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Rapidly growing mycobacterial infections in HIV-negative patients

Author
David E Griffith, MD
Section Editor
C Fordham von Reyn, MD
Deputy Editor
Allyson Bloom, MD

INTRODUCTION

Rapidly growing mycobacteria (RGM) include three clinically relevant species, Mycobacterium fortuitum, Mycobacterium chelonae, and Mycobacterium abscessus (table 1). The RGM are environmental organisms found worldwide that usually grow in subculture within one week (eg, rapidly, as compared with other mycobacteria). M. abscessus is the most commonly encountered species of this group isolated from clinical respiratory specimens, and M. fortuitum is the most common from non-respiratory specimens.

The clinical manifestations, diagnosis, and treatment of RGM infections in HIV-negative patients will be discussed here. The clinical manifestations and diagnosis of nontuberculous mycobacterial (NTM) pulmonary infection (other than those caused by RGM), microbiology of NTM infection, infection due to Mycobacterium marinum, and Mycobacterium ulcerans are discussed separately. (See "Overview of nontuberculous mycobacterial infections in HIV-negative patients" and "Diagnosis of nontuberculous mycobacterial infections of the lungs in HIV-negative patients" and "Microbiology of nontuberculous mycobacteria".)

EPIDEMIOLOGY

The epidemiology of nontuberculous mycobacterial (NTM) infections is discussed separately. (See "Epidemiology of nontuberculous mycobacterial infections".)

NOMENCLATURE

The taxonomy and nomenclature for M. abscessus is in flux. There are three proposed M. abscessus subspecies, including M. abscessus subsp abscessus (the organism traditionally labeled "M. abscessus"), M. abscessus subsp massiliense, and M. abscessus subsp bolletii. These are difficult to distinguish from each other in the clinical laboratory. Furthermore, the organism most frequently referred to as M. massiliense has also historically been labeled M. bolletii by certain groups.

The most important aspect of this confusing nomenclature is that M. abscessus subsp abscessus almost universally has an active inducible macrolide resistance (erm) gene, which impacts treatment decisions. In contrast, the organism most frequently referred to "M. massiliense" does not. (See 'Susceptibility testing' below.)

                                   

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Literature review current through: Nov 2016. | This topic last updated: Mon Jan 05 00:00:00 GMT 2015.
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