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==Overview== | ==Overview== | ||
Mycobacterium abscessus is a rapidly growing [[mycobacterium]] (RGM) that is a common water contaminant. Mycobacterium abscessus is a bacterium distantly related to the ones that cause [[tuberculosis]] and [[leprosy]]. It is part of a group known as rapidly growing mycobacteria and is found in water, soil, and dust. It has been known to contaminate medications and products, including medical devices. M. abscessus can cause a variety of infections. Healthcare-associated infections due to this bacterium are usually of the skin and the soft tissues under the skin. It is also a cause of serious lung infections in persons with various chronic lung diseases, such as cystic fibrosis, post-traumatic wound infections, and disseminated cutaneous diseases, mostly in patients with suppressed immune systems. | ''Mycobacterium abscessus'' (''M. abscessus'') is a rapidly growing [[mycobacterium]] (RGM) that is a common water contaminant. Mycobacterium abscessus is a bacterium distantly related to the ones that cause [[tuberculosis]] and [[leprosy]]. It is part of a group known as rapidly growing mycobacteria and is found in water, soil, and dust. It has been known to contaminate medications and products, including medical devices. M. abscessus can cause a variety of infections. Healthcare-associated infections due to this bacterium are usually of the skin and the soft tissues under the skin. It is also a cause of serious lung infections in persons with various chronic lung diseases, such as cystic fibrosis, post-traumatic wound infections, and disseminated cutaneous diseases, mostly in patients with suppressed immune systems. | ||
==Historical Perspective== | |||
''M. abscessus'' was first isolated in 1953 from gluteal abscesses in a 62-year-old patient who had injured her [[knee]] as a child and had a disseminated infection 48 years later.<ref name="pmid13035193">{{cite journal| author=MOORE M, FRERICHS JB| title=An unusual acid-fast infection of the knee with subcutaneous, abscess-like lesions of the gluteal region; report of a case with a study of the organism, Mycobacterium abscessus, n. sp. | journal=J Invest Dermatol | year= 1953 | volume= 20 | issue= 2 | pages= 133-69 | pmid=13035193 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13035193 }} </ref> It was until 1992 that ''M. abscessus'' is considered a separate organism from [[Mycobacterium chelonae]]. The species ''M. bolletii'', named after the late microbiologist and taxonomist Claude Bollet, was described in 2006. In current taxonomy, ''M. bolletii'' and ''M. massiliense'' (named for Massilia, the ancient Greek and Roman name for Marseille, where the organism was isolated) have been incorporated into ''M. abscessus'' subsp. ''bolletii''. <ref> Etymologia: Mycobacterium abscessus subsp. bolletii. Emerg Infect Dis [Internet]. 2014 Mar [February 20, 2014]. http://dx.doi.org/10.3201/eid2003.ET2003 </ref><ref name=CDC> [http://wwwnc.cdc.gov/eid/article/20/3/et-2003_article CDC.gov Etymologia: Mycobacterium abscessus subsp. bolletii] </ref> | |||
==Causes== | |||
''M. abscessus'' is a bacterium distantly related to the ones that cause [[tuberculosis]] and [[leprosy]]. It is part of a group known as rapidly growing [[mycobacteria]] (RGM) and is found in water, soil, and dust. It has been known to contaminate medications and products, including medical devices. | |||
==Epidemiology and Demographics== | |||
''M. abscessus'' infection can occur worldwide. Although ''M. abscessus'' infection has been reported throughout the United States, South Eastern states such as Florida and Texas have the highest [[incidence]].<ref name="pmid17277290">{{cite journal| author=Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F et al.| title=An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. | journal=Am J Respir Crit Care Med | year= 2007 | volume= 175 | issue= 4 | pages= 367-416 | pmid=17277290 | doi=10.1164/rccm.200604-571ST | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17277290 }} </ref> In July 2014, an outbreak of ''M. abscessus'' infection was reported in South Carolina among surgical patients. Moreover, 80% of rapidly growing [[mycobacterium|mycobacterial]] related respiratory disease are caused by ''M. abscessus'' infection in the United States. While infected patients who have no predisposing factors are likely non smoker females older than 60 years of age, ''M. abscessus'' infection among patients with predisposing factors occurs at an earlier age.