 100% and 100% identity with GenBank accession no. GQ496109.1). Antimicrobial drug susceptibility testing (broth microdilution method) showed that the isolate was susceptible to trimethoprim/sulfamethoxazole, imipenem, amikacin, doxycycline, and linezolid and resistant to erythromycin, ceftriaxone, and ciprofloxacin. At this point, we gave the patient cotrimoxazole and imipenem for 20 days and then trimethoprim/sulfamethoxazole for 6 months. The clinical, biological, and radiologic outcomes of the treatment were optimal, and no recurrence occurred after 8 months. N. ignorata is a rare human pathogen. However, soil samples have been described as a possible reservoir (2,7,8). Accordingly, this patient, who had frequent exposure to soil through his work as a gardener, might have acquired the infection from that source.

Mycobacterium senegalensecatheter-related bloodstream infection

“…It is known to cause bovine farcy in sub-Saharan Africa 4. It has been isolated as a human pathogen to cause CRBSI,4 musculoskeletal infection,5 skin and soft tissue infection,6 as well as surgical site infection7 and implant-associated infection 8. A reported case of infected laceration wound by shattered fish tank glass by this pathogen suggests zoonotic potential 6.…”

“…As she had renal failure and multiple comorbidities, an intensive combination of anti-NTM therapy was rendered difficult, which required close monitoring for possible life-threatening side effects such as azithromycin-induced prolonged QT interval and renal-adjustment dosage for certain drugs such as amikacin. Based on the previously reported cases, besides antimicrobial therapy, source control is important as the cases related to catheter and implant needed their removal for the infection to resolve 4 8. However, in the case of CRBSI in renal failure patients, insertion of a new catheter is always a challenge due to difficult vascular access, and may delay the clearance of micro-organisms even with the targeted antimicrobial agents.…”

Case Report: Mycobacterium senegalense Infection After Cholecystectomy

“…Only 7 cases about human infection with M. senegalense have been reported, the recent report found it to cause skin infections in immunocompetent patients (7). Most patients had minimal history of contact with animals and travel to areas where M. senegalense infection was more commonly endemic (8)(9)(10). And most of those cases were identified by various sequencing techniques.…”

A living donor kidney transplant recipient with mycobacterium senegalense bacteremia: A case report

“…Human infection with M senegalense is extremely rare, with only 6 case reports and their characteristics are described in Table 1. [6][7][8][9][10][11] We are unaware of any previously reported cases of M senegalense in SOT recipients.…”