Isolation of Rapidly Growing Nontuberculous Mycobacteria in Wounds Following Combat-Related Injury.
Objectives: Rapidly growing nontuberculous mycobacteria (RGNTM) have yet to be described in combat-related injuries. This study investigates the epidemiology, clinical findings, treatment, and outcomes of RGNTM infections among combat casualties wounded in Afghanistan from 2010 to 2012.Methods: Pati...
| Publicado en: | Military Medicine Vol. 181; no. 6; pp. 530 - 537 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Jun2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=115937545&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 115937545 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00264075 4DV jtl: Military Medicine issn: 00264075 maglogo: N pubinfo: dt: Jun2016 vid: 181 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 115937545 115937545 NLM27244062 115937545 10.7205/MILMED-D-14-00731 NLM27244062 115937545 ppf: 530 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Isolation of Rapidly Growing Nontuberculous Mycobacteria in Wounds Following Combat-Related Injury. aug: au: Fiske, Lauren C. Homeyer, Maj Diane C. Zapor, Michael Hartzell, Joshua Warkentien, Tyler Weintrob, Amy C. Ganesan, Anuradha Burgess, Timothy Snesrud, Erik Waterman, Paige Nielsen, Lindsey Ressner, Roseanne A. Homeyer, Diane C affil: Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889. sug: subj: Mycobacterium Mycobacterium Infections Epidemiology Wounds and Injuries Epidemiology Data Collection Military Personnel Statistics and Numerical Data Mycobacterium Infections Microbiology Afghanistan Adult Male Wounds and Injuries Microbiology Human Adult: 19-44 years Male ab: Objectives: Rapidly growing nontuberculous mycobacteria (RGNTM) have yet to be described in combat-related injuries. This study investigates the epidemiology, clinical findings, treatment, and outcomes of RGNTM infections among combat casualties wounded in Afghanistan from 2010 to 2012.Methods: Patients with RGNTM were identified from the Department of Defense Trauma Registry through the Trauma Infectious Disease Outcomes Study. Trauma history, surgical management, and clinical data were collected. Six isolates from patients requiring antimycobacterial therapy were sequenced.Results: Seventeen cases were identified. Six cases, predominantly associated with Mycobacterium abscessus, required aggressive debridement and a median of 180 days of multidrug antimycobacterial therapy that included clofazimine. M. abscessus isolates expressed the erythromycin resistance methylase (erm(41)) gene for inducible macrolide resistance, yet there were no clinical treatment failures when macrolides were utilized in combination therapy. No clonal similarity between M. abscessus isolates was found. Eleven cases had positive wound cultures, but did not require antimycobacterial therapy. The median duration of time of injury to first detection of a RGNTM was 57 days.Conclusions: This represents the first report of RGNTM infections in war-wounded patients. RGNTM should be recognized as potential pathogens in grossly infected combat wounds. Surgical debridement and multidrug antimycobacterial therapy, when clinically indicated, was associated with satisfactory clinical outcomes. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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