{"title":"Atypical mycobacteria infections of surgical sites: a case series.","authors":"Sreevathsa M Ramachar, Nishan Shetty, Chaitra D Y","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Atypical mycobacteria (ATB) are a rare cause of surgical site infections (SSIs). They present with clinical features of erythema, induration, and sinus formation, which recur despite conventional treatment. Early diagnosis is difficult and requires a high index of suspicion for further investigations to confirm atypical mycobacterial infection. Treatment encompasses a combination of polymicrobial agents and surgical debridement.</p><p><strong>Objective: </strong>To describe the clinical presentation, diagnostic challenges, and treatment outcomes of atypical mycobacterial infections in surgical sites.</p><p><strong>Materials and methods: </strong>Written informed consent was obtained from all participants in this observational retrospective descriptive study. Scientific and ethical clearance was granted by the Ethical Clearance Committee at M.S Ramaiah Medical College and Hospital, Bengaluru. The study included 5 female patients from a tertiary care hospital in Bengaluru, India, who presented with SSIs that did not resolve with standard treatment. Discharge or wound scrapings from these patients with delayed infections were examined for the causative agent, with ATB isolates identified using solid and liquid culture methods.</p><p><strong>Results: </strong>ATB were isolated in 3 clean and 2 clean-contaminated surgeries, that is, in 60% and 40% of cases, respectively. Discharge alone did not yield growth in any of the cases (0%), whereas tissue scrapings revealed ATB in all 5 patients (100%). The most common organism cultured was Mycobacterium fortuitum (60%), followed by Mycobacterium abscessus (20%) and Mycobacterium chelonae (20%). Clarithromycin and ciprofloxacin alone for a period of 3 to 6 months yielded a 100% cure rate (5 of 5 patients).</p><p><strong>Conclusion: </strong>ATB infections are a rare cause of postoperative SSIs. These infections require multimodal management, with complete resolution possible after appropriate therapy. This series emphasizes the significance of ATB infection of surgical sites as a notable cause of postoperative morbidity.</p>","PeriodicalId":23752,"journal":{"name":"Wounds : a compendium of clinical research and practice","volume":"37 2","pages":"90-94"},"PeriodicalIF":1.4000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Wounds : a compendium of clinical research and practice","FirstCategoryId":"3","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Atypical mycobacteria (ATB) are a rare cause of surgical site infections (SSIs). They present with clinical features of erythema, induration, and sinus formation, which recur despite conventional treatment. Early diagnosis is difficult and requires a high index of suspicion for further investigations to confirm atypical mycobacterial infection. Treatment encompasses a combination of polymicrobial agents and surgical debridement.
Objective: To describe the clinical presentation, diagnostic challenges, and treatment outcomes of atypical mycobacterial infections in surgical sites.
Materials and methods: Written informed consent was obtained from all participants in this observational retrospective descriptive study. Scientific and ethical clearance was granted by the Ethical Clearance Committee at M.S Ramaiah Medical College and Hospital, Bengaluru. The study included 5 female patients from a tertiary care hospital in Bengaluru, India, who presented with SSIs that did not resolve with standard treatment. Discharge or wound scrapings from these patients with delayed infections were examined for the causative agent, with ATB isolates identified using solid and liquid culture methods.
Results: ATB were isolated in 3 clean and 2 clean-contaminated surgeries, that is, in 60% and 40% of cases, respectively. Discharge alone did not yield growth in any of the cases (0%), whereas tissue scrapings revealed ATB in all 5 patients (100%). The most common organism cultured was Mycobacterium fortuitum (60%), followed by Mycobacterium abscessus (20%) and Mycobacterium chelonae (20%). Clarithromycin and ciprofloxacin alone for a period of 3 to 6 months yielded a 100% cure rate (5 of 5 patients).
Conclusion: ATB infections are a rare cause of postoperative SSIs. These infections require multimodal management, with complete resolution possible after appropriate therapy. This series emphasizes the significance of ATB infection of surgical sites as a notable cause of postoperative morbidity.
期刊介绍：
Wounds is the most widely read, peer-reviewed journal focusing on wound care and wound research. The information disseminated to our readers includes valuable research and commentaries on tissue repair and regeneration, biology and biochemistry of wound healing, and clinical management of various wound etiologies.
Our multidisciplinary readership consists of dermatologists, general surgeons, plastic surgeons, vascular surgeons, internal medicine/family practitioners, podiatrists, gerontologists, researchers in industry or academia (PhDs), orthopedic surgeons, infectious disease physicians, nurse practitioners, and physician assistants. These practitioners must be well equipped to deal with a myriad of chronic wound conditions affecting their patients including vascular disease, diabetes, obesity, dermatological disorders, and more.
Whether dealing with a traumatic wound, a surgical or non-skin wound, a burn injury, or a diabetic foot ulcer, wound care professionals turn to Wounds for the latest in research and practice in this ever-growing field of medicine.
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