Mycobacterium abscessus complex

脓肿分枝杆菌复合体
  • 文章类型: Case Reports
    近几十年来,非结核分枝杆菌(NTM)感染的发病率大幅上升.然而,全球NTM的诊断和管理面临重大挑战,特别是在涉及脓肿分枝杆菌复合体(MABC)感染的病例中,有效的治疗选择有限。
    我们报道了一名38岁的女性患者,因美容院的“美容针”而感染了MABC的皮肤,双颊上有肿块,伴随着红肿,和痛苦,其中一些被切除了。从双侧脸颊肿块多次穿刺抽脓,用“甲硝唑”冲洗,口服“头孢菌素”治疗无效。因此,她来到我们医院。通过核酸质谱检测脓肿穿刺脓液中的MABC,并由脓液的培养结果证明。因此,患者被诊断为皮肤MABC感染,并采取抗NTM治疗。然而,不良反应,如耳鸣,在初始治疗期间发生肝毒性和神经毒性。在调整到含有康奈唑胺的方案后,这些不良反应有所改善。经过近6个月的治疗,面颊肿块逐渐减少,皮肤破裂逐渐愈合。随访10个月,患者面部症状明显改善,无药物相关不良反应发生。
    这是使用含有康奈唑胺的抗生素管理策略治疗的皮肤多重耐药性MABC感染的首例成功病例,在这种顽固性疾病中表现出显著的疗效和良好的安全性。
    UNASSIGNED: In recent decades, there has been a substantial surge in the incidence of non-tuberculous Mycobacteria (NTM) infections. However, the diagnosis and management of NTM globally present significant challenges, particularly in cases involving Mycobacterium abscessus complex (MABC) infection where effective therapeutic options are limited.
    UNASSIGNED: We reported a 38-year-old female patient who was infected with MABC of skin due to \"beauty needle\" at a beauty salon, with mass on both cheeks, accompanied by redness, and pain, and some of them was ulcered and effused. Puncture pumping pus from bilateral cheek mass for many times, rinsed with \"metronidazole\", and oral \"cephalosporin\" treatment did not work. Therefore, she came to our hospital. MABC was detected in abscess paracentesis pus by nucleic acid mass spectrometry, and was proved by the cultured result of the pus. Thus, the patient was diagnosed as skin MABC infection, and anti-NTM treatment was taken. However, adverse reactions such as tinnitus, hepatotoxicity and neurovirulence occurred during the initial treatment. After adjusting to the contezolid-containing regimen, these adverse reactions improved. After nearly 6 months of treatment, the cheek mass was gradually reduced and the skin ruptures were gradually healed. Follow-up for 10 months showed that the patient\'s facial symptoms were significantly improved, and no drug-related adverse reactions happened.
    UNASSIGNED: This was the first successful case of multiple drug resistance MABC infection of skin treated with contezolid-containing antibiotic management strategies, which exhibited remarkable efficacy and good safety in this intractable disease.
