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World Journal of Orthopedics May 2022() is an emerging cause of hip and knee prosthetic joint infection (PJI), and different species of this organism may be responsible for the same.
BACKGROUND
() is an emerging cause of hip and knee prosthetic joint infection (PJI), and different species of this organism may be responsible for the same.
AIM
To evaluate the profile of hip and knee PJI cases as published in the past 30 years.
METHODS
A literature search was performed in PubMed using the MeSH terms "Prosthesis joint infection" AND "Mycobacterium" for studies with publication dates from January 1, 1990, to May 30, 2021. To avoid missing any study, another search was performed with the terms "Arthroplasty infection" AND "Mycobacterium" in the same period as the previous search. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses chart was used to evaluate the included studies for further review. In total, 51 studies were included for further evaluation of the cases, type of pathogen, and treatment of PJI caused by .
RESULTS
Seventeen identified were reportedly responsible for hip/knee PJI in 115 hip/knee PJI cases, whereas in two cases there was no mention of any specific () was detected in 50/115 (43.3%) of the cases. Nontuberculous mycobacteria (NTM) included (26/115, 22.6%), (10/115, 8.6%), (8/115, 6.9%), and (8/115, 6.9%). Majority of the cases (82/114, 71.9%) had an onset of infection > 3 mo after the index surgery, while in 24.6% (28/114) the disease had an onset in ≤ 3 mo. Incidental intraoperative PJI diagnosis was made in 4 cases (3.5%). Overall, prosthesis removal was needed in 77.8% (84/108) of the cases to treat the infection. Overall infection rate was controlled in 88/102 (86.3%) patients with PJI. Persistent infection occurred in 10/108 (9.8%) patients, while 4/108 (3.9%) patients died due to the infection.
CONCLUSION
At least 17 can be responsible for hip/knee PJI. Although is the most common causal pathogen, NTM should be considered as an emerging cause of hip/knee PJI.
PubMed: 35633748
DOI: 10.5312/wjo.v13.i5.503 -
Infectious Diseases (London, England) Jun 2018Nontuberculous mycobacterium (NTM) infections are important complications in renal transplant recipients. (Review)
Review
BACKGROUND
Nontuberculous mycobacterium (NTM) infections are important complications in renal transplant recipients.
METHODS
Cases of NTM diseases post-renal transplantation published in English were identified in the PubMed database. The clinical and laboratory characteristics of these cases were reviewed.
RESULTS
One-hundred and fifteen cases of NTM infection in renal transplant recipients in 100 articles were identified. The median time of NTM infection from renal transplantation was 37 months (range, 3 d to 252 months). Disseminated disease (40.0%) was the most common manifestation of NTM infection in renal transplant recipients. The main diagnostic procedure was culture combined with histopathological examination (38.3%). Thirteen NTM species were identified; the most common pathogen was Mycobacterium chelonae (19.1%). The anti-Mycobacterium treatment lasted more than 12 months in 43.3% of the recorded patients. During the treatment, 30.2% of the recipients lost kidney graft function and 20.9% died from NTM infection and/or other complications, including cardiac death and respiratory failure.
CONCLUSIONS
NTM infection is easily neglected. Physicians must keep a high suspicion for NTM infections in renal transplant recipients.
Topics: Anti-Bacterial Agents; Humans; Immunosuppressive Agents; Kidney Transplantation; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Time Factors; Treatment Outcome
PubMed: 29400108
DOI: 10.1080/23744235.2017.1411604 -
Nephrology, Dialysis, Transplantation :... Apr 2012Peritonitis caused by nontuberculous mycobacterium (NTM) is an important complication in peritoneal dialysis (PD) patients. (Review)
Review
BACKGROUND
Peritonitis caused by nontuberculous mycobacterium (NTM) is an important complication in peritoneal dialysis (PD) patients.
METHODS
Cases of PD complicated by NTM peritonitis reported in the English language literature were identified in the PubMed database. The characteristics of these cases were reviewed.
RESULTS
In 41 articles, we identified 57 cases of PD-associated NTM peritonitis in patients ranging from 5 to 82 years. The prevalent clinical findings of these cases were fever, abdominal pain, cloudy fluid and an elevated leukocyte count in peritoneal fluid. These findings were non-specific and could not be differentiated from symptoms caused by Mycobacterium tuberculosis or other bacteria. The majority of these cases received empirical antibacterial therapy before diagnosis of NTM peritonitis. Isolates in more than half of the peritonitis cases were the rapidly growing Mycobacterium, Mycobacterium fortuitum (38.6%) and Mycobacterium chelonae (14.0%). In most cases, PD catheters were removed and experience with non-removal was limited.
