Skin, Soft Tissue, and Bone Infections Due to Mycobacterium chelonae chelonae: Importance of Prior Corticosteroid Therapy, Frequency of Disseminated Infections, and Resistance to Oral Antimicrobials Other than Clarithromycin
Little is known of clinical disease due to Mycobacterium chelonaechelonae. One hundred skin, soft tissue, or bone isolates of this rapidly growing mycobacterium were identified over 10 years. Clinical disease included disseminated cutaneous infection (53%); localized cellulitis, abscess, or osteomye...
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| Veröffentlicht in: | The Journal of infectious diseases 1992-08, Vol.166 (2), p.405-412 |
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| description | Little is known of clinical disease due to Mycobacterium chelonaechelonae. One hundred skin, soft tissue, or bone isolates of this rapidly growing mycobacterium were identified over 10 years. Clinical disease included disseminated cutaneous infection (53%); localized cellulitis, abscess, or osteomyelitis (35%); and catheter infections (12%). Underlying conditions with disseminated infection included organ transplantation, rheumatoid arthritis, and autoimmune disorders; 92% involved corticosteroid use. Trauma and medical procedures were risk factors for localized infections. Corticosteroids and chronic renal failure were risk factors for catheter infections. Overall, 62% of patients were receiving corticosteroids and 72% were immunosuppressed. MICs of six oral antimicrobials were obtained for 180 isolates by broth microdilution. Up to 20% of isolates were susceptible to doxycycline, ciprofloxacin, ofloxacin, and sulfamethoxazole. In contrast, 100% were susceptible to clarithromycin (MICs ⩽1 µg/mL). Disease due to M. chelonae usually occurs in the setting of corticosteroid therapy and is often disseminated; the organisms require high MICs of oral antimicrobials other than clarithromycin. |
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One hundred skin, soft tissue, or bone isolates of this rapidly growing mycobacterium were identified over 10 years. Clinical disease included disseminated cutaneous infection (53%); localized cellulitis, abscess, or osteomyelitis (35%); and catheter infections (12%). Underlying conditions with disseminated infection included organ transplantation, rheumatoid arthritis, and autoimmune disorders; 92% involved corticosteroid use. Trauma and medical procedures were risk factors for localized infections. Corticosteroids and chronic renal failure were risk factors for catheter infections. Overall, 62% of patients were receiving corticosteroids and 72% were immunosuppressed. MICs of six oral antimicrobials were obtained for 180 isolates by broth microdilution. Up to 20% of isolates were susceptible to doxycycline, ciprofloxacin, ofloxacin, and sulfamethoxazole. In contrast, 100% were susceptible to clarithromycin (MICs ⩽1 µg/mL). Disease due to M. chelonae usually occurs in the setting of corticosteroid therapy and is often disseminated; the organisms require high MICs of oral antimicrobials other than clarithromycin.</description><identifier>ISSN: 0022-1899</identifier><identifier>EISSN: 1537-6613</identifier><identifier>DOI: 10.1093/infdis/166.2.405</identifier><identifier>PMID: 1386098</identifier><identifier>CODEN: JIDIAQ</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>Abscess - microbiology ; Administration, Oral ; Adrenal Cortex Hormones - therapeutic use ; Anti-Bacterial Agents - administration & dosage ; Anti-Bacterial Agents - pharmacology ; Antibacterial agents ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Arthritis, Rheumatoid - complications ; Arthritis, Rheumatoid - drug therapy ; Autoimmune diseases ; Autoimmune Diseases - complications ; Autoimmune Diseases - drug therapy ; Biological and medical sciences ; Bones ; Catheters, Indwelling ; Cellulitis - complications ; Cellulitis - microbiology ; Chronic diseases ; Clarithromycin ; Corticosteroids ; Drug Resistance, Microbial ; Erythromycin - analogs & derivatives ; Erythromycin - pharmacology ; Fungal infections ; Humans ; Infections ; Lesions ; Lung diseases ; Major Articles ; Medical sciences ; Mycobacterium chelonae ; Mycobacterium chelonae - drug effects ; Mycobacterium chelonae - physiology ; Mycobacterium Infections, Nontuberculous - complications ; Mycobacterium Infections, Nontuberculous - microbiology ; Organ Transplantation ; Osteomyelitis - complications ; Osteomyelitis - microbiology ; Pharmacology. 