• Tuberculosis and Respiratory Diseases
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• 제64권6호
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• pp.422-426
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• 2008

연구배경: Mycobacterium abscessus는 빠른 성장성을 지닌 비결핵균중에서 높은 병원성과 약제 내성을 나타내는 종이며, clarithromycin과 azithromycin 항결핵제가 M. abscessus에 효과가 있는 유일한 경구용 항결핵제이다. 본 연구에서는 역교잡반응법과 약제감수성검사법을 이용하여 clarithromycin 약제에 대한 M. abscessus 임상 내성균주 검출을 시도하였다. 방 법: 역교잡반응법과 약제감수성검사법을 이용하여 220개의 M. abscessus 임상 균주를 대상으로 내성 균주를 분리하였다. 결 과: 약제감수성검사법으로 7개의 임상 내성 균주들을 검출하였고, 이들 중 3개의 내성 균주는 점 돌연변이 균주로서 역교잡반응법으로도 확인하였다. 결 론: M. abscess 균주에서는 점 돌연변이 및 다른 종류의 내성 특성을 나타내고 있음을 확인할 수 있었다.

• 대한족부족관절학회지
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• 제15권1호
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• pp.39-43
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• 2011

Non-tuberculous mycobacterium has a wide-spread occurrence in nature, and skin, soft tissue, bone, lung and disseminated infection can be involved. Non-tuberculous mycobacterium infection occurs both in immunocompetent patients without underlying diseases and in immunocompromised hosts. Non-tuberculous mycobactrial osteomyelitis is a rare cause of granulomatous osteomyelitis, and has been previously reported in the sternum, spine, humerus, femur, tibia or metatarsal. Mycobacterium abscessus osteomyelitis is a very rare infection in the foot and only 1 case has been reported. Authors report a case of Mycobacterium abscessus osteomyelitis involving the tarsal and metatarsal bones in a non-immunocompromized middle aged women.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.289-292
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• 2010

Purpose: Mycobacterium abscessus belongs to the group of rapid-growing atypical mycobacterium. The organism is ubiquitous and is found in soil, dust, and water. Although it rarely causes disease in humans, Mycobacterium abscessus has been associated with soft tissue infection. To the best of our knowledge, this is the first case report of facial soft tissue Mycobacterium abscessus infection in a healthy child in Korea. Methods: A 12-year-old girl presented with an erythematous skin lesion with serous discharge on her chin, which had been present for 3 weeks. On her history, she had a laceration wound on her chin at public bath and the lesion was repaired at emergency department immediately. Although conventional soft tissue infecton treatment, her lesion remains unhealed state and had serous discharge for 2 months. Moreover, we found a 1 cm sized nodular mass on her chin. Therefore we performed excision operation and referred the specimen to the laboratory for microbial and histopathologic study. Results: Pathology report confirmed the mass was enlarged lymph node with chronic necrotizing granulomatous inflammation with central microabscess. Non-Tuberculous mycobacterium identification test through tissue specimen resulted Mycobacterium abscessus. We prescribed clarithromycin for three weeks by oral administration as well as performed wound debridement and mass excision via previous wound. This way, her lesion appeared to be complete healing with minimal scarring. There were no evidence of inflammation sign or palpable mass. Conclusion: Although the prevalence is rare, Mycobacterium abscessus infections of soft tissue should be considered even in a healthy child with a lesion caused by trauma or which fails to respond to conventional treatment.

• Journal of Chest Surgery
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• 제50권1호
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• pp.50-53
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• 2017

A mixed infection of Mycobacterium abscessus subsp. abscessus (Mab) and Mycobacterium tuberculosis (MTB) in the lung is an unusual clinical manifestation and has not yet been reported. A 61-year-old woman had been treated for Mab lung disease and concomitant pneumonia, and was diagnosed with pulmonary tuberculosis (PTB). Despite both anti-PTB and anti-Mab therapy, her entire left lung was destroyed and collapsed. She underwent left pneumonectomy and received medical therapy. We were able to successfully treat her mixed infection by pneumonectomy followed by inhaled amikacin therapy. To the best of our knowledge, thus far, this is the first description of a mixed Mab and MTB lung infection.

• Annals of Geriatric Medicine and Research
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• 제22권4호
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• pp.204-207
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• 2018

Mycobacterium abscessus comprises rapidly growing mycobacteria, and the clinical manifestations of M. abscessus skin infection include papule, nodule, ulcer, scar and mixed form. The cutaneous infections have been reported due to minor trauma, cosmetic therapy, acupuncture and disseminated infection. A 75-year-old man presented with pruritic diffuse various sized erythematous papuloplaques and pustules on the neck and chest for 2 months. The cutaneous lesions were spread around the wound of the shaving on the neck. The histopathologic findings were consistent with abscess showing infiltrations of neutrophils and lymphocytes in the dermis and negative findings were observed on immunohistochemical stain including acid-fast bacilli stain. One month later, mycobacterial culture result showed positive findings, and the pathogen was identified by reversetranscriptase polymerase chain reaction with hybridization. The patient was treated with combination of clarithromycin and ethambutol for 5 months and there is no evidence of recurrence after 6 months of follow-up. Herein, we report a case of M. abscessus cutaneous infection through minor trauma caused by shaving in the elderly.

