Mycobacterium abscessus
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Etiology
- uncommon in patients with HIV1 infection
- occurs in patients with cystic fibrosis, COPD
- occurs in patients with solid organ tranplantation
- occurs in post-operative wound infections
Pathology
- dissseminated infection
- pulmonary infection
- cutaneous lesions
- immunosuppressed patients
- generally after trauma, surgery, catheterization, cosmetic procedures
Laboratory
- rapidly growing in culture
- cultures generally positive in 1 week vs 2-6 weeks
- Mycobacterium abscessus clarithromycin resistance
- also see Mycobacterium
Management
- not susceptible to standard anti-tuberculosis drugs
- most strains are susceptible to clarithromycin & amikacin
- other potentially useful agents include: Bactrim, fluoroquinolones, tetracyclines, imipenem, cefoxitin
- minimum of 4 months of therapy
- 3 bioengineered bacteriophages IV every 12 hours for 32 weeks cleared an antibiotic-resistant Mycobacterium abscessus infection from serum & sputum in a patient with cystic fibrosis[2]
More general terms
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 15, 17, 18, 19. American College of Physicians, Philadelphia 2009, 2015, 2018, 2021.
- ↑ 2.0 2.1 Dedrick RM, Guerrero-Bustamante CA, Garlena RA et al Engineered bacteriophages for treatment of a patient with a disseminated drug-resistant Mycobacterium abscessus. Nature Medicine, 25, 730-733, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30948168 https://www.nature.com/articles/s41591-019-0437-z
Schmidt C Phage therapy's latest makeover. Nature Biotechnology (2019). May 8 Not indexed in PubMed https://www.nature.com/articles/s41587-019-0133-z