Infections caused by nontuberculous mycobacteria (NTM) are increasing globally and are notoriously difficult to treat due to their intrinsic resistance to many commonly used antibiotics. NTM are diverse and ubiquitous in the environment, with only a few species causing serious and often opportunistic infections in humans, including Mycobacterium abscessus. It is one of the commonly identified NTM species responsible for severe respiratory, skin, and mucosal infections in humans and is often regarded one of the most antibiotic-resistant mycobacteria, leaving us with few therapeutic options. Although historically known to cause infections in immunocompromised individuals, the incidence of infections in immunocompetent humans is on the rise, giving it the status of a true pathogen. This is a case report of an 18-month-old child diagnosed in an urban secondary care center with M. abscessus soft tissue infection, which was acquired postimmunization. Microbiological evidence was consistent with multidrug-resistant strains of M. abscessus. The child was evaluated for primary and secondary immunodeficiencies and was started on appropriate treatment based on culture and sensitivity, that is, linezolid and amikacin, which led to the resolution of the infection. Prevention of these infections at the source level is of utmost importance. Since the organisms are frequently found on hospital instruments, water sources, and surfaces, timely and regular sterilization and microbiological quality checks should be carried out.
Sharma SK, Upadhyay V. Epidemiology, diagnosis & treatment of non-tuberculous mycobacterial diseases. Indian J Med Res 2020;152(3):185–226. DOI: 10.4103/ijmr.IJMR_902_20
Ferrell KC, Johansen MD, Triccas JA, et al. Virulence mechanisms of Mycobacterium abscessus: current knowledge and implications for vaccine design. Front Microbiol 2022;13:842017. DOI: 10.3389/fmicb.2022.842017
Lee MR, Sheng WH, Hung CC, et al. Mycobacterium abscessus complex infections in humans. Emerg Infect Dis 2015;21(9):1638–1646. DOI: 10.3201/2109.141634
Thomson R, Tolson C, Sidjabat H, et al. Mycobacterium abscessus isolated from municipal water - a potential source of human infection. BMC Infect Dis 2013;13:241. DOI: 10.1186/1471-2334-13-241
Mukherjee R, Chatterji D. Glycopeptidolipids: immuno-modulators in greasy mycobacterial cell envelope. IUBMB Life 2012;64(3):215–225. DOI: 10.1002/iub.602
Yamaguchi N, Ichijo T, Sakotani A, et al. Global dispersion of bacterial cells on Asian dust. Sci Rep 2012;2:525. DOI: 10.1038/srep00525
Burgess W, Margolis A, Gibbs S, et al. Disinfectant susceptibility profiling of glutaraldehyde-resistant nontuberculous mycobacteria. Infect Control Hosp Epidemiol 2017;38(7):784–791. DOI: 10.1017/ice.2017.75
Sharma SK, Upadhyay V. Non-tuberculous mycobacteria: a disease beyond TB and preparedness in India. Expert Rev Respir Med 2021;15(7):949–958. DOI: 10.1080/17476348.2021.1925545
Umrao J, Singh D, Zia A, et al. Prevalence and species spectrum of both pulmonary and extrapulmonary nontuberculous mycobacteria isolates at a tertiary care center. Int J Mycobacteriol 2016;5(3):288–293. DOI: 10.1016/j.ijmyco.2016.06.008
Kothavade RJ, Dhurat RS, Mishra SN, et al. Clinical and laboratory aspects of the diagnosis and management of cutaneous and subcutaneous infections caused by rapidly growing mycobacteria. Eur J Clin Microbiol Infect Dis 2013;32(2):161–188. DOI: 10.1007/s10096-012-1766-8
Jones RS, Shier KL, Master RN, et al. Current significance of the Mycobacterium chelonae-abscessus group. Diagn Microbiol Infect Dis 2019;94(3):248–254. DOI: 10.1016/j.diagmicrobio.2019.01.021
Leto Barone AA, Grzelak MJ, Frost C, et al. Atypical mycobacterial infections after plastic surgery procedures abroad: a multidisciplinary algorithm for diagnosis and treatment. Ann Plast Surg 2020;84(3):257–262. DOI: 10.1097/SAP.0000000000002061
Benwill JL, Wallace RJ Jr. Mycobacterium abscessus: challenges in diagnosis and treatment. Curr Opin Infect Dis 2014;27(6):506–510. DOI: 10.1097/QCO.0000000000000104
Fraud S, Hann AC, Maillard JY, et al. Effects of ortho-phthalaldehyde, glutaraldehyde and chlorhexidine diacetate on Mycobacterium chelonae and Mycobacterium abscessus strains with modified permeability. J Antimicrob Chemother 2003;51(3):575–584. DOI: 10.1093/jac/dkg099
Phillips MS, von Reyn CF. Nosocomial infections due to nontuberculous mycobacteria. Clin Infect Dis 2001;33(8):1363–1374. DOI: 10.1086/323126