Clinical Management of Rapidly Growing Mycobacterial Cutaneous Infections in Patients after Mesotherapy

被引:51
作者
Regnier, Stephanie [1 ]
Cambau, Emmanuelle [3 ]
Meningaud, Jean-Paul [4 ]
Guihot, Amelie [1 ]
Deforges, Lionel [3 ]
Carbonne, Anne [2 ]
Bricaire, Francois [1 ]
Caumes, Eric [1 ]
机构
[1] Assistance Publ Hop Paris, Infect Dis Unit, Pitie Salpetriere Hosp, Paris, France
[2] Assistance Publ Hop Paris, Reg Ctr Nosocomial Infect Control, Paris, France
[3] Assistance Publ Hop Paris, Henri Mondor Hosp, Bacteriol Lab, Paris, France
[4] Assistance Publ Hop Paris, Henri Mondor Hosp, Plast Surg Unit, Paris, France
关键词
CHELONAE INFECTION; OUTBREAK; CLARITHROMYCIN; FORTUITUM; SUBGROUPS; ABSCESSES;
D O I
10.1086/606050
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Increasing numbers of patients are expressing an interest in mesotherapy as a method of reducing body fat. Cutaneous infections due to rapidly growing mycobacteria are a common complication of such procedures. Methods. We followed up patients who had developed cutaneous infections after undergoing mesotherapy during the period October 2006-January 2007. Results. Sixteen patients were infected after mesotherapy injections performed by the same physician. All patients presented with painful, erythematous, draining subcutaneous nodules at the injection sites. All patients were treated with surgical drainage. Microbiological examination was performed on specimens that were obtained before and during the surgical procedure. Direct examination of skin smears demonstrated acid-fast bacilli in 25% of the specimens that were obtained before the procedure and 37% of the specimens obtained during the procedure; culture results were positive in 75% of the patients. Mycobacterium chelonae was identified in 11 patients, and Mycobacterium frederiksbergense was identified in 2 patients. Fourteen patients were treated with antibiotics, 6 received triple therapy as first-line treatment (tigecycline, tobramycin, and clarithromycin), and 8 received dual therapy (clarithromycin and ciprofloxacin). The mean duration of treatment was 14 weeks ( range, 1-24 weeks). All of the patients except 1 were fully recovered 2 years after the onset of infection, with the mean time to healing estimated at 6.2 months (range, 1-15 months). Conclusions. This series of rapidly growing mycobacterial cutaneous infections highlights the difficulties in treating such infections and suggests that in vitro susceptibility to antibiotics does not accurately predict their clinical efficacy.
引用
收藏
页码:1358 / 1364
页数:7
相关论文
共 24 条
[1]   ACTIVITIES OF 4 MACROLIDES, INCLUDING CLARITHROMYCIN, AGAINST MYCOBACTERIUM-FORTUITUM, MYCOBACTERIUM-CHELONAE, AND M-CHELONAE-LIKE ORGANISMS [J].
BROWN, BA ;
WALLACE, RJ ;
ONYI, GO ;
DEROSAS, V ;
WALLACE, RJ .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1992, 36 (01) :180-184
[2]   Comparison of in vitro activities of gatifloxacin and ciprofloxacin against four taxa of rapidly growing mycobacteria [J].
Brown-Elliott, BA ;
Wallace, RJ ;
Crist, CJ ;
Mann, L ;
Wilson, RW .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2002, 46 (10) :3283-3285
[3]   Clinical and taxonomic status of pathogenic nonpigmented or late-pigmenting rapidly growing mycobacteria [J].
Brown-Elliott, BA ;
Wallace, RJ .
CLINICAL MICROBIOLOGY REVIEWS, 2002, 15 (04) :716-+
[4]   Outbreak of Nontuberculous Mycobacterial Subcutaneous Infections Related to Multiple Mesotherapy Injections [J].
Carbonne, Anne ;
Brossier, Florence ;
Arnaud, Isabelle ;
Bougmiza, Iheb ;
Caumes, Eric ;
Meningaud, Jean-Paul ;
Dubrou, Sylvie ;
Jarlier, Vincent ;
Cambau, Emmanuelle ;
Astagneau, Pascal .
JOURNAL OF CLINICAL MICROBIOLOGY, 2009, 47 (06) :1961-1964
[5]  
*CDCP, 1978, MMWR-MORBID MORTAL W, V27, P97
[6]   Epidemiology of infection by nontuberculous mycobacteria [J].
Falkinham, JO .
CLINICAL MICROBIOLOGY REVIEWS, 1996, 9 (02) :177-+
[7]   Insulin injection abscesses caused by Mycobacterium chelonae [J].
Finucane, K ;
Ambrey, P ;
Narayan, S ;
Archer, CB ;
Dayan, C .
DIABETES CARE, 2003, 26 (08) :2483-2484
[8]   An outbreak of mycobacterium chelonae infection after LASIK [J].
Freitas, D ;
Alvarenga, L ;
Sampaio, J ;
Mannis, M ;
Sato, E ;
Sousa, L ;
Vieira, L ;
Yu, MC ;
Martins, MC ;
Hoffling-Lima, A ;
Belfort, R .
OPHTHALMOLOGY, 2003, 110 (02) :276-285
[9]   Mycobacterium abscessus infection secondary to mesotherapy [J].
Garcia-Navarro, X. ;
Barnadas, M. A. ;
Dalmau, J. ;
Coll, P. ;
Gurgui, M. ;
Alomar, A. .
CLINICAL AND EXPERIMENTAL DERMATOLOGY, 2008, 33 (05) :658-659
[10]   The role of ancillary antimicrobial therapy for treatment of uncomplicated skin infections in the era of community-associated methicillin-resistant Staphylococcus aureus [J].
Gorwitz, Rachel J. .
CLINICAL INFECTIOUS DISEASES, 2007, 44 (06) :785-787