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Semin Respir Crit Care Med 2008; 29(5): 577-588
DOI: 10.1055/s-0028-1085709
Published Thieme Medical Publishers

Diagnosis and Treatment of Infections Caused by Rapidly Growing Mycobacteria

Rhonda E. Colombo1 , Kenneth N. Olivier1
  • 1Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
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Publikationsverlauf

Publikationsdatum:
22. September 2008 (online)

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ABSTRACT

Rapidly growing mycobacteria (RGM) are ubiquitous environmental organisms capable of causing a wide variety of infections in humans. The prevalence of RGM infections appears to be increasing, although exact incidence rates are unknown. Although some risk factors for pulmonary RGM infection have been determined, the specific host factors predisposing to disease in the majority of cases are not clear. Significant advances in molecular methods of mycobacterial identification have led to isolation of more varieties, changes in taxonomy, and more rapid and accurate diagnosis of RGM from clinical isolates. Despite significant advances in the field, diagnosing and treating RGM pulmonary infections remain complicated. Current guidelines are based on the most commonly encountered NTM. Their applicability to less frequent RGM isolates has not been definitively established. Treatment often requires multiple antimicrobial agents for prolonged periods of time, with varying degrees of success and significant associated morbidity.

KEYWORDS

Rapidly growing mycobacteria (RGM) - nontuberculous mycobacteria (NTM) - diagnosis - treatment

