Catheter-related infections caused by <i>Mycobacterium abscessus</i> in a patient with motor neurone disease: A case report

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Abstract

BACKGROUND

Mycobacterium abscessus ( M. abscessus) is a rapidly growing mycobacterium and ubiquitous in the environment, which infrequently causes disease in humans. However, it can cause cutaneous or respiratory infections among immunocompromised hosts. Due to the resistance to most antibiotics, the pathogen is formidable and difficult-to-treat.

CASE SUMMARY

Here, we present a case of catheter-related M. abscessus infections in a patient with motor neurone disease. Catheter and peripheral blood cultures of the patient showed positive results during Gram staining and acid-fast staining. The alarm time of catheter blood culture was 10.6 h earlier than that of peripheral blood. After removal of the peripherally inserted central catheter, secretion and catheter blood culture were positive. M. abscessus was identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry and 16S rDNA sequencing.

CONCLUSION

For catheter-related M. abscessus infection, rapid diagnosis and timely and adequate antimicrobial therapy are crucial.

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Most cited references 17

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Rifabutin Is Active against Mycobacterium abscessus Complex

Dinah Binte Aziz, Jian Liang Low, Mu-Lu Wu … (2017)

ABSTRACT Lung infections caused by Mycobacterium abscessus are emerging as a global threat to individuals with cystic fibrosis and to other patient groups. Recent evidence for human-to-human transmission worsens the situation. M. abscessus is an intrinsically multidrug-resistant pathogen showing resistance to even standard antituberculosis drugs, such as rifampin. Here, our objective was to identify existing drugs that may be employed for the treatment of M. abscessus lung disease. A collection of more than 2,700 approved drugs was screened at a single-point concentration against an M. abscessus clinical isolate. Hits were confirmed with fresh solids in dose-response experiments. For the most attractive hit, growth inhibition and bactericidal activities against reference strains of the three M. abscessus subspecies and a collection of clinical isolates were determined. Surprisingly, the rifampin derivative rifabutin had MICs of 3 ± 2 μM (3 μg/ml) against the screening strain, the reference strains M. abscessus subsp. abscessus ATCC 19977, M. abscessus subsp. bolletii CCUG 50184-T, and M. abscessus subsp. massiliense CCUG 48898-T, as well as against a collection of clinical isolates. Furthermore, rifabutin was active against clarithromycin-resistant strains. In conclusion, rifabutin, in contrast to rifampin, is active against the Mycobacterium abscessus complex bacteria in vitro and may be considered for treatment of M. abscessus lung disease.

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Mycobacterium abscessus: an emerging rapid-growing potential pathogen.

Björn Petrini (2006)

Mycobacterium abscessus is the most pathogenic and chemotherapy-resistant rapid-growing mycobacterium. It is commonly associated with contaminated traumatic skin wounds and with post-surgical soft tissue infections. It is also one of the mycobacteria that are most often isolated from cystic fibrosis patients. It is essential to differentiate this species from the formerly indistinct "M. chelonae-complex", as chemotherapy is especially difficult in M. abscessussenso strictu. Clarithromycin or azithromycin are the only regular oral antimycobacterial agents with an effect on M. abscessus, and should preferably be supplemented with other drugs since long-term monotherapy may cause resistance. Amikacin is a major parenteral drug against M. abscessus that should also be given in combination with another drug. The recently introduced drug tigecycline may prove to be an important addition to chemotherapy, but has yet to be fully clinically evaluated as an antimycobacterial agent. Surgery can be curative, or at least helpful, in the healing of M. abscessus infection, and if conducted, it should include the removal of all foreign or necrotic material. There is increasing awareness of M. abscessus as an emerging pathogen.

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Clinical significance of differentiation of Mycobacterium massiliense from Mycobacterium abscessus.

Nora Kim, Yoon-Hoh Kook, Moo Lee … (2011)

Mycobacterium massiliense has been recognized as a separate species from Mycobacterium abscessus; however, little is known regarding the clinical impact of this differentiation. To compare clinical features and treatment outcomes between patients with M. abscessus lung disease and those with M. massiliense lung disease. We performed molecular identification of stored clinical isolates of M. abscessus complex and compared clinical characteristics and treatment outcomes between 64 patients with M. abscessus lung disease and 81 patients with M. massiliense lung disease. The clinical and radiographic manifestations of disease caused by each species were similar. Standardized combination antibiotic therapy, including a clarithromycin-containing regimen in combination with an initial 4-week course of cefoxitin and amikacin, was given to 57 patients (24 with M. abscessus and 33 with M. massiliense) for more than 12 months. The proportion of patients with sputum conversion and maintenance of negative sputum cultures was higher in patients with M. massiliense infection (88%) than in those with M. abscessus infection (25%; P < 0.001). Inducible resistance to clarithromycin (minimal inhibitory concentrations ≥ 32 μg/ml) was found in all tested M. abscessus isolates (n = 19), but in none of the M. massiliense isolates (n = 28). Treatment response rates to combination antibiotic therapy including clarithromycin were much higher in patients with M. massiliense lung disease than in those with M. abscessus lung disease. The inducible resistance to clarithromycin could explain the lack of efficacy of clarithromycin-containing antibiotic therapy against M. abscessus lung disease.

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Author and article information

Contributors

Su-Fei Pan

Yuan-Yuan Zhang

Xiao-Zhen Wang

Jing-Jing Sun

Shao-Ling Song

Yu-Rong Tang

Ji-Liang Wang

Journal

Journal ID (nlm-ta): World J Clin Cases

Journal ID (publisher-id): WJCC

Title: World Journal of Clinical Cases

Publisher: Baishideng Publishing Group Inc

ISSN (Electronic): 2307-8960

Publication date (Print): 26 May 2022

Publication date (Electronic): 26 May 2022

Volume: 10

Issue: 15

Pages: 5082-5087

Affiliations

Department of Laboratory Medicine, Shengli Oilfield Central Hospital, Dongying 257034, Shandong Province, China

Department of Laboratory Medicine, Shengli Oilfield Central Hospital, Dongying 257034, Shandong Province, China. zxyywjl@ 123456163.com

Author notes

Author contributions: Pan SF, Zhang YY, and Wang JL designed the research and wrote the paper; Pan SF, Zhang YY, Wang XZ, Sun JJ, Song SL, and Tang YR collected all the data related to the case report; Wang JL supervised the report; all authors have read and approved the final manuscript.

Corresponding author: Ji-Liang Wang, MS, Chief Doctor, Department of Laboratory Medicine, Shengli Oilfield Central Hospital, No. 31 Jinan Road, Dongying District, Dongying 257034, Shandong Province, China. zxyywjl@ 123456163.com

Article

Other ID: jWJCC.v10.i15.pg5082

DOI: 10.12998/wjcc.v10.i15.5082

PMC ID: 9198855

SO-VID: a787b64e-5b3b-414f-b4f8-79c2ec335c4f

License:

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

History

Date received : 16 December 2021

Date revision received : 23 February 2022

Date accepted : 26 March 2022

Catheter-related infections caused by Mycobacterium abscessus in a patient with motor neurone disease: A case report

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Abstract

BACKGROUND

CASE SUMMARY

CONCLUSION

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ScienceOpen Clinical Case Reports Collection

Most cited references 17

Rifabutin Is Active against Mycobacterium abscessus Complex

Mycobacterium abscessus: an emerging rapid-growing potential pathogen.

Clinical significance of differentiation of Mycobacterium massiliense from Mycobacterium abscessus.

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Contributors

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