Epidemiology, clinical characteristics, and outcomes of nontuberculous mycobacterial skin, soft tissue, and bone infections from a single center over a 10-year period
Introduction: Non-tuberculous mycobacteria (NTM) cause a wide variety of clinical syndromes. Data guiding diagnosis and treatment of NTM skin and soft tissue infections (SSTI) and bone infections are limited. We sought to better understand SSTI and bone infections caused by NTM. Methods: All NTM cli...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405579423000591 |
| _version_ | 1797435721056780288 |
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| author | Mary B. Ford Jason F. Okulicz Jesse R. Salinas John L. Kiley |
| author_facet | Mary B. Ford Jason F. Okulicz Jesse R. Salinas John L. Kiley |
| author_sort | Mary B. Ford |
| collection | DOAJ |
| description | Introduction: Non-tuberculous mycobacteria (NTM) cause a wide variety of clinical syndromes. Data guiding diagnosis and treatment of NTM skin and soft tissue infections (SSTI) and bone infections are limited. We sought to better understand SSTI and bone infections caused by NTM. Methods: All NTM clinical isolates recovered at Brooke Army Medical Center from 2012 to 2022 were screened; SSTI and bone isolates were included. Electronic health records were reviewed for epidemiologic, microbiologic, and clinical data. Infections were defined as recovery of one or more NTM isolate from skin, soft tissue, or bone cultures with a corresponding clinical syndrome. Results: Forty isolates of skin, soft tissue, or bone origin from 29 patients were analyzed. Twenty (69 %) patients, majority female (14/20, 70 %), had infecting isolates, most commonly secondary to surgery (35 %) or trauma (35 %). Six of 20 (30 %) had bone infections. Time from symptom onset to isolate recovery was a median 61 days (IQR 43–95). Eight (40 %) had combined medical/surgical therapy, 8 (40 %) had surgery alone, and 4 (20 %) had medical therapy alone. M. abscessus was more frequently isolated from patients with true infections. Conclusions: Data supporting diagnosis and treatment decisions in NTM SSTI/bone infections is sparse. In this study the majority of NTM isolated were true infections. We confirm that surgery and trauma are the most common routes of exposure. The delay between symptom onset and directed therapy and the wide variety of treatment regimens highlight a need for additional studies delineating criteria for diagnosis and treatment. |
| first_indexed | 2024-03-09T10:52:20Z |
| format | Article |
| id | doaj.art-57e027bac8d9443180ee854f63bfd2ef |
| institution | Directory Open Access Journal |
| issn | 2405-5794 |
| language | English |
| last_indexed | 2024-03-09T10:52:20Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| spelling | doaj.art-57e027bac8d9443180ee854f63bfd2ef2023-12-01T05:02:23ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942023-12-0133100403Epidemiology, clinical characteristics, and outcomes of nontuberculous mycobacterial skin, soft tissue, and bone infections from a single center over a 10-year periodMary B. Ford0Jason F. Okulicz1Jesse R. Salinas2John L. Kiley3Infectious Disease Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA; Division of Infectious Disease, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Corresponding author at: Brooke Army Medical Center, 3551 Roger Brooke Dr, JBSA Fort Sam Houston, TX 78234, USA.Infectious Disease Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA; Division of Infectious Disease, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USADepartment of Pathology and Laboratory Services, Microbiology Laboratory, Brooke Army Medical Center, Fort Sam Houston, TX, USAInfectious Disease Service, Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA; Division of Infectious Disease, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USAIntroduction: Non-tuberculous mycobacteria (NTM) cause a wide variety of clinical syndromes. Data guiding diagnosis and treatment of NTM skin and soft tissue infections (SSTI) and bone infections are limited. We sought to better understand SSTI and bone infections caused by NTM. Methods: All NTM clinical isolates recovered at Brooke Army Medical Center from 2012 to 2022 were screened; SSTI and bone isolates were included. Electronic health records were reviewed for epidemiologic, microbiologic, and clinical data. Infections were defined as recovery of one or more NTM isolate from skin, soft tissue, or bone cultures with a corresponding clinical syndrome. Results: Forty isolates of skin, soft tissue, or bone origin from 29 patients were analyzed. Twenty (69 %) patients, majority female (14/20, 70 %), had infecting isolates, most commonly secondary to surgery (35 %) or trauma (35 %). Six of 20 (30 %) had bone infections. Time from symptom onset to isolate recovery was a median 61 days (IQR 43–95). Eight (40 %) had combined medical/surgical therapy, 8 (40 %) had surgery alone, and 4 (20 %) had medical therapy alone. M. abscessus was more frequently isolated from patients with true infections. Conclusions: Data supporting diagnosis and treatment decisions in NTM SSTI/bone infections is sparse. In this study the majority of NTM isolated were true infections. We confirm that surgery and trauma are the most common routes of exposure. The delay between symptom onset and directed therapy and the wide variety of treatment regimens highlight a need for additional studies delineating criteria for diagnosis and treatment.http://www.sciencedirect.com/science/article/pii/S2405579423000591Nontuberculous mycobacteriaSkin and soft tissue infectionBone infection |
| spellingShingle | Mary B. Ford Jason F. Okulicz Jesse R. Salinas John L. Kiley Epidemiology, clinical characteristics, and outcomes of nontuberculous mycobacterial skin, soft tissue, and bone infections from a single center over a 10-year period Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Nontuberculous mycobacteria Skin and soft tissue infection Bone infection |
| title | Epidemiology, clinical characteristics, and outcomes of nontuberculous mycobacterial skin, soft tissue, and bone infections from a single center over a 10-year period |
| title_full | Epidemiology, clinical characteristics, and outcomes of nontuberculous mycobacterial skin, soft tissue, and bone infections from a single center over a 10-year period |
| title_fullStr | Epidemiology, clinical characteristics, and outcomes of nontuberculous mycobacterial skin, soft tissue, and bone infections from a single center over a 10-year period |
| title_full_unstemmed | Epidemiology, clinical characteristics, and outcomes of nontuberculous mycobacterial skin, soft tissue, and bone infections from a single center over a 10-year period |
| title_short | Epidemiology, clinical characteristics, and outcomes of nontuberculous mycobacterial skin, soft tissue, and bone infections from a single center over a 10-year period |
| title_sort | epidemiology clinical characteristics and outcomes of nontuberculous mycobacterial skin soft tissue and bone infections from a single center over a 10 year period |
| topic | Nontuberculous mycobacteria Skin and soft tissue infection Bone infection |
| url | http://www.sciencedirect.com/science/article/pii/S2405579423000591 |
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