REFERENCES

  • 1 Witebsky F G, Conville P S. Rapidly growing mycobacteria. In: Borriello PS, Murray PR, Funke G Topley and Wilson's Microbiology and Microbial Infections: Bacteriology Volume 2. London; Hodder Arnold 2005: 1236-1269
    Google Scholar
  • 2 Tortoli E. The new mycobacteria: an update.  FEMS Immunol Med Microbiol. 2006;  48 169-178
    PubMedGoogle Scholar
  • 3 Euzeby J P. List of prokaryotic names with standing in nomenclature—genus Mycobacterium . Accessed May 16, 2008 at http://www.bacterio.cict.fr/m/mycobacterium.html
    Google Scholar
  • 4 Griffith D E, Aksamit T, Brown-Elliott B A et al.. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases.  Am J Respir Crit Care Med. 2007;  175 367-416
    CrossrefPubMedGoogle Scholar
  • 5 Herdman A V, Steele Jr J C. The new mycobacterial species: emerging or newly distinguished pathogens.  Clin Lab Med. 2004;  24 651-690
    CrossrefPubMedGoogle Scholar
  • 6 Falkinham J O. Epidemiology of infection by nontuberculous mycobacteria.  Clin Microbiol Rev. 1996;  9 177-215
    CrossrefPubMedGoogle Scholar
  • 7 Brown-Elliott B A, Wallace Jr R J. Clinical and taxonomic status of pathogenic nonpigmented or late-pigmenting rapidly growing mycobacteria.  Clin Microbiol Rev. 2002;  15 716-746
    CrossrefPubMedGoogle Scholar
  • 8 De Groote M A, Huitt G. Infections due to rapidly growing mycobacteria.  Clin Infect Dis. 2006;  42 1756-1763
    CrossrefPubMedGoogle Scholar
  • 9 Howard S T, Byrd T F. The rapidly growing mycobacteria: saprophytes and parasites.  Microbes Infect. 2000;  2 1845-1853
    CrossrefPubMedGoogle Scholar
  • 10 Munayco C V, Grijalva C G, Culqui D R et al.. Outbreak of persistent cutaneous abscesses due to Mycobacterium chelonae after mesotherapy sessions, Lima, Peru.  Rev Saude Publica. 2008;  42 146-149
    PubMedGoogle Scholar
  • 11 Winthrop K L, Abrams M, Yakrus M et al.. An outbreak of mycobacterial furunculosis associated with footbaths at a nail salon.  N Engl J Med. 2002;  346 1366-1371
    CrossrefPubMedGoogle Scholar
  • 12 Wallace Jr R J, Brown B A, Griffith D E. Nosocomial outbreaks/pseudo outbreaks caused by nontuberculous mycobacteria.  Annu Rev Microbiol. 1998;  52 453-490
    CrossrefPubMedGoogle Scholar
  • 13 Marras T K, Daley C L. Epidemiology of human pulmonary infection with nontuberculous mycobacteria.  Clin Chest Med. 2002;  23 553-567
    CrossrefPubMedGoogle Scholar
  • 14 Esteban J, Martin-de-Hijas N Z, Fernandez A I et al.. Epidemiology of infections due to nonpigmented rapidly growing mycobacteria diagnosed in an urban area.  Eur J Clin Microbiol Infect Dis. 2008 May 6;  , [Epub ahead of print]
    PubMedGoogle Scholar
  • 15 Martin-Casabona N, Bahrmand A R, Bennedsen J et al.. Non-tuberculous mycobacteria: patterns of isolation: a multi-country retrospective survey.  Int J Tuberc Lung Dis. 2004;  8 1186-1193
    PubMedGoogle Scholar
  • 16 Han X Y, De I, Jacobson K L. Rapidly growing mycobacteria: clinical and microbiologic studies of 115 cases.  Am J Clin Pathol. 2007;  128 612-621
    CrossrefPubMedGoogle Scholar
  • 17 Bodle E E, Cunningham J A, Della-Latta P, Schluger N W, Saiman L. Epidemiology of nontuberculous mycobacteria in patients without HIV infection, New York City.  Emerg Infect Dis. 2008;  14 390-396
    CrossrefPubMedGoogle Scholar
  • 18 Han X Y. Seasonality of clinical isolation of rapidly growing mycobacteria.  Epidemiol Infect. 2008;  136 1188-1191
    PubMedGoogle Scholar
  • 19 Holland S M. Interferon gamma, IL-12, IL-12R and STAT-1 immunodeficiency diseases: disorders of the interface of innate and adaptive immunity.  Immunol Res. 2007;  38 342-346
    CrossrefPubMedGoogle Scholar
  • 20 Ebert D L, Olivier K. Nontuberculous mycobacteria in cystic fibrosis.  Infect Dis Clin North Am. 2002;  16 221-233
    CrossrefPubMedGoogle Scholar
  • 21 Iseman M D, Buchanan D L, Ackerson L M. Pectus excavatum and scoliosis: thoracic anomalies associated with pulmonary disease caused by Mycobacterium avium complex.  Am Rev Respir Dis. 1991;  144 914-916
    CrossrefPubMedGoogle Scholar
