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Mycobacterium abscessus

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]

General

Mycobacterium

Properties

KINGDOM: monera DIVISION: SCHIZOMYCETES

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 15, 17, 18, 19. American College of Physicians, Philadelphia 2009, 2015, 2018, 2021.
  2. 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: 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