CONCLUSION
Diagnosis of NTM infection should be considered in PD patients with peritonitis that are culture negative or refractory to empirical antibiotic therapy.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Child, Preschool; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Peritoneal Dialysis; Peritonitis; Prognosis; Young Adult
PubMed: 21891775
DOI: 10.1093/ndt/gfr504 -
Seminars in Arthritis and Rheumatism Apr 2013To report 2 cases of skin nontuberculous mycobacteria (NTM) occurring in lupus patients and to systematically review the medical literature addressing skin NTM in lupus. (Review)
Review
OBJECTIVES
To report 2 cases of skin nontuberculous mycobacteria (NTM) occurring in lupus patients and to systematically review the medical literature addressing skin NTM in lupus.
METHODS
We reported 2 cases of skin NTM in lupus patients followed at the Toronto Lupus Clinic. We conducted a systematic review of the literature on NTM in lupus patients. Ovid Medline (1946 to March 12, 2012) and Embase (1980 to March 12, 2012) were searched for relevant publications.
RESULTS
Of the 1356 retrieved abstracts, 19 publications were identified and 25 cases of skin NTM were extracted. Skin presentations in this review ranged from papules, plaques, and nodules to ulcerative lesions and abscesses. Skin lesions occurred in the setting of active and inactive lupus and while patients were maintained on steroids and sometimes immunosuppressants. The pathogen species included Mycobacterium chelonae, Mycobacterium haemophilum, Mycobacterium kansasii, Mycobacterium avium, Mycobacterium scrofulaceum, Mycobacterium fortuitum, Mycobacterium marinatum, and Mycobacterium szulgai. The duration of antimycobacterial drugs ranged from 3 to 12 months. Skin excision, drainage, and debridement might be required in some cases. Empirical monotherapy was used initially, and the final choice of antibiotics was based on the susceptibility determined in culture. Overall, the outcomes of the skin lesions resulted in either complete recovery or improvement.
CONCLUSIONS
A high index of suspicion in lupus patients is required to diagnose NTM, as the initial presentation of NTM can mimic lupus skin manifestations.
Topics: Diagnosis, Differential; Humans; Lupus Erythematosus, Systemic; Lupus Vasculitis, Central Nervous System; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Skin Diseases, Infectious
PubMed: 23332736
DOI: 10.1016/j.semarthrit.2012.08.002 -
Dermatology Online Journal Jun 2015In recent years, several case reports and outbreaks reported occurrence of non-tuberculous mycobacteria (NTM) infections within 6 months after receiving a tattoo in... (Review)
Review
In recent years, several case reports and outbreaks reported occurrence of non-tuberculous mycobacteria (NTM) infections within 6 months after receiving a tattoo in healthy individuals. NTM species (e.g., Chelonae, Fortuitum, Hemophillum, and Abscessus) are widespread in the environment and it is often suspected that contamination may occur through unsterile instrumentation or unsterile water used for diluting tattoo ink to dilute color. In reported cases, lesions were mainly restricted to a single color 'gray' part of the tattoo. Mycobacterium Chelonae was the most common cause of tattoo associated NTM infections. Less than 50% of the case reports tested tattoo ink for acid fast bacilli stains and cultures. Subjects required treatment with either clarithromycin alone or in combination with quinolones for 6 to 9 months. An increase in NTM skin infections in healthy individuals after tattooing indicates the need for sterile standards during tattooing and improved local and regional regulatory oversight.
Topics: Anti-Bacterial Agents; Humans; Ink; Mycobacterium Infections, Nontuberculous; Tattooing
PubMed: 26158355
DOI: No ID Found -
Plastic and Reconstructive Surgery Dec 2018Medical tourism has become increasingly globalized as individuals travel abroad to receive medical care. Cosmetic patients in particular are more likely to seek surgery...
BACKGROUND
Medical tourism has become increasingly globalized as individuals travel abroad to receive medical care. Cosmetic patients in particular are more likely to seek surgery abroad to defray costs. Unfortunately, not all procedures performed abroad adhere to strict hygienic regulations, and bacterial flora vary. As a result, it is not uncommon for consumers to return home with difficult-to-treat postoperative infections.
METHODS
A systematic literature review of PubMed, Ovid, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases was performed to assess the microbiology patterns and medical management of patients with postoperative infections after undergoing elective surgery abroad.
