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Journal of the Association of Medical... Jun 2022Non-tuberculous mycobacteria (NTM) are an uncommon but serious cause of peritoneal dialysis (PD)-related infections. NTM peritonitis typically necessitates PD catheter...
BACKGROUND
Non-tuberculous mycobacteria (NTM) are an uncommon but serious cause of peritoneal dialysis (PD)-related infections. NTM peritonitis typically necessitates PD catheter removal, PD withdrawal, and aggressive, prolonged antimicrobial treatment. Few reported cases of NTM peritonitis in the pediatric population exist.
METHODS
We describe a case of a 9-year-old boy on PD after kidney allograft failure who developed peritonitis, and we summarize the available literature on peritonitis in pediatric patients receiving PD.
RESULTS AND CONCLUSION
Therapeutic options were limited by adverse medication effects and risk of drug-drug interactions in a patient with complex mental health comorbidities. Clofazimine presented an acceptable oral treatment option for long-term therapy in combination with ciprofloxacin and was well tolerated by this patient. Prompt PD catheter removal followed by 6 months of dual antimicrobial therapy resulted in a full recovery and successful re-transplantation with no infection relapse.
PubMed: 36337360
DOI: 10.3138/jammi-2021-0029 -
Pneumonia (Nathan Qld.) Nov 2022A mixed pulmonary infection of Mycobacterium bacteremicum and three different isolates of nontuberculous mycobacteria (NTM) is an unusual clinical manifestation and have...
BACKGROUND
A mixed pulmonary infection of Mycobacterium bacteremicum and three different isolates of nontuberculous mycobacteria (NTM) is an unusual clinical manifestation and have not yet been indicated. In this case report, we reported four isolates of NTM using phenotypic and genotypic test of pulmonary sample in Tehran, Iran.
CASE PRESENTATION
We report a case of severe pulmonary disease in a 19-year-old male patient with productive cough, shortness of breath, and low-grade fever for several weeks. The C-reactive protein (CRP) level (80.2 mg/L) and erythrocyte sedimentation rate (ESR) (95 mm/h) were high. The computed tomographic scan indicated bronchiectasis, nodular opacities, consolidation, and cavitary lesions on both sides. The result of purified protein derivative (PPD) test was equal to 15 mm. The sequences of hsp65, rpoB, and 16S rDNA genes indicated more than 99% homology to four isolates of nontuberculous mycobacteria (NTM), including Mycobacterium fortuitum, M. chelonae, M. mucogenicum, and M. bacteremicum. We found that all four strains were susceptible to amikacin, cefoxitin, ciprofloxacin, clarithromycin, imipenem, and linezolid. The patient was treated with ciprofloxacin, clarithromycin, and amikacin, along with Montelukast, for five months.
CONCLUSION
We report a case of severe pulmonary infection by four isolates of NTM. After treatment, the patient reported complete resolution of the signs and a weight gain of 5 kg; also, the CRP and ESR were normal. Nine months after the infection diagnosis, a new CT scan revealed further improvements.
PubMed: 36333817
DOI: 10.1186/s41479-022-00100-6 -
Journal of Infection in Developing... Oct 2022Mycobacterium fortuitum infections of the musculoskeletal system are commonly missed, given their rarity and the absence of systemic symptoms. In this study, we isolated... (Review)
Review
Mycobacterium fortuitum infections of the musculoskeletal system are commonly missed, given their rarity and the absence of systemic symptoms. In this study, we isolated the M. fortuitum from the skin sinus tract of a traffic accident patient's right medial knee surgical incision (over the open fracture wound), and confirmed by Morphological analysis, MALDI-TOF MS, 16S rRNA gene sequencing, and mNGS. Then we adjusted the treatment plan and treated the patient with cefoxitin, amikacin, and doxycycline. At three months follow-up review, his wound had completely healed. This report may provide a reference for the clinical treatment of Mycobacterium fortuitum infection in patients with open fractures.