  • 22 Falkinham J O. The changing pattern of nontuberculous mycobacterial disease.  Can J Infect Dis. 2003;  14 281-286
    PubMedGoogle Scholar
  • 23 Somoskovi A, Hotaling J E, Fitzgerald M et al.. Lessons from a proficiency testing event for acid-fast microscopy.  Chest. 2001;  120 250-257
    CrossrefPubMedGoogle Scholar
  • 24 Somoskovi A, Mester J, Hale Y M, Parsons L M, Salfinger M. Laboratory diagnosis of nontuberculous mycobacteria.  Clin Chest Med. 2002;  23 585-597
    CrossrefPubMedGoogle Scholar
  • 25 Bange F C, Bottger E C. Improved decontamination method for recovering mycobacteria from patients with cystic fibrosis.  Eur J Clin Microbiol Infect Dis. 2002;  21 546-548
    CrossrefPubMedGoogle Scholar
  • 26 Daley P, Petrich A, May K et al.. Comparison of in-house and commercial 16S rRNA sequencing with high performance liquid chromatography and genotype AS and CM for identification of nontuberculous mycobacteria.  Diagn Microbiol Infect Dis. 2008;  61 284-293
    CrossrefPubMedGoogle Scholar
  • 27 Zelazny A M, Calhoun L B, Shea Y R et al.. Identification of Mycobacterium species by secA1 sequences.  J Clin Microbiol. 2005;  43 1051-1058
    CrossrefPubMedGoogle Scholar
  • 28 Böddinghaus B, Rogall T, Flohr T, Blöcker H, Böttger E C. Detection and identification of mycobacteria by amplification of rRNA.  J Clin Microbiol. 1990;  28 1751-1759
    PubMedGoogle Scholar
  • 29 Telenti A, Marchesi F, Balz M et al.. Rapid identification of mycobacteria to the species level by polymerase chain reaction and restriction enzyme analysis.  J Clin Microbiol. 1993;  31 175-178
    PubMedGoogle Scholar
  • 30 Plikaytis B B, Plikaytis B D, Yakrus M A et al.. Differentiation of slowly growing Mycobacterium species, including Mycobacterium tuberculosis, by gene amplification and restriction fragment length polymorphism analysis.  J Clin Microbiol. 1992;  30 1815-1822
    PubMedGoogle Scholar
  • 31 Steingrube V A, Gibson J L, Brown B A, Zhang Y, Wilson R A. PCR Amplification and restriction endonuclease analysis of a 65-kilodalton heat shock protein gene sequence for taxonomic separation of rapidly growing mycobacteria.  J Clin Microbiol. 1995;  33 149-153
    PubMedGoogle Scholar
  • 32 Cloud J L, Neal H, Rosenberry R et al.. Identification of Mycobacterium spp. By using a commercial 16S ribosomal DNA sequencing kit and additional sequencing libraries.  J Clin Microbiol. 2002;  40 400-406
    CrossrefPubMedGoogle Scholar
  • 33 Ringuet H, Akoua-Koffi C, Honore S. hsp65 sequencing for identification of rapidly growing mycobacteria.  J Clin Microbiol. 1999;  37 852-857
    PubMedGoogle Scholar
  • 34 Roth A, Fischer M, Hamid M E, Michalke S, Ludwig W, Mauch H. Differentiation of phylogenetically related slowly growing mycobacteria based on 16S–23S rRNA gene internal transcribed spacer sequences.  J Clin Microbiol. 1998;  36 139-147
    CrossrefPubMedGoogle Scholar
  • 35 Kim B, Lee S, Lyu M et al.. Identification of mycobacterial species by comparative sequence analysis of the RNA polymerase gene (rpoB).  J Clin Microbiol. 1999;  37 1714-1720
    PubMedGoogle Scholar
  • 36 Griffith D E, Girard W M, Wallace Jr R J. Clinical features of pulmonary disease caused by rapidly growing mycobacteria: an analysis of 154 patients.  Am Rev Respir Dis. 1993;  147 1271-1278
    CrossrefPubMedGoogle Scholar
  • 37 Chan E D, Kaminska A M, Gill W et al.. Alpha-1-antitrypsin (AAT) anomalies are associated with lung disease due to rapidly growing mycobacteria and AAT inhibits Mycobacterium abscessus infection of macrophages.  Scand J Infect Dis. 2007;  39 690-696
    CrossrefPubMedGoogle Scholar
  • 38 Daley C L, Griffith D E. Pulmonary disease caused by rapidly growing mycobacteria.  Clin Chest Med. 2002;  23 623-632
    CrossrefPubMedGoogle Scholar
  • 39 Shelton B G, Flanders W D, Morris G K. Mycobacterium sp. as a possible cause of hypersensitivity pneumonitis in machine workers.  Emerg Infect Dis. 1999;  5 270-273
    PubMedGoogle Scholar
