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Mycobacterium abscessus Complex Infections in Humans - Volume 21, Number 9—September 2015 - Emerging Infectious Disease journal - CDC


Mycobacterium abscessus Complex Infections in Humans - Volume 21, Number 9—September 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 9—September 2015


Mycobacterium abscessus Complex Infections in Humans

Meng-Rui Lee, Wang-Huei Sheng, Chien-Ching Hung, Chong-Jen Yu, Li-Na Lee, and Po-Ren HsuehComments to Author 
Author affiliations: National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan (M.-R. Lee, W.-H. Sheng, C.-C. Hung, C.-J. Yu, L.-N. Lee, P.-R. Hsueh)National Taiwan University Hospital, Taipei, Taiwan (M.-R. Lee, W.-H. Sheng, C.-C. Hung, C.-J. Yu, L.-N. Lee, P.-R. Hsueh)


Mycobacterium abscessus complex comprises a group of rapidly growing, multidrug-resistant, nontuberculous mycobacteria that are responsible for a wide spectrum of skin and soft tissue diseases, central nervous system infections, bacteremia, and ocular and other infections. M. abscessus complex is differentiated into 3 subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii. The 2 major subspecies, M. abscessus subsp. abscessus and M. abscessus subsp.massiliense, have different erm(41) gene patterns. This gene provides intrinsic resistance to macrolides, so the different patterns lead to different treatment outcomes. M. abscessus complex outbreaks associated with cosmetic procedures and nosocomial transmissions are not uncommon. Clarithromycin, amikacin, and cefoxitin are the current antimicrobial drugs of choice for treatment. However, new treatment regimens are urgently needed, as are rapid and inexpensive identification methods and measures to contain nosocomial transmission and outbreaks.
Mycobacteria are divided into 2 major groups for the purpose of diagnosis and treatment: Mycobacterium tuberculosis complex, which comprises M. tuberculosis, and nontuberculous mycobacteria (NTM), which comprise all of the other mycobacteria species that do not cause tuberculosis. NTM can cause pulmonary disease resembling tuberculosis, skin and soft tissue infections (SSTIs), central nervous system infections, bacteremia, and ocular and other infections (1,2). Over the past decade, the number of NTM disease cases worldwide has markedly increased (3,4), and the upsurge cannot be explained solely by increased awareness among physicians and advances in laboratory methods (3).
M. abscessus complex is a group of rapidly growing, multidrug-resistant NTM species that are ubiquitous in soil and water (1). Species comprising M. avium complex (MAC) are the most common NTM species responsible for disease; however, infections caused by M. abscessus complex are more difficult to treat because of antimicrobial drug resistance (5). M. abscessus complex is also resistant to disinfectants and, therefore, can cause postsurgical and postprocedural infections (2,5). Although M. abscessus complex most commonly causes SSTIs and pulmonary infections, the complex can also cause disease in almost all human organs (2,5). To improve our understanding ofM. abscessus complex infections, we reviewed the epidemiology and clinical features of and treatment and prevention measure for diseases caused by the organisms as well as the taxonomy and antimicrobial susceptibilities of these organisms.
Dr. Lee is attending physician at the Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan, and Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. His primary research interests include emerging infections and epidemiologic and clinical research on diseases caused by nontuberculous mycobacteria.


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Suggested citation for this article: Lee MR, Sheng WH, Hung CC, Yu CJ, Lee LN, Hsueh PR. Mycobacterium abscessus complex infections in humans. Emerg Infect Dis. 2015 Sep [date cited]. http://dx.doi.org/10.3201/eid2109.141634
DOI: 10.3201/eid2109.141634

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