Topics: Humans; Mycobacterium fortuitum; Mycobacterium Infections, Nontuberculous; Leg; RNA, Ribosomal, 16S; Amikacin; Mycobacterium Infections
PubMed: 36332221
DOI: 10.3855/jidc.16635 -
BMC Microbiology Oct 2022Nontuberculous mycobacteria (NTM) are ubiquitous bacteria that are naturally resistant to disinfectants and antibiotics and can colonize systems for supplying drinking...
PURPOSE
Nontuberculous mycobacteria (NTM) are ubiquitous bacteria that are naturally resistant to disinfectants and antibiotics and can colonize systems for supplying drinking water. Therefore, this study aimed to evaluate the prevalence of NTM in the drinking water of six hospitals in Tehran, Iran.
METHODS
Totally, 198 water samples were collected. Each water sample was filtered via a membrane filter with a pore size of 0.45 µm and then decontaminated by 0.005% cetylpyridinium chloride. The membrane filters were incubated on two Lowenstein-Jensen media at 25 °C and 37 °C for 8 weeks. The positive cultures were identified with phenotypic tests, and then NTM species were detected according to the hsp65, rpoB, and 16S rDNA genes. Drug susceptibility testing (DST) was also carried out.
RESULTS
Overall, 76 (40.4%) of the isolates were slowly growing mycobacteria (SGM) and 112 (59.6%) of the ones were rapidly growing mycobacteria (RGM). The most common NTM were Mycobacterium aurum, M. gordonae, M. phocaicum, M. mucogenicum, M. kansasii, M. simiae, M. gadium, M. lentiflavum, M. fortuitum, and M. porcinum. Among these 188 samples, NTM ranged from 1 to > 300 colony-forming unit (CFU) /500 mL, with a median of 182 CFU/500 mL. In the infectious department of all hospitals, the amount of CFU was higher than in other parts of the hospitals. The DST findings in this study indicated the diversity of resistance to different drugs. Among RGM, M. mucogenicum was the most susceptible isolate; however, M. fortuitum showed a different resistance pattern. Also, among SGM isolates, M. kansasii and M. simiae, the diversity of DST indicated.
CONCLUSIONS
The current study showed NTM strains could be an important component of hospital water supplies and a possible source of nosocomial infections according to the CFU reported in this study. The obtained findings also help clarify the dynamics of NTM variety and distribution in the water systems of hospitals in the research area.
Topics: Humans; Nontuberculous Mycobacteria; Mycobacterium Infections, Nontuberculous; Microbial Sensitivity Tests; Drinking Water; Iran; RNA, Ribosomal, 16S; Mycobacterium tuberculosis; Hospitals
PubMed: 36309645
DOI: 10.1186/s12866-022-02674-z -
Pathogens (Basel, Switzerland) Aug 2022Rapidly growing mycobacteria (RGM) has gained increasing clinical importance, and treatment is challenging due to diverse drug resistance. The minimum inhibitory...
Rapidly growing mycobacteria (RGM) has gained increasing clinical importance, and treatment is challenging due to diverse drug resistance. The minimum inhibitory concentrations (MIC) of 13 antimicrobial agents using modified broth microdilution and E-test were determined for 32 clinical isolates of RGM, including (22 isolates) and (10 isolates). Our results showed high rates of resistance to available antimicrobial agents. Amikacin remained highly susceptible (87.5%). Clarithromycin was active against the isolates of (95.5%), and (50%), but 36.4% and 20% had inducible macrolide resistance, respectively. Rates of susceptibility to tigecycline were 68.2-70%, and linezolid 45.5-50%, respectively. The quinolones (ciprofloxacin and moxifloxacin) showed better in vitro activity against isolates (50% susceptibility) than the isolates (31.8% susceptibility). The susceptibilities to other conventional anti-mycobacterial agents were poor. The MICs of E-test were higher than broth microdilution and may result in reports of false resistance. In conclusion, the implementation of the modified broth microdilution plates into the routine clinical laboratory workflow to provide antimicrobial susceptibility early, allows for the timely selection of appropriate treatment of RGM infections to improve outcome.