  • 40 Adekambi T, Berger P, Raoult D, Drancourt M. rpoB gene sequence-based characterization of emerging non-tuberculous mycobacteria with descriptions of Mycobacterium bolletii sp. nov. Mycobacterium phocaicum sp. nov and Mycobacterium aubagnense sp nov.  Int J Syst Evol Microbiol. 2006;  56 133-143
    PubMedGoogle Scholar
  • 41 Viana-Niero C, Lima K V, Lopes J L et al.. Molecular characterization of Mycobacterium massiliense and Mycobacterium bolletii in isolates collected from outbreaks of infections after laparascopic surgeries and cosmetic procedures.  J Clin Microbiol. 2008;  46 850-855
    CrossrefPubMedGoogle Scholar
  • 42 Olivier K N, Weber D J, Wallace Jr R J et al.. Nontuberculous mycobacteria, I: Multicenter prevalence study in cystic fibrosis.  Am J Respir Crit Care Med. 2003;  167 828-834
    CrossrefPubMedGoogle Scholar
  • 43 Hadjiliadis D, Adlakha A, Prakash U. Rapidly growing mycobacterial lung infection in association with esophageal disorders.  Mayo Clin Proc. 1999;  74 45-51
    CrossrefPubMedGoogle Scholar
  • 44 Park S, Suh G Y, Chung M P et al.. Clinical significance of Mycobacterium fortuitum isolated from respiratory specimens.  Respir Med. 2008;  102 437-442
    CrossrefPubMedGoogle Scholar
  • 45 Cullen A R, Cannon C L, Mark E J, Colin A A. Mycobacterium abscessus infection in cystic fibrosis: colonization or infection?.  Am J Respir Crit Care Med. 2000;  161 641-645
    PubMedGoogle Scholar
  • 46 Boxerbaum B. Isolation of rapidly growing mycobacteria in patients with cystic fibrosis.  J Pediatr. 1980;  96 689-691
    PubMedGoogle Scholar
  • 47 Jacobson K, Libshitz H, Whimbey E, Rolston K, Abi-Said D, Raad I. Clinical and radiological features of pulmonary disease caused by rapidly growing mycobacteria in cancer patients.  Eur J Clin Microbiol Infect Dis. 1998;  17 615-621
    PubMedGoogle Scholar
  • 48 Han D, Lee K S, Koh W, Yi C A, Kim T A, Kwon O J. Radiographic and CT findings of nontuberculous mycobacterial pulmonary infection caused by Mycobacterium abscessus .  AJR Am J Roentgenol. 2003;  181 513-517
    PubMedGoogle Scholar
  • 49 Hazelton T R, Newell J D, Cook J L et al.. CT finding in 14 patients with Mycobacterium chelonae pulmonary infection.  AJR Am J Roentgenol. 2000;  175 413-416
    PubMedGoogle Scholar
  • 50 Woods G L, Bergmann J S, Witebsky F G et al.. Multisite reproducibility of results obtained by the broth microdilution method for susceptibility testing of Mycobacterium abscessus, Mycobacterium chelonae, and Mycobacterium fortuitum .  J Clin Microbiol. 1999;  37 1676-1682
    PubMedGoogle Scholar
  • 51 Nash K A, Zhang Y, Brown-Elliott B A, Wallace Jr R J. Molecular basis of intrinsic macrolide resistance in clinical isolates of Mycobacterium fortuitum .  J Antimicrob Chemother. 2005;  55 170-177
    CrossrefPubMedGoogle Scholar
  • 52 Nash K A, Andini N, Zhang Y, Brown-Elliott B A, Wallace Jr R J. Intrinsic macrolide resistance in rapidly growing mycobacteria.  Antimicrob Agents Chemother. 2006;  50 3476-3478
    CrossrefPubMedGoogle Scholar
  • 53 Wallace Jr R J, Brown-Elliott B A, Crist C J, Mann L, Wilson R W. Comparison of the in vitro activity of the glycylcycline tigecycline (formerly GAR-936) with those of tetracycline, minocycline, and doxycycline against isolates of nontuberculous mycobacteria.  Antimicrob Agents Chemother. 2002;  46 3164-3167
    CrossrefPubMedGoogle Scholar
  • 54 Wallace Jr R J, Brown-Elliott B A, Ward S C, Crist C J, Mann L B, Wilson R W. Activities of linezolid against rapidly growing mycobacteria.  Antimicrob Agents Chemother. 2001;  45 764-767
    CrossrefPubMedGoogle Scholar
  • 55 Wallace Jr R J, Meir A, Brown B A et al.. Genetic basis for clarithromycin resistance among isolates of Mycobacterium chelonae and Mycobacterium abscessus .  Antimicrob Agents Chemother. 1996;  40 1676-1681
    PubMedGoogle Scholar
  • 56 Davis K K, Kao P N, Jacobs S S, Ruoss S J. Aerosolized amikacin for treatment of pulmonary Mycobacterium avium infections: an observational case series.  BMC Pulm Med. 2007;  7 2
    CrossrefPubMedGoogle Scholar
