Distal infection of the middle finger caused by Mycobacterium abscessus

In-house polymerase chain reaction amplification of mycobacterial 16S rRNA gene directly from solid tissue sample and subsequent gene sequencing using Sanger method in our Microbiology Unit confirmed the presence of Mycobacterium abscessus subsp. abscessus. Intrinsic resistance is attributed to multiple factors like low permeability of the cell envelope, drug efflux pumps (ABC-type multidrug transporters), genetic polymorphism of antibiotic target genes and enzymes in the cytoplasm that neutralize antibiotics, such as aminoglycosides. Molecular biology techniques such as polymerase chain reaction offer high sensitivity and rapid results and represent an interesting alternative to the microbiological culture.