<ref name="pmid8484642">{{cite journal| author=Griffith DE, Girard WM, Wallace RJ| title=Clinical features of pulmonary disease caused by rapidly growing mycobacteria. An analysis of 154 patients. | journal=Am Rev Respir Dis | year= 1993 | volume= 147 | issue= 5 | pages= 1271-8 | pmid=8484642 | doi=10.1164/ajrccm/147.5.1271 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8484642 }} </ref> Approximately 15% of patients who have ''M. abscessus'' infection also have a co-infection with ''[[mycobacterium avium complex]]'' (MAC).<ref name="pmid8484642">{{cite journal| author=Griffith DE, Girard WM, Wallace RJ| title=Clinical features of pulmonary disease caused by rapidly growing mycobacteria. An analysis of 154 patients. | journal=Am Rev Respir Dis | year= 1993 | volume= 147 | issue= 5 | pages= 1271-8 | pmid=8484642 | doi=10.1164/ajrccm/147.5.1271 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8484642 }} </ref> | |||
==Risk Factors== | |||
Skin, soft tissue, and bone infection with ''M. abscessus'' has been associated with penetrating injuries, open [[wound]]s, intramuscular injections, and inappropriate disinfection of medical devices. Some of the risk factors for respiratory ''M. abscessus'' infection are chronic lung diseases such as [[cystic fibrosis]] and previous untreated [[mycobacterium|mycobacterial]] infection. | |||
==Natural History, Complications and Prognosis== | |||
Infection with ''M. abscessus'' can lead to [[skin and soft tissue infection|skin, soft tissues]] and [[bone]] infections, bronchopulmonary infections, and disseminated infection in non-[[AIDS]] immunocompromised patients<ref name="pmid22290346">{{cite journal| author=Nessar R, Cambau E, Reyrat JM, Murray A, Gicquel B| title=Mycobacterium abscessus: a new antibiotic nightmare. | journal=J Antimicrob Chemother | year= 2012 | volume= 67 | issue= 4 | pages= 810-8 | pmid=22290346 | doi=10.1093/jac/dkr578 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22290346 }} </ref> Minor infections with ''M. abscessus'' can resolve either spontaneously or following surgical debridement.<ref name="pmid17277290">{{cite journal| author=Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F et al.| title=An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. | journal=Am J Respir Crit Care Med | year= 2007 | volume= 175 | issue= 4 | pages= 367-416 | pmid=17277290 | doi=10.1164/rccm.200604-571ST | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17277290 }} </ref> The majority of pulmonary ''M. abscessus'' infection are chronic and incurable. When pulmonary ''M. abscessus'' infection occurs in the absence of any predisposing conditions, the course of the disease is slowly progressive and indolent. Whereas, when the pulmonary infection is associated with underlying predisposing factors, such as gastrointestinal or pulmonary conditions, the disease is rapidly progressive and fulminant.<ref name="pmid8484642">{{cite journal| author=Griffith DE, Girard WM, Wallace RJ| title=Clinical features of pulmonary disease caused by rapidly growing mycobacteria. An analysis of 154 patients. | journal=Am Rev Respir Dis | year= 1993 | volume= 147 | issue= 5 | pages= 1271-8 | pmid=8484642 | doi=10.1164/ajrccm/147.5.1271 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8484642 }} </ref> | |||
==References== | ==References== | ||
Revision as of 14:08, 24 July 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
Mycobacterium abscessus (M. abscessus) is a rapidly growing mycobacterium (RGM) that is a common water contaminant. Mycobacterium abscessus is a bacterium distantly related to the ones that cause tuberculosis and leprosy. It is part of a group known as rapidly growing mycobacteria and is found in water, soil, and dust. It has been known to contaminate medications and products, including medical devices. M. abscessus can cause a variety of infections. Healthcare-associated infections due to this bacterium are usually of the skin and the soft tissues under the skin. It is also a cause of serious lung infections in persons with various chronic lung diseases, such as cystic fibrosis, post-traumatic wound infections, and disseminated cutaneous diseases, mostly in patients with suppressed immune systems.