RESULTS
Forty-two cases of postoperative infections were reported among patients who underwent elective surgery abroad. Most cases were reported from the Dominican Republic, and the most common elective procedures were abdominoplasty, mastopexy, and liposuction. Rapidly growing mycobacteria such as Mycobacterium abscessus, Mycobacterium fortuitum, and Mycobacterium chelonae were among the most common causes of postoperative infection, with M. abscessus involving 74 percent of cases. Most cases were treated with surgical débridement and a combination of antibiotics. Clarithromycin, amikacin, and moxifloxacin were the most common drugs used for long-term treatment.
CONCLUSIONS
When encountering a patient with a history of medical tourism and treatment-refractory infection, rapidly growing mycobacteria must be considered. To increase the likelihood of yielding a diagnostic organism, multiple acid-fast bacilli cultures from fluid and débridement content should be performed. There has been reported success in treating rapidly growing mycobacterial infections with a combination of antibiotics including clarithromycin, amikacin, and moxifloxacin.
Topics: Anti-Bacterial Agents; Debridement; Drug Therapy, Combination; Elective Surgical Procedures; Humans; Medical Tourism; Mycobacterium Infections; Reoperation; Risk Factors; Surgical Wound Infection
PubMed: 30489537
DOI: 10.1097/PRS.0000000000005014 -
The Journal of Infection Dec 2016Despite increasing attention towards the non-tuberculous mycobacterial (NTM) diseases, the overall epidemiological information remains unavailable for China. A... (Meta-Analysis)
Meta-Analysis Review
Despite increasing attention towards the non-tuberculous mycobacterial (NTM) diseases, the overall epidemiological information remains unavailable for China. A systematic review and meta-analysis was conducted using data of 105 qualified publications from Chinese mainland. The assay demonstrated that the prevalence of NTM infections among tuberculosis suspects was 6.3% (5.4%-7.4%) in mainland, while the Southeastern region had the highest NTM prevalence at 8.6% (7.1%-10.5%). In Northern China, slow growing mycobacteria (SGM) consistituted 63.7% of all the NTM isolates, while this rate in Southern China was 53.0%. More rapid growing mycobacteria (RGM) were present in southern China than the northern (χ = 57.996, P < 0.001). According to the coastal provinces' data (from north to south), the NTM prevalence rate and the number of isolated NTM species increased apparently in accordance with geographic latitude. The information obtained in this assay will facilitate the NTM disease diagnosis and screening policy making in China.
Topics: China; Humans; Mycobacterium; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Prevalence; Tuberculosis
PubMed: 27717784
DOI: 10.1016/j.jinf.2016.08.020 -
Chirurgie de La Main Feb 2015Non-tuberculous mycobacterial infections of the hand are difficult to treat and require a long time before remission. But how long should we wait to see an improvement?... (Review)
Review
UNLABELLED
Non-tuberculous mycobacterial infections of the hand are difficult to treat and require a long time before remission. But how long should we wait to see an improvement? To answer this question, the published scientific literature was reviewed in English, French and German. Tuberculosis, arthritis and osteomyelitis cases were excluded. A total of 241 non-tuberculous mycobacterial hand infections in 38 scientific publications were retrieved. Most were case reports or series. The median age of the patients was 58years and one third was female. Patients were immunocompromised in 17 episodes. The most common species were Mycobacterium marinum in 198 episodes (82%), followed by M. chelonae in 13 cases (5%). There were no cases of mixed infection. Most infections were aquatic in origin and community-acquired, and were treated with a combination of surgical debridement and long-duration systemic combination antibiotic therapy (14 different regimens; no local antibiotics) for a median duration of 6months. The median number of surgical procedures was 2.5 (range 1-5). Clinical success was not immediate: a median period of 3months (range 2-6) was necessary before the first signs of improvement were observed. The majority (173 cases; 76%) remained entirely cured after a median follow-up time of 1.7years (range, 1-6). Only two microbiological recurrences occurred (1%). However, 49 patients (21%) had long-term sequelae such as pain, stiffness and swelling. The approach of long-duration antibiotic treatment in combination with repeated surgery for mycobacterial soft tissue infections of the hand leads to few recurrences. However, clinical success is not immediate and may take up to 3months.
TYPE OF STUDY
Therapeutic study: systematic review of level III studies.
LEVEL OF EVIDENCE
III.
Topics: Aged; Female; Hand; Humans; Male; Middle Aged; Mycobacterium Infections, Nontuberculous
PubMed: 25579828
DOI: 10.1016/j.main.2014.12.004 -
Euro Surveillance : Bulletin Europeen... Aug 2013
Review
Topics: Humans; Infection Control; Mycobacterium chelonae; Public Health; Scotland; Skin Diseases, Bacterial; Tattooing
PubMed: 23968828
DOI: 10.2807/1560-7917.es2013.18.32.20553