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  • 文章类型: Case Reports
    美容手术是非常受欢迎和魅力的主流媒体和名人。许多人认为某些身体特征对身体吸引力很有吸引力,并试图通过手术获得这些特征。然而,这些手术并非没有风险,如果不是由合格的医疗专业人员在无菌程序下进行,可能会产生重大后果。作者介绍了两名健康的年轻女性患者的新病例,这些患者在墨西哥的同一位整形外科医生相隔一周接受了巴西臀部提升(BBL)手术,并出现了继发于脓肿分枝杆菌的深色疼痛性病变(M.脓肿),多重耐药非结核分枝杆菌(NTM)。文献综述显示,通过此类外科手术进行NTM感染的数据很少。第一例是一名31岁的女性,她接受了BBL,并在几周后出现了双侧深色疼痛性臀部病变。病人回到整形外科医生那里,引流一些病变并开了口服抗生素。患者的临床状态继续恶化,并提交医院进行进一步评估。患者最初开始接受广谱抗生素治疗。发现该患者患有HIV感染,CD4淋巴细胞计数相对保留,并开始接受抗逆转录病毒治疗(ART)。术中切除组织样本培养物生长。患者开始服用经验性替加环素,头孢西丁,和利奈唑胺.初步培养物的敏感性显示对利奈唑胺具有抗性。利奈唑胺停药了,阿米卡星开始了,头孢西丁和替加环素继续使用。替加环素,头孢西丁,和阿米卡星继续进行,最终的敏感性显示出对当前治疗的敏感性。病人总共接受了四个月的替加环素治疗,头孢西丁,还有阿米卡星.第二例是一名28岁的妇女,该妇女在同一位外科医生的第一例患者一周后接受了BBL,并出现了多个臀部和身体脓肿。患者接受了双侧大腿和臀肌,右胸壁,在不同的医院设施进行乳腺外科清创术和术中培养,长了M.脓肿。在那里没有进行敏感性。患者被转移到我们的机构接受进一步治疗。术中文化保持阴性,患者接受了为期六个月的替加环素治疗,头孢西丁,还有阿米卡星.
    Cosmetic surgeries are very popular and glamorized by the mainstream media and celebrities. Many individuals perceive certain bodily features as appealing for physical attraction and will attempt to obtain these features by surgery. However, these surgeries are not without risk, and significant consequences can occur if not performed by qualified medical professionals under sterile procedures. The authors present novel cases of two healthy young female patients who underwent a Brazilian butt lift (BBL) procedure a week apart by the same plastic surgeon in Mexico and developed dark painful lesions secondary to Mycobacterium abscessus (M. abscessus), a multidrug-resistant non-tuberculous mycobacterium (NTM). The literature review shows a paucity of data concerning NTM infections via surgical procedures of this type. The first case was of a 31-year-old woman who underwent a BBL and presented with bilateral dark painful buttock lesions weeks later. The patient returned to the plastic surgeon, who drained some lesions and prescribed oral antibiotics. The patient\'s clinical status continued to deteriorate and presented to the hospital for further assessment. The patient was initially started on broad-spectrum antibiotic therapy. The patient was found to have an HIV infection with a relatively preserved CD4 lymphocyte count and was started on antiretroviral therapy (ART). Intraoperative excisional tissue sample cultures grew M. abscessus. The patient was started on empiric tigecycline, cefoxitin, and linezolid. Preliminary culture susceptibilities showed resistance to linezolid. Linezolid was discontinued, amikacin was started, and cefoxitin and tigecycline were continued. Tigecycline, cefoxitin, and amikacin were continued and final susceptibilities showed sensitivity to the current treatment. The patient received a total of four months of treatment with tigecycline, cefoxitin, and amikacin. The second case was of a 28-year-old woman who underwent a BBL a week after the first patient by the same surgeon and developed multiple gluteal and body abscesses. The patient underwent bilateral thigh and gluteal, right chest wall, and breast surgical debridements with intraoperative cultures at a different hospital facility, which grew M. abscessus. Susceptibilities were not performed there. The patient was transferred to our facility for further care. Intraoperative cultures remained negative, and the patient was treated with a six-month course of tigecycline, cefoxitin, and amikacin.
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  • 文章类型: Case Reports
    脓肿分枝杆菌复合体(MABSC)是一种生长迅速的分枝杆菌,在免疫功能低下的患者中很少引起播散性感染。在囊性纤维化(CF)患者中,它的峰值在11到15岁之间。我们介绍了一个5个月大的婴儿,患有CF和进行性家族性肝内胆汁淤积症(PFIC),其肺部和皮肤传播了MABSC感染。在患有两种并存的慢性疾病的婴儿中,这种播散性感染的管理具有挑战性,并导致肺功能的快速恶化和PFIC进展为肝硬化,具有致命的后果。
    Mycobacterium abscessus complex (MABSC) is a rapidly growing mycobacterium and may rarely cause disseminated infections in immunocompromised patients. In patients with cystic fibrosis (CF), it peaks between the ages of 11 and 15 years. We present a five-month-old infant with coexisting CF and progressive familial intrahepatic cholestasis (PFIC) who had pulmonary and cutaneous dissemination of MABSC infection. The management of this disseminated infection in an infant with two coexisting chronic diseases was challenging and resulted in the rapid deterioration of lung function and progression of PFIC to liver cirrhosis with a fatal outcome.