Historical Perspective
M. abscessus was first isolated in 1953 from gluteal abscesses in a 62-year-old patient who had injured her knee as a child and had a disseminated infection 48 years later.[1] It was until 1992 that M. abscessus is considered a separate organism from Mycobacterium chelonae. The species M. bolletii, named after the late microbiologist and taxonomist Claude Bollet, was described in 2006. In current taxonomy, M. bolletii and M. massiliense (named for Massilia, the ancient Greek and Roman name for Marseille, where the organism was isolated) have been incorporated into M. abscessus subsp. bolletii. [2][3]
Causes
M. abscessus is a bacterium distantly related to the ones that cause tuberculosis and leprosy. It is part of a group known as rapidly growing mycobacteria (RGM) and is found in water, soil, and dust. It has been known to contaminate medications and products, including medical devices.
Epidemiology and Demographics
M. abscessus infection can occur worldwide. Although M. abscessus infection has been reported throughout the United States, South Eastern states such as Florida and Texas have the highest incidence.[4] In July 2014, an outbreak of M. abscessus infection was reported in South Carolina among surgical patients. Moreover, 80% of rapidly growing mycobacterial related respiratory disease are caused by M. abscessus infection in the United States. While infected patients who have no predisposing factors are likely non smoker females older than 60 years of age, M. abscessus infection among patients with predisposing factors occurs at an earlier age.[5] Approximately 15% of patients who have M. abscessus infection also have a co-infection with mycobacterium avium complex (MAC).[5]
Risk Factors
Skin, soft tissue, and bone infection with M. abscessus has been associated with penetrating injuries, open wounds, intramuscular injections, and inappropriate disinfection of medical devices. Some of the risk factors for respiratory M. abscessus infection are chronic lung diseases such as cystic fibrosis and previous untreated mycobacterial infection.
Natural History, Complications and Prognosis
Infection with M. abscessus can lead to skin, soft tissues and bone infections, bronchopulmonary infections, and disseminated infection in non-AIDS immunocompromised patients[6] Minor infections with M. abscessus can resolve either spontaneously or following surgical debridement.[4] The majority of pulmonary M. abscessus infection are chronic and incurable. When pulmonary M. abscessus infection occurs in the absence of any predisposing conditions, the course of the disease is slowly progressive and indolent. Whereas, when the pulmonary infection is associated with underlying predisposing factors, such as gastrointestinal or pulmonary conditions, the disease is rapidly progressive and fulminant.[5]
References
- ↑ MOORE M, FRERICHS JB (1953). "An unusual acid-fast infection of the knee with subcutaneous, abscess-like lesions of the gluteal region; report of a case with a study of the organism, Mycobacterium abscessus, n. sp". J Invest Dermatol. 20 (2): 133–69. PMID 13035193.
- ↑ Etymologia: Mycobacterium abscessus subsp. bolletii. Emerg Infect Dis [Internet]. 2014 Mar [February 20, 2014]. http://dx.doi.org/10.3201/eid2003.ET2003
- ↑ CDC.gov Etymologia: Mycobacterium abscessus subsp. bolletii
- ↑ 4.0 4.1 Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F; et al. (2007). "An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases". Am J Respir Crit Care Med. 175 (4): 367–416. doi:10.1164/rccm.200604-571ST. PMID 17277290.
- ↑ 5.0 5.1 5.2 Griffith DE, Girard WM, Wallace RJ (1993). "Clinical features of pulmonary disease caused by rapidly growing mycobacteria. An analysis of 154 patients". Am Rev Respir Dis. 147 (5): 1271–8. doi:10.1164/ajrccm/147.5.1271. PMID 8484642.
- ↑ Nessar R, Cambau E, Reyrat JM, Murray A, Gicquel B (2012). "Mycobacterium abscessus: a new antibiotic nightmare". J Antimicrob Chemother. 67 (4): 810–8. doi:10.1093/jac/dkr578. PMID 22290346.