Mycobacterium abscessus subspecies abscessus infection associated with cosmetic surgical procedures: Case series
| Autor: | F.I. Contreras-Yametti, M.A. Jara-Palacios, C. Moreno-Izquierdo, J. Zurita |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Imipenem medicine.medical_specialty Cosmetic surgery medicine.drug_class medicine.medical_treatment 030106 microbiology Antibiotics Infectious and parasitic diseases RC109-216 Mycobacterium abscessus Article 03 medical and health sciences 0302 clinical medicine Clarithromycin medicine polycyclic compounds 030212 general & internal medicine Nontuberculous mycobacteria Debridement biology business.industry biochemical phenomena metabolism and nutrition Surgical infection biology.organism_classification bacterial infections and mycoses Dermatology Clinical trial Infectious Diseases Amikacin bacteria business medicine.drug |
| Zdroj: | IDCases, Vol 22, Iss, Pp e00992-(2020) IDCases |
| ISSN: | 2214-2509 |
| Popis: | Highlights • Mycobacterium abscessus is a drug-resistant nontuberculous mycobacterium (NTM). • Cutaneous & subcutaneous NTM infections post-cosmetic surgery are poorly diagnosed. • Initial surgical evaluation facilitates early suspicion of M. abscessus infection. • Rapidly evolving infection & negative culture/antibiotic response are indicators. • Amikacin, imipenem, & clarithromycin combination may treat M. abscessus infection. Background Mycobacterium abscessus is one of the most pathogenic and drug-resistant opportunistic microorganisms among the nontuberculous mycobacteria (NTM) involved in skin and soft tissue infections (SSTI) associated with cosmetic surgical procedures. However, NTM infection is often wrongly diagnosed initially causing prolonged suffering. Here is described the author’s experience working with patients who developed M. abscessus SSTI after cosmetic procedures. Methods Patients who developed NTM infection after undergoing cosmetic procedures, and who presented at the Hospital Metropolitano and Hospital Vozandes (Quito, Ecuador) between 2013–2016. A review of patient medical records was performed. Results Five patients with culture proven M. abscessus subspecies abscessus SSTI after cosmetic surgeries were identified. All patients were treated with aggressive surgical debridement and antibiotics. Conclusions A rapidly spreading wound infection presenting two or more weeks after a cosmetic procedure that fails to respond to standard antimicrobial therapy should raise suspicion for NTM infection. Samples for acid-fast bacilli smear, cultures, and PCR from infected tissue should be taken. Surgical drainage and debridement are recommended along with a long course of antibiotics. In the absence of clinical trials, a combination of amikacin, imipenem, and clarithromycin may be an adequate initial treatment for M. abscessus subspecies abscessus SSTI in immunocompetent patients. |
| Databáze: | OpenAIRE |
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