Emerging Infectious Diseases (Nov 2024)

Extrapulmonary Mycobacterium abscessus Infections, France, 2012–2020

  • Benoît Heid-Picard,
  • Faiza Mougari,
  • Anne Pouvaret,
  • Fanny Lanternier,
  • Zeina Awad,
  • Emmanuelle Bille,
  • Olivier Lortholary,
  • Emmanuelle Cambau

DOI
https://doi.org/10.3201/eid3011.240459
Journal volume & issue
Vol. 30, no. 11
pp. 2294 – 2302

Abstract

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Mycobacterium abscessus infection is challenging to treat. Extrapulmonary M. abscessus infections (EP-MAB) are less common than pulmonary M. abscessus infections. To evaluate treatment regimens, we retrospectively analyzed consecutive microbiologically confirmed EP-MAB cases diagnosed in France during 2012–2020. We studied 45 patients with EP-MAB, including 14 bone and joint infections, 10 skin and soft tissue infections, and 8 lymph node infections. Most (62%) patients had no reported immunodeficiency. In 27 patients, EP-MAB followed healthcare-associated (44%) or environmental (16%) injuries. Of the 45 isolates, 25 were subspecies abscessus, 10 bolletii, and 9 massiliense; 1 was unidentified. Cure was achieved for 36 (80%) patients who received a median antimicrobial regimen of 6 months; 22 (55%) also underwent surgery. Four patients died, and 5 were unavailable for follow-up. EP-MAB predominantly affects immunocompetent patients after an injury; outcomes are favorable. We propose a >6-month regimen of antimicrobial therapy with consideration for surgery and regular patient reassessment.

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