Spectrum of Disease Due to Rapidly Growing Mycobacteria

Wallace, Richard J.; Swenson, Jana M.; Silcox, Vella A.; Good, Robert C.; Tschen, Jaime A.; Stone, Mary Seabury

doi:10.1093/clinids/5.4.657

Cited by 542 publications

(362 citation statements)

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“…It has been included within the M. fortuitum complex and three subspecies have been described: M. chelonei subspecies: chelonei, abscessus and M. chelonei-like (unnamed) [5], but only two subspecies are recognized: abscessus and chelonae. Recently a proposal has been made to elevate the subspecies abscessus to species status [4].…”

Section: Introductionmentioning

confidence: 99%

“…These include vaccinations [15], injections with homesterilized needles, gunshot wounds, farm machinery accidents [5] and surgery [5,17,[23][24][25]. Use of nondisposable syringes or needles and multiple injections with the same needle, have also been found to be risk factors [10].…”

Section: Introductionmentioning

confidence: 99%

“…Disease can occur at any site where the skin is broken and may result in a wart-like skin lesion, soft tissue abscess that drains small amounts of watery fluid, or nodular lesions that despite their dark red appearance, are only minimally tender [5]. Extensive tissue destruction is also possible [26].…”

Section: Introductionmentioning

confidence: 99%

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Iatrogenic outbreak of M. chelonae skin abscesses

et al. 1996

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SUMMARYWe describe an outbreak of skin lesions due to Mycobacterium chelonae subsp. abscessus associated with injections of lidocaine (lignocaine) given by a 'bioenergetic' (a practitioner of alternative medicine) in Colombia. The lidocaine carpules and the lesions of the patients yielded mycobacteria with identical biochemical characteristics.Using the methodology of Sartwell and a case control design we examined the incubation period and assessed risk factors. Of 667 potentially exposed individuals, a total of 298 patients were interviewed, of whom 232 had skin lesions. The median incubation period was 305 days (range 15-59 days). Male sex (OR 2-85, 95 % CI 126-6-5 1), increasing age (OR 1-25, 95 % CI 103-1-53), subcutaneous injection route (OR 3-72, 95 % CI 1-09-12-7) and number of injections (OR 101, 95% CI 1001-03) were risk factors for disease.To our knowledge, this is the largest reported outbreak of M. chelonae infection, the first in which the organism has been isolated from the putative vehicle of infection, and the first in which the incubation period could be determined.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Iatrogenic outbreak of M. chelonae skin abscesses

et al. 1996

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“…Rapidly growing mycobacteria are not usually pathogenic for humans but they can cause several type of infections including skin and soft tissue infections, osteomyelitis, lymphadenitis, disseminated disease, meningitis, postsurgical wound infections, infections of prostethic devices, and chronic lung disease (3)(4)(5)(6)(7)(15)(16)(17)(18). Some cases have been described in Colombia (8,11).…”

Section: Discussionmentioning

confidence: 99%

Micobacteriosis diseminada con compromiso de válvula aórtica protésica: primer caso de Mycobacterium peregrinum de tipo III reportada en Colombia