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  • 文章类型: Case Reports
    Mycobacterium abscessus complex, hereinafter Mab, is a taxonomic group of rapidly growing, nontuberculous mycobacteria (NTM). Despite major advances in understanding virulence, pathogenicity and mechanism of antibiotic resistance, Mab remains a significant cause of pulmonary and extra-pulmonary disease. Herein, we describe a disseminated, macrolide-resistant, Mab subspecies abscessus infection occurring in a severely immune-compromised 34-year-old allotransplanted female patient affected by pulmonary chronic graft versus host disease (cGVHD). The infection was characterized by hematogenous spread, and besides lungs, it involved skin, and soft tissues, resulting in a highly debilitating, painful, and finally fatal disease. Our case describes the severe impact of Mab infections in the setting of allogeneic hematopoietic stem cells transplant (alloHSCT) and related complications. It also highlights the unmet need of preventive and surveillance measures together with the urgency of developing effective vaccines and drugs against emerging NTM. The scarce literature regarding Mab infections in alloHSCT patients is also reviewed.
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  • 文章类型: Journal Article
    BACKGROUND: Mycobacterium abscessus subspecies massiliense is a non-tuberculous mycobacteriosis and was subdivided from Mycobacterium abscessus in 2006. This article is the first report on nasopharyngitis caused by Mycobacterium abscessus subspecies massiliense.
    METHODS: A 45-year-old woman had an 18-month history of recurrent nasopharyngitis and presented with pain in the throat. Mycobacterial tissue culture and polymerase chain reaction testing revealed the presence of Mycobacterium abscessus subspecies massiliense in the nasopharyngeal tissue. This patient underwent surgery, followed by multiple rounds of chemotherapy with oral and intravenous antibiotic agents for 16 weeks. She has had no recurrence during the 56 weeks since treatment.
    CONCLUSIONS: It is difficult to detect the presence of Mycobacterium abscessus subspecies massiliense in a culture from the swabbing sample. The tissue culture from a biopsy specimen is mandatory for the identification of the species. Currently, no definite treatment policy is available and only empirical treatment is applied. This case is an important for the diagnosis and treatment of this bacterial infection on nasopharynx.
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  • 文章类型: Case Reports
    OBJECTIVE: Mycobacterium abscessus, and rapidly growing mycobacteria in general, are rare but increasing causes of central nervous system (CNS) infections. The aim of this study is to highlight the importance of considering these microorganism in the differential diagnosis of CNS infections, obtaining a prompt diagnosis, and improving clinical outcomes.
    METHODS: Case report and literature review.
    RESULTS: We report a case of meningeal infection in a patient who underwent decompressive craniectomy after a craniofacial trauma. The diagnosis was made analyzing a sample obtained during a second operation of cranioplasty. A regimen of amikacin, clarithromycin, and imipenem/cilastatin was started. In the following days, the patient experienced a variety of side effects. So, first clarithromycin was replaced with linezolid, then amikacin was stopped and cefoxitin added to the therapy and at the end all the antibiotics were withdrawn. The patient was discharged in good conditions and a clinical interdisciplinary follow-up was started. After 12 months, the patient is still doing well. After a literature analysis, 15 cases of M. abscessus CNS infections were identified. Various modes of acquisition, underlying disease and therapeutic schemes were evident.
    CONCLUSIONS: Considering the results of the literature analysis and the increasing incidence of M. abscessus, all specialists involved in the management of CNS infection should be aware of the importance of atypical microorganisms in differential diagnosis.
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