• IMMUNE NETWORK
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• 제21권6호
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• pp.40.1-40.20
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• 2021

Mycobacteroides abscessus (previously Mycobacterium abscessus; Mabc), one of rapidly growing nontuberculous mycobacteria (NTM), is an important pathogen of NTM pulmonary diseases (NTM-PDs) in both immunocompetent and immunocompromised individuals. Mabc infection is chronic and often challenging to treat due to drug resistance, motivating the development of new therapeutics. Despite this, there is a lack of understanding of the relationship between Mabc and the immune system. This review highlights recent progress in the molecular architecture of Mabc and host interactions. We discuss several microbial components that take advantage of host immune defenses, host defense pathways that can overcome Mabc pathogenesis, and how host-pathogen interactions determine the outcomes of Mabc infection. Understanding the molecular mechanisms underlying host-pathogen interactions during Mabc infection will enable the identification of biomarkers and/or drugs to control immune pathogenesis and protect against NTM infection.

• Tuberculosis and Respiratory Diseases
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• 제86권1호
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• pp.47-56
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• 2023

Background: There is a global increase in isolation of nontuberculous mycobacteria (NTM). The aim of the study was to analyze longitudinal trends of NTM identification and pattern of antimicrobial susceptibility testing. Methods: NTM recovery rates, distribution of NTM species identification, and antimicrobial susceptibility pattern of NTM at Pusan National University Yangsan Hospital between January 2016 and December 2020 were retrospectively analyzed. Results: A total of 52,456 specimens from 21,264 patients were submitted for mycobacterial culture, of which 2,521 from 1,410 patients were NTM positive over five years (January 2016 to December 2020). NTM isolation showed an increasing trend from 2016 to 2020 (p<0.001, test for trend) mainly caused by Mycobacterium avium complex. The vast majority of M. avium complex were susceptible to key agents clarithromycin and amikacin. For Mycobacterium kansasii, resistance to rifampin and clarithromycin is rare. Amikacin was the most effective drug against Mycobacterium abscessus subspecies abscessus and Mycobacterium subspecies massiliense. Most of M. subspecies massiliense were susceptible to clarithromycin, while the majority of M. abscessus subspecies abscessus were resistant to clarithromycin (p<0.001). Conclusion: There was an increasing trend of NTM isolation in our hospital. Resistance to key drugs was uncommon for most NTM species except for M. abscessus subspecies abscessus against clarithromycin.

• Tuberculosis and Respiratory Diseases
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• 제62권2호
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• pp.98-104
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• 2007

연구배경: M. abscessus 폐질환은 최근 우리나라에서 유병률이 증가하는 질환이다. 국내 M. abscessus 폐감염증에 대한 치료성적 및 치료 후 장기결과에 대해서 알아보고자 의무기록을 후향적으로 분석하였다. 방 법: 1996년부터 2003년까지 서울아산병원에서 미국흉부학회진단기준에 부합하는 35명의 M. abscessus 폐질환 환자 중 치료를 받은 29명의 환자를 대상으로 임상적 특징과 치료, 치료 후 추적결과에 대해 분석하였다. 결 과: 29명의 평균 나이는 56.1세(${\pm}13.6$)였고 여성이 76% 이었으며(22/29), 20명(69%)에서 결절 기관지확장증형이었다. 29명 중 19명(65.5%)에서 치료성공하였고 9명(31%)은 치료실패하였다. 1명은 약물부작용으로 치료를 중단하였다. 치료성공군은 중앙값 543일(범위 176 - 1,160)동안 치료를 받았고, 균배양음전까지의 기간은 중앙값 42일(범위 15-362)이었다. 수술은 5명에서 시행되었으며 한 엽에만 국한된 병변을 가진 두 환자에서 치료성공하였다. 치료 완료 후 중앙값 931일 (범위 230-2294일)동안 추적관찰이 이루어졌고, 19명 중 1명(5.3%)이 재발하였다. 결 론: M. abscessus 폐질환의 세균학적 치료 성적은 외국의 보고에 비하여 우수한 편이며 치료성공 후 재발률은 낮았다.

• Journal of Yeungnam Medical Science
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• 제26권2호
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• pp.137-142
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• 2009

Nontuberculous mycobacterial infections are a rare, but clinically important cause of infections in continuous ambulatory peritoneal dialysis (CAPD) patients. This is typically suspected when a patient does not respond to treatment with the usual antibiotics. We describe here a case of $Mycobacterium$ $abscessus$ exit site infection with abdominal wall abscess formation that was associated with CAPD, which required peritoneal catheter removal, surgical debridement of the abscess and long term antibiotic therapy.

• Tuberculosis and Respiratory Diseases
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• 제72권3호
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• pp.275-283
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• 2012

Background: Healthy individuals who develop nontuberculous mycobacteria (NTM) lung disease are likely to have specific susceptibility factors which can lead to a NTM infection. The aim of the present study was to investigate the mechanism underlying innate immune responses, including the role of mitogen-activated protein kinase (MAPK), in Mycobacterium abscessus lung disease. Methods: Extracellular signal-regulated kinase (ERK1/2) and p38 MAPK expression in monocytes from peripheral blood mononuclear cells were measured by Western blot analysis after stimulation by Mycobacterium avium in five patients with M. abscessus lung disease and seven healthy controls. A M. avium-induced cytokine assay was performed after inhibition of ERK1/2 and p38 MAPK pathways. Results: Mycobacterium avium induced p38 and ERK1/2 expression in monocytes from healthy controls and subsequently upregulated tumor necrosis factor (TNF)-${\alpha}$, interleukin (IL)-6, and IL-10 production. In monocytes from patients with M. abscessus lung disease, however, induction of p38 and ERK1/2 expression, and the production of TNF-${\alpha}$, IL-6, and IL-10 were significantly lower. Conclusion: Decreased activity of MAPK and cytokine secretion in monocytes from patients with M. abscessus lung disease may provide an explanation regarding host susceptibility to these uncommon infections.