Shintaro Hamada1, Tomoaki Takata2, Tsuyoshi Kitaura3, Chiori Teraoka4, Akio Aono5, Sosuke Taniguchi1, Yukari Mae1, Hajime Isomoto1, Hiroki Chikumi3, Satoshi Mitarai5. 1. Division of Gastroenterology and Nephrology, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan. 2. Division of Gastroenterology and Nephrology, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan. t-takata@tottori-u.ac.jp. 3. Division of Infectious Diseases, Tottori University Faculty of Medicine, Yonago, Tottori, 683-8504, Japan. 4. Department of Clinical Laboratory, Tottori University Hospital, Yonago, Tottori, 683-8504, Japan. 5. The Research Institute of Tuberculosis, Japan Anti-tuberculosis Association, Kiyose, Tokyo, 204-0023, Japan.
Abstract
BACKGROUND: Peritoneal dialysis (PD)-associated peritonitis caused by nontuberculous Mycobacterium is rare; however, the number of cases has increased over the past decades. Mycobacteroides massiliense is a subspecies of the Mycobacteroides abscessus complex. It has different clinical characteristics compared to the other subspecies of the complex. Previous case reports of PD-associated peritonitis caused by Mycobacteroides abscessus complex have not distinguished the subspecies in detail. CASE PRESENTATION: A 40-year-old man presented with an exit-site and tunnel infection refractory to antibiotic therapy. Peritonitis occurred after simultaneous catheter removal and reinsertion. The Mycobacteroides abscessus complex was detected in the culture of the dialysis effluent. Removal of the PD catheter combined with antibiotics, including macrolides, resulted in a good clinical course. Further analysis of multiplex PCR and the hsp65 gene sequence identified the bacterium as Mycobacteroides massiliense. CONCLUSIONS: The Mycobacteroides abscessus complex is classified into three subspecies; Mycobacteroides abscessus, Mycobacteroides massiliense, and Mycobacteroides bolletii. These have different characteristics, particularly antibiotic susceptibility. Therefore, clear identification of the subspecies of the Mycobacteroides abscessus complex is necessary for definitive treatment.
BACKGROUND: Peritoneal dialysis (PD)-associated peritonitis caused by nontuberculous Mycobacterium is rare; however, the number of cases has increased over the past decades. Mycobacteroides massiliense is a subspecies of the Mycobacteroides abscessus complex. It has different clinical characteristics compared to the other subspecies of the complex. Previous case reports of PD-associated peritonitis caused by Mycobacteroides abscessus complex have not distinguished the subspecies in detail. CASE PRESENTATION: A 40-year-old man presented with an exit-site and tunnel infection refractory to antibiotic therapy. Peritonitis occurred after simultaneous catheter removal and reinsertion. The Mycobacteroides abscessus complex was detected in the culture of the dialysis effluent. Removal of the PD catheter combined with antibiotics, including macrolides, resulted in a good clinical course. Further analysis of multiplex PCR and the hsp65 gene sequence identified the bacterium as Mycobacteroides massiliense. CONCLUSIONS: The Mycobacteroides abscessus complex is classified into three subspecies; Mycobacteroides abscessus, Mycobacteroides massiliense, and Mycobacteroides bolletii. These have different characteristics, particularly antibiotic susceptibility. Therefore, clear identification of the subspecies of the Mycobacteroides abscessus complex is necessary for definitive treatment.
Authors: David E Griffith; Timothy Aksamit; Barbara A Brown-Elliott; Antonino Catanzaro; Charles Daley; Fred Gordin; Steven M Holland; Robert Horsburgh; Gwen Huitt; Michael F Iademarco; Michael Iseman; Kenneth Olivier; Stephen Ruoss; C Fordham von Reyn; Richard J Wallace; Kevin Winthrop Journal: Am J Respir Crit Care Med Date: 2007-02-15 Impact factor: 21.405
Authors: Josephine M Bryant; Dorothy M Grogono; Daniel Greaves; Juliet Foweraker; Iain Roddick; Thomas Inns; Mark Reacher; Charles S Haworth; Martin D Curran; Simon R Harris; Sharon J Peacock; Julian Parkhill; R Andres Floto Journal: Lancet Date: 2013-03-29 Impact factor: 79.321