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One hundred skin, soft tissue, or bone isolates of this rapidly growing mycobacterium were identified over 10 years. Clinical disease included disseminated cutaneous infection (53%); localized cellulitis, abscess, or osteomyelitis (35%); and catheter infections (12%). Underlying conditions with disseminated infection included organ transplantation, rheumatoid arthritis, and autoimmune disorders; 92% involved corticosteroid use. Trauma and medical procedures were risk factors for localized infections. Corticosteroids and chronic renal failure were risk factors for catheter infections. Overall, 62% of patients were receiving corticosteroids and 72% were immunosuppressed. MICs of six oral antimicrobials were obtained for 180 isolates by broth microdilution. Up to 20% of isolates were susceptible to doxycycline, ciprofloxacin, ofloxacin, and sulfamethoxazole. In contrast, 100% were susceptible to clarithromycin (MICs ⩽1 µg/mL). Disease due to M. chelonae usually occurs in the setting of corticosteroid therapy and is often disseminated; the organisms require high MICs of oral antimicrobials other than clarithromycin.</description><subject>Abscess - microbiology</subject><subject>Administration, Oral</subject><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Antibacterial agents</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Arthritis, Rheumatoid - complications</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Autoimmune diseases</subject><subject>Autoimmune Diseases - complications</subject><subject>Autoimmune Diseases - drug therapy</subject><subject>Biological and medical sciences</subject><subject>Bones</subject><subject>Catheters, Indwelling</subject><subject>Cellulitis - complications</subject><subject>Cellulitis - microbiology</subject><subject>Chronic diseases</subject><subject>Clarithromycin</subject><subject>Corticosteroids</subject><subject>Drug Resistance, Microbial</subject><subject>Erythromycin - analogs & derivatives</subject><subject>Erythromycin - pharmacology</subject><subject>Fungal infections</subject><subject>Humans</subject><subject>Infections</subject><subject>Lesions</subject><subject>Lung diseases</subject><subject>Major Articles</subject><subject>Medical sciences</subject><subject>Mycobacterium chelonae</subject><subject>Mycobacterium chelonae - drug effects</subject><subject>Mycobacterium chelonae - physiology</subject><subject>Mycobacterium Infections, Nontuberculous - complications</subject><subject>Mycobacterium Infections, Nontuberculous - microbiology</subject><subject>Organ Transplantation</subject><subject>Osteomyelitis - complications</subject><subject>Osteomyelitis - microbiology</subject><subject>Pharmacology. Drug treatments</subject><subject>Risk Factors</subject><subject>Skin diseases</subject><subject>Skin Diseases, Infectious - complications</subject><subject>Skin Diseases, Infectious - microbiology</subject><subject>United States</subject><issn>0022-1899</issn><issn>1537-6613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUU1v0zAYjhBolMGdC5IPiFPT2bHjONy2jrJKRUW0iImL5Ti26i2xi-1I9N_yU_BI6bhx8is_H-_Hk2WvEZwhWOMLY3VrwgWidFbMCCyfZBNU4iqnFOGn2QTCosgRq-vn2YsQ7iCEBNPqLDtDmFFYs0n2a3Nv7BRsnI5ga0IY1BQI24IrZxVYWq1kNM4GcD0oEB34dJCuETIqb4YeyJ3qnBXqVLwHy37vfBRWKuA0-OyN82Cefox0IamcacF2p7zYH6Zg4dWPQVl5eKBep-aqN1ZE1f7TeJzmiwomjK5piLUXHbi00fRGetcY0QWwjskVxJ2wYN4Jb-LOu_4gjX2ZPdOJoF4d3_Ps6-LDdn6Tr9Yfl_PLVS4JgzGXsEKCQVVWDYFMlE3blJIqQksGERStYFjARrSSsaauYCGxbnQ6Yc1IA7Vu8Xn2bvTde5e2CpH3JkjVdcIqNwReYViVFaX_JSJKcIlIkYhwJKYlQ_BK8703vfAHjiB_SJ-P6ScF5QVP6SfJm6P30PSqfRSMcSf87REXQYpO-3TSZPCXRkjJCkIfbe5CdP4EY4hQUf-ZLB_xFIr6ecKFv-e0wlXJb26_c1x_u11sVpgv8G8JNdc0</recordid><startdate>19920801</startdate><enddate>19920801</enddate><creator>Wallace, Richard J.</creator><creator>Brown, Barbara A.</creator><creator>Onyi, Grace O.</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>19920801</creationdate><title>Skin, Soft Tissue, and Bone Infections Due to Mycobacterium chelonae chelonae: Importance of Prior Corticosteroid Therapy, Frequency of Disseminated Infections, and Resistance to Oral Antimicrobials Other than Clarithromycin</title><author>Wallace, Richard J. ; Brown, Barbara A. ; Onyi, Grace O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c480t-c071a80e57b408a5bdb5c6e4658010ada83a0badc88b9702c3fbf609984b0ffd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Abscess - microbiology</topic><topic>Administration, Oral</topic><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Antibacterial agents</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Arthritis, Rheumatoid - complications</topic><topic>Arthritis, Rheumatoid - drug therapy</topic><topic>Autoimmune diseases</topic><topic>Autoimmune Diseases - complications</topic><topic>Autoimmune Diseases - drug therapy</topic><topic>Biological and medical sciences</topic><topic>Bones</topic><topic>Catheters, Indwelling</topic><topic>Cellulitis - complications</topic><topic>Cellulitis - microbiology</topic><topic>Chronic diseases</topic><topic>Clarithromycin</topic><topic>Corticosteroids</topic><topic>Drug