Figure - available from: Current Treatment Options in Infectious Diseases
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Mycobacterium marinum infection of the hand. a Erythemato-edematous lesions with suppuration. b Verrucous plaques covered by scales and crusts.
Source publication
Opinion statement
Among cutaneous infections caused by mycobacteria, those caused by non-tuberculous mycobacteria are the most common ones and their incidence seems to be progressively increasing. These infections could affect both immunocompetent and immunocompromised subjects. The majority of the pathogens have a worldwide distribution, and the t...
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Citations
... It is postulated that contaminated water or surgical instruments might be possible sources of post-operative infection [6]. It has been reported that rapid grower NTM are responsible for most of atypical mycobacterial cutaneous and soft tissue surgical infections, where environmental contamination is usually the source [8,9]. Clinical diagnosis of mycobacterial infections is considered challenging, and suspicion is usually built on late, mild, however persistent clinical presentation with poor response to antibiotics [10,11]. ...
Background
Surgical site infection (SSI) is a post-operative complication of high concern with adverse impact on patient prognosis and public health systems. Recently, SSI pathogens have experienced a change in microbial profile with increasing reports of non-tuberculous mycobacteria (NTM) as important pathogens.
Aim
of the study
The study aimed to detect the prevalence of NTM among cases with SSIs and describe their species using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) and PCR-based microarray.
Methods
The study was conducted with 192 pus samples collected from patients with SSI. Mycobacterial investigations were done in the form of Ziehl–Neelsen (ZN) smears for acid-fast bacilli, automated mycobacterial culture to isolate mycobacteria, followed by immunochromatography test to predict NTM. NTM-positive cultures were tested by MALDI -TOF MS and PCR-based microarray to reach species-level identification.
Results
Mycobacterial growth was found in 11/192 samples (5.7%) and identified as 4 NTM and 7 M . tuberculosis isolates with prevalence of 2.1% and 3.64%, respectively. The NTM species were described by MALDI-TOF as M. abscessus, M. porcinum, M. bacteremicum, and M. gordonae. Microarray agreed with MALDI-TOF in identifying one isolate (M. abscessus), while two isolates were classified as belonging to broad groups and one isolate failed to be identified.
Conclusions
The prevalence of NTM among SSI was found to be low, yet have to be considered in the diagnosis of mycobacteria. Employing advanced technologies in diagnosis is recommended to guide for appropriate treatment.
Surgical Site Infection (SSI) is an infection that occurs after any surgical procedure with adverse effects on a patient’s prognosis. SSIs are caused by a variety of bacteria including Non-Tuberculous Mycobacteria (NTM). Nowadays, NTM is reported as an important pathogen in delayed healing of surgical site infections in post-operative cases in many countries, however, there is no report yet in the country due to lacking any sensitive detection method. By multiplex PCR we previously reported the existence of NTM in a variety of clinical specimens and here we report NTM in SSI. Out of 98 patients with SSI, the total NTM positive cases were 20(20.4%) and Mycobacterium Tuberculosis (MTB) was 6(6.1%). NTM positivity rate was higher in female 13(65%) than male 7(35%). The majority (13) of the patients were treated with a combination of Clarithromycin and Ciprofloxacin with or without the first line of Anti-Tubercular Therapy (ATT) and cured. In the case of patients with delayed recovery of SSI, there should be a high level of clinical suspicion for the NTM as a causative agent and Multiplex PCR can be utilized to diagnose NTM and to discriminate from MTB. Pulse Vol.15, 2023 P: 22-27
