Management of <i>Mycobacterium avium</i> complex and <i>Mycobacterium abscessus</i> pulmonary disease: therapeutic advances and emerging treatments

Kumar, Kartik; Daley, Charles L.; Griffith, David E.; Loebinger, Michael R.

doi:10.1183/16000617.0212-2021

Cited by 20 publications

(9 citation statements)

References 128 publications

(142 reference statements)

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“…Because of the scarcity of literature on M. senegalense , we draw on treatment guidelines for NTM infections ( 14 , 15 ). From the literature review, we found that the management of NTM infections is quite difficult.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Mycobacterium senegalense Infection After Cholecystectomy

Zhou

Gong

et al. 2022

Front. Public Health

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BackgroundMycobacterium senegalense is a non-tuberculous mycobacterium and is found everywhere in the environment. However, M. senegalense infection in human is extremely rare, especially in immunocompetent individuals. It is difficult to detect M. senegalense infection because its symptoms are non-specific, and routine diagnostic tests are less sensitive. It is also resistant to commonly used antibiotics. Here, we report the first case of M. senegalense infection after laparoscopic cholecystectomy in China.Case PresentationA 55-year-old man was admitted because of repeated infections at multiple incision sites for more than 1 year. Although routine diagnostic test results were negative, metagenomic next-generation sequencing (mNGS) identified DNA sequences of M. senegalense in tissue samples from incision sites. The presence of M. senegalense was further confirmed by polymerase chain reaction and capillary electrophoresis. After 60 days of quadruple therapy with clarithromycin, moxifloxacin, rifampicin, and oxycycline, the patient's wound healed.ConclusionWe believe the case findings contribute to the limited amount of knowledge about M. senegalense infection and raises awareness that this infection can result in poor wound healing, even in an immunocompetent host. Owing to a lack of early, precise diagnosis, it is difficult to treat M. senegalense infections. Based on our findings, mNGS is a sensitive diagnostic test for M. senegalense infections.

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Section: Discussionmentioning

confidence: 99%

Case Report: Mycobacterium senegalense Infection After Cholecystectomy

Zhou

Gong

et al. 2022

Front. Public Health

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“…One example is tedizolid, an oxazolidinone typically used to treat acute bacterial skin and skin structure infections (ABSSSI), which has demonstrated efficacy in a macrophage model and in a case study of an immunocompromised patient with M. abscessus infection. Omadacycline, also more commonly used for ABSSSI, has similarly demonstrated significant in vitro activity against M. abscessus , but clinical data are currently limited to case series [ 96 , 97 ].…”

Section: Methodsmentioning

confidence: 99%

Meeting the challenges of NTM-PD from the perspective of the organism and the disease process: innovations in drug development and delivery

Laan¹,

Snabilié²,

Obradović³

2022

Respir Res

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Non-tuberculous mycobacterial pulmonary disease (NTM-PD) poses a substantial patient, healthcare, and economic burden. Managing NTM-PD remains challenging, and factors contributing to this include morphological, species, and patient characteristics as well as the treatment itself. This narrative review focusses on the challenges of NTM-PD from the perspective of the organism and the disease process. Morphological characteristics of non-tuberculous mycobacteria (NTM), antimicrobial resistance mechanisms, and an ability to evade host defences reduce NTM susceptibility to many antibiotics. Resistance to antibiotics, particularly macrolides, is of concern, and is associated with high mortality rates in patients with NTM-PD. New therapies are desperately needed to overcome these hurdles and improve treatment outcomes in NTM-PD. Amikacin liposome inhalation suspension (ALIS) is the first therapy specifically developed to treat refractory NTM-PD caused by Mycobacterium avium complex (MAC) and is approved in the US, EU and Japan. It provides targeted delivery to the lung and effective penetration of macrophages and biofilms and has demonstrated efficacy in treating refractory MAC pulmonary disease (MAC-PD) in the Phase III CONVERT study. Several other therapies are currently being developed including vaccination, bacteriophage therapy, and optimising host defences. Newly developed antibiotics have shown potential activity against NTM-PD and include benzimidazole, delamanid, and pretomanid. Antibiotics commonly used to treat other infections have also been repurposed for NTM-PD, including clofazimine and bedaquiline. Data from larger-scale studies are needed to determine the potential of many of these therapies for treating NTM-PD.

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“…massiliense (hereafter M massiliense). [3,4] Human diseases caused by NTM are classified into 4 distinct clinical syndromes: chronic pulmonary disease, lymphadenitis, cutaneous disease, and disseminated disease. [5] Disseminated infections are known to occur in immunocompromised hosts, such as those with AIDS, hematologic malignancy, or a history of immunosuppressive therapy.…”

Section: Introductionmentioning

confidence: 99%

Disseminated nontuberculous mycobacteria infection in an immunocompetent host: A case report

et al. 2023

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Rationale: Disseminated nontuberculous mycobacterial (NTM) infections are rare and occur primarily in immunocompromised hosts. Mycobacterium abscessus complex (MABC), including M abscessus subsp. massiliense (hereafter M massiliense) is a complex of rapidly growing mycobacterial (RGM) species of NTM. Here, we present a rare case of disseminated NTM infection with RGM bacteremia caused by M massiliense in an immunocompetent host.Patient concerns: A 64-year-old woman with a recent history of spine fracture and septic pneumonia was transferred to our emergency room for dyspnea and fever. A peripherally inserted central catheter (PICC) had been placed over 6 months prior.Diagnoses: Chest computed tomography (CT) showed multifocal patchy consolidations and ground-glass opacity in both lungs. NTM suspected of RGM was isolated from the blood cultures. During hospitalization, multiple erythematous and hemorrhagic crusted nodules developed on the patient's upper and lower extremities, which were confirmed as disseminated NTM infection on skin biopsy.Interventions: After NTM suspected of RGM was isolated from the blood cultures, the patient was empirically treated with antibiotics used for NTM infection, and the PICC was removed. Thereafter, the subspecies of NTM was reported as M massiliense and she was treated according to the antibiotic susceptibility testing results.Outcome: Although skin lesions and inflammatory markers improved gradually during antibiotic treatment over 10 weeks, NTM could still be isolated from the blood culture.Lessons: Disseminated NTM infections with RGM bacteremia in an immunocompetent host have rarely been reported. In this case, PICC placement for more than 6 months was suspected to be an important risk factor for RGM bacteremia in an immunocompetent patient. To date, there are only insufficient case reports, moreover no clear guidelines regarding the optimal choice of antibiotics or length of treatment for disseminated NTM infection. Therefore, it is necessary to establish treatment guidelines for patients with disseminated NTM infection and bacteremia.Abbreviations: CRP = C-reactive protein, CT = computed tomography, ICU = intensive care unit, IV = intravenous, MABC = Mycobacterium abscessus complex, MAC = Mycobacterium avium complex, NTM = nontuberculous mycobacteria, O 2 = oxygen, PICC = peripherally inserted central catheter, RGM = rapidly growing mycobacteria.

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Management of Mycobacterium avium complex and Mycobacterium abscessus pulmonary disease: therapeutic advances and emerging treatments

Cited by 20 publications

References 128 publications

Case Report: Mycobacterium senegalense Infection After Cholecystectomy

Case Report: Mycobacterium senegalense Infection After Cholecystectomy

Meeting the challenges of NTM-PD from the perspective of the organism and the disease process: innovations in drug development and delivery

Disseminated nontuberculous mycobacteria infection in an immunocompetent host: A case report

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