Resistance, Microbial</topic><topic>Erythromycin - analogs & derivatives</topic><topic>Erythromycin - pharmacology</topic><topic>Fungal infections</topic><topic>Humans</topic><topic>Infections</topic><topic>Lesions</topic><topic>Lung diseases</topic><topic>Major Articles</topic><topic>Medical sciences</topic><topic>Mycobacterium chelonae</topic><topic>Mycobacterium chelonae - drug effects</topic><topic>Mycobacterium chelonae - physiology</topic><topic>Mycobacterium Infections, Nontuberculous - complications</topic><topic>Mycobacterium Infections, Nontuberculous - microbiology</topic><topic>Organ Transplantation</topic><topic>Osteomyelitis - complications</topic><topic>Osteomyelitis - microbiology</topic><topic>Pharmacology. Drug treatments</topic><topic>Risk Factors</topic><topic>Skin diseases</topic><topic>Skin Diseases, Infectious - complications</topic><topic>Skin Diseases, Infectious - microbiology</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wallace, Richard J.</creatorcontrib><creatorcontrib>Brown, Barbara A.</creatorcontrib><creatorcontrib>Onyi, Grace O.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wallace, Richard J.</au><au>Brown, Barbara A.</au><au>Onyi, Grace O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Skin, Soft Tissue, and Bone Infections Due to Mycobacterium chelonae chelonae: Importance of Prior Corticosteroid Therapy, Frequency of Disseminated Infections, and Resistance to Oral Antimicrobials Other than Clarithromycin</atitle><jtitle>The Journal of infectious diseases</jtitle><addtitle>J Infect Dis</addtitle><date>1992-08-01</date><risdate>1992</risdate><volume>166</volume><issue>2</issue><spage>405</spage><epage>412</epage><pages>405-412</pages><issn>0022-1899</issn><eissn>1537-6613</eissn><coden>JIDIAQ</coden><abstract>Little is known of clinical disease due to Mycobacterium chelonaechelonae. One hundred skin, soft tissue, or bone isolates of this rapidly growing mycobacterium were identified over 10 years. Clinical disease included disseminated cutaneous infection (53%); localized cellulitis, abscess, or osteomyelitis (35%); and catheter infections (12%). Underlying conditions with disseminated infection included organ transplantation, rheumatoid arthritis, and autoimmune disorders; 92% involved corticosteroid use. Trauma and medical procedures were risk factors for localized infections. Corticosteroids and chronic renal failure were risk factors for catheter infections. Overall, 62% of patients were receiving corticosteroids and 72% were immunosuppressed. MICs of six oral antimicrobials were obtained for 180 isolates by broth microdilution. Up to 20% of isolates were susceptible to doxycycline, ciprofloxacin, ofloxacin, and sulfamethoxazole. In contrast, 100% were susceptible to clarithromycin (MICs ⩽1 µg/mL). Disease due to M. chelonae usually occurs in the setting of corticosteroid therapy and is often disseminated; the organisms require high MICs of oral antimicrobials other than clarithromycin.</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>1386098</pmid><doi>10.1093/infdis/166.2.405</doi><tpages>8</tpages></addata></record> |
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| ispartof | The Journal of infectious diseases, 1992-08, Vol.166 (2), p.405-412 |
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| source | MEDLINE; Jstor Complete Legacy |
| subjects | Abscess - microbiology Administration, Oral Adrenal Cortex Hormones - therapeutic use Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - pharmacology Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Arthritis, Rheumatoid - complications Arthritis, Rheumatoid - drug therapy Autoimmune diseases Autoimmune Diseases - complications Autoimmune Diseases - drug therapy Biological and medical sciences Bones Catheters, Indwelling Cellulitis - complications Cellulitis - microbiology Chronic diseases Clarithromycin Corticosteroids Drug Resistance, Microbial Erythromycin - analogs & derivatives Erythromycin - pharmacology Fungal infections Humans Infections Lesions Lung diseases Major Articles Medical sciences Mycobacterium chelonae Mycobacterium chelonae - drug effects Mycobacterium chelonae - physiology Mycobacterium Infections, Nontuberculous - complications Mycobacterium Infections, Nontuberculous - microbiology Organ Transplantation Osteomyelitis - complications Osteomyelitis - microbiology Pharmacology. Drug treatments Risk Factors Skin diseases Skin Diseases, Infectious - complications Skin Diseases, Infectious - microbiology United States |
| title | Skin, Soft Tissue, and Bone Infections Due to Mycobacterium chelonae chelonae: Importance of Prior Corticosteroid Therapy, Frequency of Disseminated Infections, and Resistance to Oral Antimicrobials Other than Clarithromycin |
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