  • 57 Stein G E, Craig W A. Tigecycline: a critical analysis.  Clin Infect Dis. 2006;  43 518-524
    CrossrefPubMedGoogle Scholar
  • 58 Smith M B, Hardin W D, Dressel D A et al.. Predicting outcomes following pulmonary resection in cystic fibrosis patients.  J Pediatr Surg. 1991;  26 655-659
    CrossrefPubMedGoogle Scholar
  • 59 Taylor J L, Palmer S M. Mycobacterium abscessus chest wall and pulmonary infection in a cystic fibrosis lung transplant recipient.  J Heart Lung Transplant. 2006;  25 985-988
    CrossrefPubMedGoogle Scholar
  • 60 Fairhurst R M, Kubak B M, Shpiner R B, Levine M S, Pegues D A, Ardehali A. Mycobacterium abscessus empyema in a lung transplant recipient.  J Heart Lung Transplant. 2002;  21 391-394
    CrossrefPubMedGoogle Scholar
  • 61 Sanguinetti M, Ardito F, Fiscarelli E et al.. Fatal pulmonary infection due to multidrug-resistant Mycobacterium abscessus in a patient with cystic fibrosis.  J Clin Microbiol. 2001;  39 816-819
    CrossrefPubMedGoogle Scholar
  • 62 Chernenko S M, Humar A, Hutcheon M et al.. Mycobacterium abscessus infections in lung transplant recipients: the international experience 2006.  J Heart Lung Transplant. 2006;  25 1447-1455
    CrossrefPubMedGoogle Scholar
  • 63 Lamy B, Marchandin H, Hamitouche K, Laurent F. Mycobacterium setense sp. nov., a Mycobacterium fortuitum-group organism isolated from a patient with soft tissue infection and osteitis.  Int J Syst Evol Microbiol. 2008;  58 486-490
    PubMedGoogle Scholar
  • 64 Talati N J, Rouphael N, Kuppalli K, Franco-Paredes C. Spectrum of CNS disease caused by rapidly growing mycobacteria.  Lancet Infect Dis. 2008;  8 390-398
    CrossrefPubMedGoogle Scholar
  • 65 Uslan D Z, Kowalski T J, Wenenack N L, Virk A, Wilson J W. Skin and soft tissue infections due to rapidly growing mycobacteria: comparison of clinical features, treatment, and susceptibility.  Arch Dermatol. 2006;  142 1287-1292
    CrossrefPubMedGoogle Scholar
  • 66 Galil K, Miller L A, Yakrus M A et al.. Abscesses due to Mycobacterium abscessus linked to injection of unapproved alternative medication.  Emerg Infect Dis. 1999;  5 681-687
    PubMedGoogle Scholar
  • 67 Wallace Jr R J, Musser J M, Hull S I et al.. Diversity and sources of rapidly growing mycobacteria associated with infections following cardiac surgery.  J Infect Dis. 1989;  159 708-716
    PubMedGoogle Scholar
  • 68 John T, Velotta E. Nontuberculous (atypical) mycobacterial keratitis after LASIK: current status and clinical implications.  Cornea. 2005;  24 245-255
    CrossrefPubMedGoogle Scholar
  • 69 Hawkins C, Qi C, Warren J, Stosor V. Catheter related bloodstream infections caused by rapidly growing nontuberculous mycobacteria: a case series including rare species.  Diagn Microbiol Infect Dis. 2008;  61 187-191
    CrossrefPubMedGoogle Scholar
  • 70 Chetchotisakd P, Mootsikapun P, Anunnatsiri S et al.. Disseminated infection due to rapidly growing mycobacteria in immunocompetent hosts presenting with chronic lymphadenopathy: a previously unrecognized clinical entity.  Clin Infect Dis. 2000;  30 29-34
    CrossrefPubMedGoogle Scholar
  • 71 Holland S M, Eisenstein E M, Kuhns D B et al.. Treatment of refractory disseminated nontuberculous mycobacterial infection with interferon gamma: a preliminary report.  N Engl J Med. 1994;  330 1348-1355
    CrossrefPubMedGoogle Scholar
  • 72 Daines B S, Vroman D T, Sandoval H P, Steed L L, Solomon K D. Rapid diagnosis and treatment of mycobacterial keratitis after laser in situ keromileusis.  J Cataract Refract Surg. 2003;  29 1014-1018
    CrossrefPubMedGoogle Scholar
  • 73 Rodriguez B, Holzinger K A, Le L H, Winkle R K, Allen R D. Mycobacterium chelonae keratitis after laser-assisted subepithelial keratectomy.  J Cataract Refract Surg. 2006;  32 1059-1061
    CrossrefPubMedGoogle Scholar

Kenneth N OlivierM.D. M.P.H. 

Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases

National Institutes of Health, 9000 Rockville Pike, Bldg. 10, Rm. 11N234, Bethesda, MD 20892-1888

eMail: olivierk@niaid.nih.gov

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