Öz
Rapidly growing mycobacteria including M. abscessus complex are normal environmental inhabitants and may become opportunistic pathogens especially in immunosuppressed hosts. We report a bloodstream infection case caused by M. abscessus in a 10 year-old female patient with stage IV neuroblastoma diagnosis. After isolation of microorganism from blood culture bottle, the microorganism was identified by matrix assisted laser desorption ionization time-of-flight mass spectrometry and BD Phoenix automated identification and drug susceptibility device. Clarithromycin was added to her current antibiotic therapy and the patient was discharged with recovery. Non-tuberculosis mycobacteria are becoming serious opportunistic pathogens, physicians must take these microorganisms under consideration for especially immunosuppressed patients. Due to wide diversity of antimicrobial resistance patterns, species level identification is crucial.
Anahtar Kelimeler
Non-tuberculosis mycobacteria rapidly-growing mycobacteria opportunistic pathogens
Kaynakça
- 1. Falkinham JO. Environmental sources of nontuberculous mycobacteria. Clin Chest Med. 2015;36:35-41.
- 2. Henkle E, Winthrop KL. Non-tuberculous mycobacteria infections in immunosuppressed hosts. Clin Chest Med. 2015;36:91-9.
- 3. Halstrom S, Price P, Thomson R. Review: Environmental mycobacteria as a cause of human infection. Int J Mycobacteriol. 2015;4:81-91.
- 4. El Helou G, Viola GM, Hachem R, Han XY, Raad II. Rapidly growing mycobacterial bloodstream infections. Lancet Infect Dis. 2013;13:166-74.
- 5. Lee Meng-Rui, Sheng WH, Hung CC, Yu CJ, Lee LN, Hsueh PR. Mycobacterium abscessus complex infections in humans. Emerg Infect Dis. 2015;21:1638.
- 6. Brown-Elliott BA, Wallace Jr. RJ. Mycobacterium: clinical and laboratory characteristics of rapidly growing mycobacteria. In Manual of Clinical Microbiology, 11th Ed. (Eds JH Jorgensen, MA Pfaller):595-612.. Washington DC, ASM Press, 2015.
- 7. Della-Latta P. Mycobacteriology and anti-mycobacterial susceptibility testing. In Clinical Microbiology Procedures Handbook, 3rd Ed. (Eds: LS Garcia, HD Isenberg):1071-139. Washington DC, ASM Press, 2010.
- 8. Panagea T, Pincus DH, Grogono D, Jones M, Bryant J, Parkhill J et al. Mycobacterium abscessus Complex identification with matrix-assisted laser desorption ionization–time of flight mass spectrometry. J Clin Microbiol. 2015;53:2355-8.
- 9. La'Tonzia LA, Salee P, Dionne K, Carroll K, Parrish N. A novel protein extraction method for identification of mycobacteria using MALDI-TOF MS. J Microbiol Methods. 2015;119:1-3.
- 10. Maurer FP, Bruderer VL, Ritter C, Castelberg C, Bloemberg GV, Böttger EC. Lack of antimicrobial bactericidal activity in Mycobacterium abscessus. Antimicrob Agents Chemother. 2014;58:3828-36.
- 11. Nessar R, Cambau E, Reyrat JM, Murray A, Gicquel B. Mycobacterium abscessus: a new antibiotic nightmare. J Antimicrob Chemother. 2012;67:810-8.
Öz
Mycobacterium abscessus kompleksin de dahil olduğu hızlı üreyen mikobakteriler, doğal ortamda bulunan ve özellikle bağışıklığı baskılanmış hastalarda fırsatçı patojen olabilen mikroorganizmalardır. Evre 4 nöroblastoma tanısı olan 10 yaşında bir kız hastada, M. abscessus tarafından oluşturulan kan dolaşımı enfeksiyonunu bildiriyoruz. Mikroorganizmanın kan kültürü şişesinden izole edilmesini müteakip; mikroorganizma, MALDI-TOF MS ve BD Phoenix otomatize tanımlama ve ilaç duyarlılık cihazı ile tanımlanmıştır. Hastanın mevcut antimikrobiyal tedavisine ek olarak klaritromisin eklenmiş ve hasta şifa ile taburcu edilmiştir. Tüberküloz dışı mikobakteriler ciddi fırsatçı patojenler olarak karşımıza çıkmakta ve hekimlerin özellikle bağışıklığı baskılanmış hastalarda bu mikroorganizmaları değerlendirmeye almaları gerekmektedir. Antimikrobiyal direnç profilindeki değişkenlikten dolayı, tür düzeyinde tanımlama kritik rol oynamaktadır.
Kaynakça
- 1. Falkinham JO. Environmental sources of nontuberculous mycobacteria. Clin Chest Med. 2015;36:35-41.
- 2. Henkle E, Winthrop KL. Non-tuberculous mycobacteria infections in immunosuppressed hosts. Clin Chest Med. 2015;36:91-9.
- 3. Halstrom S, Price P, Thomson R. Review: Environmental mycobacteria as a cause of human infection. Int J Mycobacteriol. 2015;4:81-91.
- 4. El Helou G, Viola GM, Hachem R, Han XY, Raad II. Rapidly growing mycobacterial bloodstream infections. Lancet Infect Dis. 2013;13:166-74.
- 5. Lee Meng-Rui, Sheng WH, Hung CC, Yu CJ, Lee LN, Hsueh PR. Mycobacterium abscessus complex infections in humans. Emerg Infect Dis. 2015;21:1638.
- 6. Brown-Elliott BA, Wallace Jr. RJ. Mycobacterium: clinical and laboratory characteristics of rapidly growing mycobacteria. In Manual of Clinical Microbiology, 11th Ed. (Eds JH Jorgensen, MA Pfaller):595-612.. Washington DC, ASM Press, 2015.
- 7. Della-Latta P. Mycobacteriology and anti-mycobacterial susceptibility testing. In Clinical Microbiology Procedures Handbook, 3rd Ed. (Eds: LS Garcia, HD Isenberg):1071-139. Washington DC, ASM Press, 2010.
- 8. Panagea T, Pincus DH, Grogono D, Jones M, Bryant J, Parkhill J et al. Mycobacterium abscessus Complex identification with matrix-assisted laser desorption ionization–time of flight mass spectrometry. J Clin Microbiol. 2015;53:2355-8.
- 9. La'Tonzia LA, Salee P, Dionne K, Carroll K, Parrish N. A novel protein extraction method for identification of mycobacteria using MALDI-TOF MS. J Microbiol Methods. 2015;119:1-3.
- 10. Maurer FP, Bruderer VL, Ritter C, Castelberg C, Bloemberg GV, Böttger EC. Lack of antimicrobial bactericidal activity in Mycobacterium abscessus. Antimicrob Agents Chemother. 2014;58:3828-36.
- 11. Nessar R, Cambau E, Reyrat JM, Murray A, Gicquel B. Mycobacterium abscessus: a new antibiotic nightmare. J Antimicrob Chemother. 2012;67:810-8.
Ayrıntılar
| Konular | Sağlık Kurumları Yönetimi |
|---|---|
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2017 |
| Kabul Tarihi | 3 Ekim 2016 |
| Yayımlandığı Sayı | Yıl 2017 Cilt: 42 Sayı: 3 |
