Nontuberculous Mycobacteria

BackgroundNontuberculous mycobacteria (NTM) are environmental organisms associated with a range of infections. Reports of NTM epidemiology are mainly focused on pulmonary infections and isolations, and extrapulmonary infections are less frequently described.MethodsWe conducted a retrospective study of NTM infections at the Bordeaux University Hospital, France, between January 2002 and December 2013. We used the microbiologic component of the American Thoracic Society/Infectious Diseases Society of America's pulmonary NTM disease criteria to define cases of pulmonary NTM, and patients with isolates from a normally sterile site were classified as having extrapulmonary disease.ResultsIn our setting, 170 patients were included. Pulmonary cases predominated (54.1%), followed by skin and soft tissue infections (22.9%), disseminated cases (10.6%), lymphadenitis (7.7%), bone and joint infections (2.9%) and the remaining 1.8% catheter-related infections. Overall, 16 NTM species were isolated. Mycobacterium avium (31.8%) and M. intracellulare (20%) were the most common species identified, followed by M. marinum (13.5%), M. kansasii (10.6%), M. xenopi (9.4%), rapidly growing mycobacteria (9.4%) and other slowly growing mycobacteria (5.3%). In general, NTM isolates were largely prevalent in people older than 50 (62.4%); patients aged 1–10 year-old exclusively yielded M. avium from lymph nodes, almost cases having being diagnosed after 2007. Among the 121 patients with complete follow-up, 78 (64.5%), 24 (19.8%), and 19 (15.7%) were cured, experienced relapse, or died, respectively.ConclusionIn our study, extrapulmonary NTM infections represented almost half of cases, consisting mainly in skin and soft tissue infections. The increase lymphadenitis cases in children after 2007 could be linked to the cessation of mandatory BCG vaccination in France. We observed similar cure rates (64%) between pulmonary and extrapulmonary infections.

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“…Overall, 70% of cutaneous isolates were M . marinum or RGM, which has also been noted by others [18]. M .…”

Section: Discussionsupporting

confidence: 79%

Nontuberculous Mycobacterial Infections in a French Hospital: A 12-Year Retrospective Study

et al. 2016

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“…Mycobacterial species other than those belonging to the Mycobacterium ( M. ) tuberculosis complex or M. leprae are known as nontuberculous mycobacteria (NTM), environmental mycobacteria, or atypical mycobacteria [14]. NTM are ubiquitous in the environment and induce opportunistic infections that can produce a wide range of diseases, and a large number of NTM have been isolated from mammals [20].…”

Section: Introductionmentioning

confidence: 99%

Mycobacterium vaccaeinduces a strong Th1 response that subsequently declines in C57BL/6 mice

et al. 2016

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Mycobacterium (M.) vaccae is a fast-growing species of saprophytic bacteria that is widely distributed. To understand the host immune responses induced by M. vaccae isolated from bovine submaxillary lymph nodes, C57BL/6 mice were infected with reference strain M. vaccae Bacillus Calmette-Guérin (BCG) and isolated M. vaccae using intraperitoneal injections. Comparison of the bacterial replication and organ pathology between M. vaccae and M. vaccae BCG revealed that M. vaccae was more malignant than M. vaccae in mice. We also demonstrated that serum from the M. vaccae-infected mice contained a higher expression level of gamma-interferon (IFN-γ), tumor necrosis factor alpha, monocyte chemoattractant protein-1, interleukin (IL)-4, IL-12, IL-10 and transforming growth factor beta than did the other groups, especially after week 4. Furthermore, when the numbers of CD3+CD4+IFN-γ+ and CD3+CD4+IL4+ cells in the infected mice were observed by flow cytometry, we found that a powerful T helper 1 (Th1) response was induced by M. vaccae infection, which was associated with the emergence of CD3+CD4+IFN-γ+ cells. However, the Th1 response declined over time, which was associated with appearance of the CD4+CD25+FoxP3+ and CD4+CD25+CD152+Treg cell reaction. In addition, a strong Th2 response was found. Finally, we found that M. vaccae infection increased the production of type I IFNs, which was associated with a reduced Th1 response.

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“…These infections are “inoculation” tuberculosis due to inadequately sterilised needles 112 in the M tuberculosis group and probable use of contaminated tapwater, 61 the major reservoir of rapidly growing mycobacteria (RGM) in the cluster of cases of Mycobacterium chelonae and Mycobacterium fortuitum.…”

Section: Discussionmentioning

confidence: 99%

“…fortuitum and M. chelonae are rapidly growing mycobacteria (RGM) with contaminated tap water considered to be major reservoir of these pathogens 61 . This source is more likely to explain the 47 cases reported by Borghans & Stanford, 62 than the contamination of a number of vials with the same mycobacterial strain over a 6 month period.…”

Section: Localized Clinical Syndromesmentioning

confidence: 99%

Sepsis, parenteral vaccination and skin disinfection

Cook

2016

Human Vaccines & Immunotherapeutics

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ASBSTRACTDisinfection should be required for all skin penetrative procedures including parenteral administration of vaccines. This review analyses medically attended infectious events following parenteral vaccination in terms of their microbiological aetiology and pathogenesis. Like ‘clean’ surgical site infections, the major pathogens responsible for these events were Staphylococcal species, implicating endogenous con-tamination as a significant source of infection. As 70% isopropyl alcohol swabbing has been shown to effectively disinfect the skin, it would be medico-legally difficult to defend a case of sepsis with the omission of skin disinfection unless the very low risk of this event was adequately explained to the patient and documented prior to vaccination. There was a significant cost-benefit for skin disinfection and cellulitis. Skin disinfection in the context of parenteral vaccination represents a new paradigm of medical practice; the use of a low cost intervention to prevent an event of very low prevalence but of significant cost.

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Nontuberculous Mycobacteria

Cited by 152 publications

References 104 publications

Nontuberculous Mycobacterial Infections in a French Hospital: A 12-Year Retrospective Study

Nontuberculous Mycobacterial Infections in a French Hospital: A 12-Year Retrospective Study

Mycobacterium vaccaeinduces a strong Th1 response that subsequently declines in C57BL/6 mice

Sepsis, parenteral vaccination and skin disinfection

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