Torres‐Duque¹,

Diaz²,

Vargas³

et al. 2011

biomedica

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Rapidly growing mycobacteria are non-tuberculous mycobacteria amply present in the environment. Although they are not usually pathogenic for humans, they are opportunistic in that they can cause disease in people with disadvantageous conditions or who are immunocompromised. Mycobacterium peregrinum, an opportunistic, rapidly growing mycobacteria, belongs to the M. fortuitum group and has been reported as responsible for human cases of mycobacteriosis. A case of M. peregrinum type III is herein reported as the first in Colombia. It presented as a disseminated disease involving a prosthetic aortic valve (endocarditis) in a seventeen-year-old girl with a well-established diagnosis of prosthetic aortic valve endocarditis who was referred for a surgical replacement. Due to a congenital heart disease (subaortic stenosis with valve insufficiency), she had two previous aortic valve implantation surgeries. One year after the second implantation, the patient presented with respiratory symptoms and weight lost indicative of lung tuberculosis. A chest X-ray did not show parenchymal compromise but several Ziehl-Neelsen stains were positive. An echocardiography showed a vegetation on the prosthetic aortic valve. In blood and sputum samples, M. peregrinum type III was identified through culture, biochemical tests and hsp65 gene molecular analysis (PRA). The patient underwent a valve replacement and received a multidrug antimycobacterial treatment. Progressive recovery ensued and further samples from respiratory tract and blood were negative for mycobacteria.Key words: Mycobacterium, Mycobacterium peregrinum infections, aortic valve, endocarditis, Colombia. Micobacteriosis diseminada con compromiso de válvula aórtica protésica: primer caso de Mycobacterium peregrinum de tipo III reportada en ColombiaLas micobacterias de rápido crecimiento son microorganismos pertenecientes a las micobacterias no tuberculosas que tienen amplia distribución ambiental. Aunque usualmente no son patógenas para los humanos, en condiciones desfavorables, pueden causar enfermedad en la población general o en huéspedes inmunocomprometidos, por lo cual se consideran oportunistas. Mycobacterium preregrinum es una micobacteria de rápido crecimiento perteneciente al complejo fortuitum que ha sido reportado como responsable de casos de micobacteriosis en humanos. Se presenta el caso de una micobacteriosis por M. peregrinum de tipo III, el primero reportado en Colombia, en una paciente de 17 años de edad con una endocarditis de una válvula aórtica protésica, implantada inicialmente por estenosis subaórtica congénita con insuficiencia y, posteriormente, por estenosis aórtica relacionada con la válvula inicialmente implantada. Un año después del segundo implante, presentó sintomas respiratorios y pérdida de peso sugestivos de tuberculosis pulmonar. Las coloraciones de Ziehl-Neelsen del esputo fueron positivas aunque la radiografía de tórax no mostró compromiso del parénquima. En el ecocardiograma se encontró una vegetación en la válvula aórtica. En las muestras...

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“…Innate resistance to antibiotics has been reported in several of these environmental mycobacteria. Reports from many parts of the world have emphasised that the frequency of mycobacteria other than tuberculosis is increasing in both actual numbers and in the proportion of total mycobacterial disease (7)(8)(9)(10)(11)(12)(13)(14)(15). Therefore, the environmental mycobacteria could significantly influence the control strategies of mycobacterial diseases like leprosy and tuberculosis particularly in the context of the global re-emergence of tuberculosis, emergence of mul@drug resistance in leprosy and tuberculosis and our lack of knowledge of the exact mechanism of pathogenesis and immune insufficiency in these two dreaded scourges of human health.…”

Section: Introductionmentioning

confidence: 99%

Isolation, PCR based identification, and sensitivity pattern of environmental mycobacteria from leprosy and tuberculosis patients

Saravanakumar

Elangeswaran

Senthilkumar

et al. 2000

Indian J Clin Biochem

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We have isolated and identified the biotype of environmental mycobacteria from the expectorate of leprosy patients, their contacts, their drinking water supply and also from the sputa samples of tuberculosis paUents. 78% of the isolates from lepromatous leprosy patients and their contacts were Mycobacterium fortuitum-chelonae complex (MFC), 9% Mycobacterium avium complex (MAC), 9% Mycobacterium scrofulaceum and 4=/o were Mycobactenum smegmatis. Among the isolates from tuberculosis patients 63% belonged to M. fortuitum-chelonae complex, 19% to M. avium complex, 12% to Mycobacterium Kansasliand 6% to M. smegmatis. NI the isolates were multi-drug resistant when tested for sensitivity total of 21 drugs. The Mycobacterium fortuitum.chelonae complex organisms from leprosy contacts were more sensitive to rffampicin than those isolated from lepromatous leprosy and tuberculosis patients. Among 23 Isolates from leprosy patients one isolate was resistant to 20 drugs, one isolate to 17 drugs and another isolate was resistant to 13 drugs. Among the 18 isolates from drinking water supply six showed resistance to more than 12 drugs. Polymerase Chain Reaction (PCR) and subsequent hybridisation with specific probes confirmed all the isolated strains as nontuberculous mycobacteria (Using genus primers and probe sensitivity 100%) and none as M. tuberculosis, suggesting that PCR could be used to rapidly identify mycobacteria at the genus level and to rule out tuberculosis in leprosy patients at an early stage to decide on appropriate course of therapy.

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Spectrum of Disease Due to Rapidly Growing Mycobacteria

Cited by 542 publications

References 50 publications

Iatrogenic outbreak of M. chelonae skin abscesses

Iatrogenic outbreak of M. chelonae skin abscesses

Micobacteriosis diseminada con compromiso de válvula aórtica protésica: primer caso de Mycobacterium peregrinum de tipo III reportada en Colombia

Isolation, PCR based identification, and sensitivity pattern of environmental mycobacteria from leprosy and tuberculosis patients

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