What is Mycobacterium abscessus complex (MABC)?
A group of rapidly growing, multidrug-resistant nontuberculous mycobacteria (NTM) responsible for various infections.
What infections are caused by Mycobacterium abscessus complex?
Infections in skin, soft tissues, lungs, CNS, eyes, and bloodstream.
What are the three subspecies of Mycobacterium abscessus?
- M. abscessus subsp. abscessus
- M. abscessus subsp. massiliense
- M. abscessus subsp. bolletii
Why is differentiation of MABC subspecies clinically important?
Due to varying drug resistance patterns among the subspecies.
What is the role of the erm(41) gene in MABC?
Functional in subsp. abscessus, leading to macrolide resistance; nonfunctional in subsp. massiliense, resulting in macrolide susceptibility.
What molecular methods are required for accurate subspecies identification of MABC?
rpoB gene sequencing or MALDI-TOF MS.
Where is the prevalence of Mycobacterium abscessus complex increasing?
Globally, especially in East Asia.
In which patient population is MABC common in pulmonary samples?
Patients with underlying lung conditions like cystic fibrosis.
What are common sources of nosocomial outbreaks of MABC?
Cosmetic procedures, contaminated disinfectants, surgical tools, and water sources.
What are the clinical manifestations of pulmonary infections caused by MABC?
Often chronic and difficult to treat, requiring radiographic, clinical, and microbiologic confirmation.
What is the recommended treatment for pulmonary infections caused by MABC?
Macrolide + IV amikacin + cefoxitin/imipenem for ≥12 months.
What are the associated factors for skin and soft tissue infections (SSTIs) caused by MABC?
Associated with surgeries, cosmetic procedures, tattoos, and hot tubs.
What is the treatment duration for SSTIs caused by MABC?
Macrolide + amikacin + cefoxitin/imipenem + surgery for ≥4 months.
What types of infections can occur in the CNS due to MABC?
Rare infections typically occur post-neurosurgery or in immunocompromised individuals, including meningitis and cerebral abscess.
What is the treatment recommendation for CNS infections caused by MABC?
Clarithromycin-based + amikacin for ≥12 months.
What is the risk factor for disseminated disease and bacteremia caused by MABC?
Seen in immunocompromised patients, often catheter-related or via surgical wounds.
What ocular infections are associated with MABC?
Keratitis, endophthalmitis, and scleritis.
What is the treatment for ocular infections caused by MABC?
Topical/systemic antimicrobials ± surgery for 6 weeks to 6 months.
What are the best drugs for treating MABC in vitro?
Clarithromycin, Amikacin, Cefoxitin.
What drugs show poor activity against MABC?
Ciprofloxacin, moxifloxacin, doxycycline.
What challenges exist in treating MABC infections?
Need for rapid, low-cost subspecies ID methods and lack of consensus on optimal drug regimens.
What future directions are suggested for MABC treatment?
Prospective clinical trials and novel antimicrobials (e.g., tigecycline) are urgently needed.
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Antimicrobial Peptides Against M. abscessus Infections18
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Understanding Tuberculosis: Pathogenesis and Diagnosis22
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Key Characteristics and Implications of M. tuberculosis17
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Mycobacterium Avium Complex: Overview and Treatment23
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Mycobacterial Avium Complex: Overview and Management20
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Mycobacterium abscessus Complex: Overview and Treatment22