PubMed: 36145400
DOI: 10.3390/pathogens11090969 -
Frontiers in Neurology 2022is a rapidly growing mycobacterium (RGM) that belongs to the unnamed third biovariant complex of the group, which is rarely responsible for human infection....
BACKGROUND
is a rapidly growing mycobacterium (RGM) that belongs to the unnamed third biovariant complex of the group, which is rarely responsible for human infection. Approximately 76% of infections caused by the group occur after open fractures or skin, soft tissue, bone, or puncture wounds. To date, only a few cases of human infectious disease caused b have been reported worldwide.
CASE PRESENTATION
We present a case of a 26-year-old man with a central nervous system (CNS) infection caused by . The patient was transferred to our hospital because of headaches and muscle strength changes. One month prior to presentation at our hospital, the patient was diagnosed with tuberculous meningitis at the other two hospitals, but his condition did not improve after anti-tuberculous treatment, antibiotics, and anti-viral treatment before admission to our hospital. Lumbar puncture was performed at both previous hospitals, as well as at our hospital; the results consistently indicated high cerebrospinal fluid (CSF) opening pressure. was detected in the CSF of the second hospital's lumbar puncture by metagenomic next-generation sequencing (mNGS) but was not identified at our hospital. The patient was discharged from our hospital after receiving non-tuberculous mycobacterium (NTM) treatment for 1 month according to the Chinese NTM guidelines. However, the patient died 20 days after discharge.
CONCLUSION
Since it is difficult to identify , this is the first case of human CNS infection caused by in China. This case may be considered by neurologists and infectious physicians when CNS infection does not respond to conventional treatment, especially in the uncommon type of NTM.
PubMed: 36119702
DOI: 10.3389/fneur.2022.908086 -
PLoS Neglected Tropical Diseases Sep 2022Unlike diseases caused by Mycobacterium tuberculosis, M. leprae and M. ulcerans, the epidemiology of pulmonary non-tuberculous mycobacteria (PNTM) has not received due... (Observational Study)
Observational Study
INTRODUCTION
Unlike diseases caused by Mycobacterium tuberculosis, M. leprae and M. ulcerans, the epidemiology of pulmonary non-tuberculous mycobacteria (PNTM) has not received due attention in French Guiana. The main objective of the current study was to define the incidence of these PNTM infections: NTM pulmonary diseases (NTM-PD) and casual PNTM isolation (responsible of latent infection or simple colonization). The secondary objectives were to determine species diversity and geographic distribution of these atypical mycobacteria.
METHODS
A retrospective observational study (2008-2018) of French Guiana patients with at least one PNTM positive respiratory sample in culture was conducted. Patients were then classified into two groups: casual PNTM isolation or pulmonary disease (NTM-PD), according to clinical, radiological and microbiological criteria defined by the American Thoracic Society / Infectious Disease Society of America (ATS / IDSA) in 2007.
RESULTS
178 patients were included, out of which 147 had casual PNTM isolation and 31 had NTM-PD. Estimated annual incidence rate of respiratory isolates was 6.17 / 100,000 inhabitants per year while that of NTM-PD was 1.07 / 100,000 inhabitants per year. Among the 178 patients, M. avium complex (MAC) was the most frequently isolated pathogen (38%), followed by M. fortuitum then M. abscessus (19% and 6% of cases respectively), the latter two mycobacteria being mainly found in the coastal center region. Concerning NTM-PD, two species were mainly involved: MAC (81%) and M. abscessus (16%).
DISCUSSION/CONCLUSION
This is the first study on the epidemiology of PNTM infections in French Guiana. PNTM's incidence looks similar to other contries and metropolitan France and NTM-PD is mostly due to MAC and M.abscessus. Although French Guiana is the French territory with the highest tuberculosis incidence, NTM should not be overlooked.
