Arch Plast Surg.  2012 Jan;39(1):18-24. 10.5999/aps.2012.39.1.18.

Management of Infections with Rapidly Growing Mycobacteria after Unexpected Complications of Skin and Subcutaneous Surgical Procedures

• Lim JM
• Kim JH
• Yang HJ

• KMID: 1922781
• DOI: http://doi.org/10.5999/aps.2012.39.1.18

Abstract

BACKGROUND
Infection caused by rapidly growing mycobacteria (RGM) is not uncommon, and the prevalence of RGM infection has been increasing. Clinical diagnosis is difficult because there are no characteristic clinical features. There is also no standard antibiotic regimen for treating RGM infection. A small series of patients with RGM infections was studied to examine their treatments and outcomes.
METHODS
A total of 5 patients who had developed postoperative infections from January 2009 to December 2010 were retrospectively reviewed. Patients were initially screened using a mycobacteria rapid screening test (polymerase chain reaction [PCR]-reverse blot hybridization assay). To confirm mycobacterial infection, specimens were cultured for nontuberculous mycobacteria and analyzed by 16 S ribosomal RNA and rpoB gene PCR.
RESULTS
The patients were treated with intravenous antibiotics during hospitalization, and oral antibiotics were administered after discharge. The mean duration of follow-up was 9 months, and all patients were completely cured of infection with a regimen of a combination of antibiotics plus surgical treatment. Although none of the patients developed recurrence, there were complications at the site of infection, including hypertrophic scarring, pigmentation, and disfigurement.
CONCLUSIONS
Combination antibiotic therapy plus drainage of surgical abscesses appeared to be effective for the RGM infections seen in our patients. Although neither the exact dosage nor a standardized regimen has been firmly established, we propose that our treatment can provide an option for the management of rapidly growing mycobacterial infection.

Keyword

Mycobacterium infections, nontuberculous; Therapy; Antibacterial agents

MeSH Terms

Abscess
Anti-Bacterial Agents
Chimera
Cicatrix, Hypertrophic
Drainage
Follow-Up Studies
Hospitalization
Humans
Mass Screening
Mycobacterium Infections, Nontuberculous
Nontuberculous Mycobacteria
Pigmentation
Prevalence
Recurrence
Retrospective Studies
RNA, Ribosomal
Skin
Anti-Bacterial Agents
RNA, Ribosomal