Successful treatment of infections caused by mycobacterium abscessus complex following aesthetic procedures: A case series in China

Background: Aesthetic procedure-associated infections caused by Mycobacterium abscessus complex (MABC) have been an emerging concern. However, limited evidence is available on this topic, and there are no standard treatments. The selection of antimicrobial regimens for the effective treatment of MABC infections poses a significant challenge. Case presentation: In this case series, we present three patients in China who developed MABC infections following various aesthetic procedures. Two patients presented with localized skin and soft tissue infections, whereas one patient developed a disseminated infection. Treatment involved a combination of intravenous amikacin and cefoxitin for more than two weeks, followed by an oral regimen comprising clarithromycin, linezolid, and moxifloxacin based on drug susceptibility testing results. Despite the treatment's efficacy, the patients experienced adverse reactions to the antibiotics, including gastrointestinal symptoms, anaemia, and hearing loss. All patients achieved successful outcomes with shorter treatment courses and no relapse during the 3-year follow-up period. Conclusion: This case series emphasizes the importance of employing appropriate combination antibiotic therapies based on drug susceptibility testing results for aesthetic procedure-associated infection caused by MABC when specific subspecies are unidentified. The combination of intravenous aminoglycosides and cefoxitin, followed by oral sequential therapy, with the course of treatment specifically tailored to the severity of the infection, provides a valuable treatment reference for patients with MABC infections in China.