Topics: French Guiana; Humans; Lung; Lung Diseases; Mycobacterium; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria
PubMed: 36084148
DOI: 10.1371/journal.pntd.0010693 -
Infection and Drug Resistance 2022Nontuberculous mycobacteria (NTM) can cause pulmonary and extrapulmonary diseases. Tedizolid (TZD) is a new oxazolidinone with in vitro activity against NTM such as...
OBJECTIVE
Nontuberculous mycobacteria (NTM) can cause pulmonary and extrapulmonary diseases. Tedizolid (TZD) is a new oxazolidinone with in vitro activity against NTM such as complex (MAC), , and complex. The aim of this study was to evaluate the TZD susceptibility profiles of clinical isolates of NTM.
METHODS
The microdilution method was used to identify the minimum inhibitory concentration (MIC) of TZD and linezolid (LZD) for 133 clinical NTM isolates. Broth microdilution chequerboard assays were used to investigate the synergistic effects of TZD and three antibiotics on two reference isolates and eleven clinical isolates of NTM.
RESULTS
The TZD MIC and MIC for complex were 2 and 4 μg/mL, 16 and >32 μg/mL for MAC, respectively. TZD exhibited lower MICs than that of LZD for most NTM, which were positively correlated. Due to the high MIC values of TZD against MAC, it is necessary to conduct drug sensitivity tests before TZD administration. TZD-clarithromycin combination had synergistic response on complex in 3 of the 8 isolates, which lasted only 3-5 days. TZD-cefoxitin had synergistic effect against all five isolates.
CONCLUSION
Our study demonstrates that TZD had greater in vitro potency than LZD, and synergy studies suggested that TZD may be an important component of multi-drug treatment regimen.
PubMed: 36045871
DOI: 10.2147/IDR.S362583 -
Journal of Bone and Joint Infection 2022We present the rare case of a 61-year-old female with osteomyelitis of the cuboid bone following penetrating plantar trauma. The patient underwent a single-stage...
We present the rare case of a 61-year-old female with osteomyelitis of the cuboid bone following penetrating plantar trauma. The patient underwent a single-stage surgery for the condition, including lesion debridement and bone defect filling with absorbable, gentamicin-/vancomycin-loaded, calcium sulfate-hydroxyapatite biocomposites, that resolved favorably 5 months after intervention.
PubMed: 36032800
DOI: 10.5194/jbji-7-163-2022 -
Revista Da Sociedade Brasileira de... 2022In recent years, the prevalence of nontuberculous mycobacterial (NTM) infections has increased in different regions of the world. The American Thoracic Society (ATS)...
BACKGROUND
In recent years, the prevalence of nontuberculous mycobacterial (NTM) infections has increased in different regions of the world. The American Thoracic Society (ATS) recommends standardized identification criteria, reinforcing the need for faster and less complicated clinical and laboratory techniques.
METHODS
In this retrospective study, NTM species isolated from pulmonary, extrapulmonary, and disseminated samples from patients treated at a TB/HIV reference unit in the State of Amazonas from 2011 to 2014 were identified through a combination of molecular techniques.
RESULTS
To identify the molecular technique, 50 cryopreserved NTM cultures were recovered and subcultivated in culture medium. The potentially pathogenic NTM species identified were M. avium, M. intracellulare, M. kansasii, M. chelonae, M. abscessus, M. fortuitum, and M. peregrinum. Results of GenoType® showed moderate agreement with those of genomic sequencing (kappa = 0.60), whereas the results obtained by the PRA-hsp65 technique disagreed with the results obtained by sequencing (kappa = 0.49).
CONCLUSIONS
Our findings highlight that GenoType CM is a good method for the identification of NTM, as well as the need for the application of standardized criteria, such as those set forth by the ATS.
Topics: Brazil; HIV Infections; Humans; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Retrospective Studies; Tuberculosis
PubMed: 35946635
DOI: 10.1590/0037-8682-0613-2021