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Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020

Non-tuberculous mycobacterial (NTM) infection of the musculoskeletal system is rare but poses a grave threat to public health. These infections yield non-specific symptoms that remain undetected until the development of the later stages of the disease. In this study, we performed a retrospective rev...

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Autores principales: Ma, Qiong, Chen, Rende, Yang, Enhui, Yuan, Youhua, Tian, Yongfu, Han, Yongguang, Wang, Shanmei, Wang, Baoya, Yan, Wenjuan, Zhang, Qi, Jing, Nan, Ma, Bing, Wang, Zhen, Li, Yi, Li, Yongjun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718100/
https://www.ncbi.nlm.nih.gov/pubmed/34975815
http://dx.doi.org/10.3389/fmicb.2021.791918
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author Ma, Qiong
Chen, Rende
Yang, Enhui
Yuan, Youhua
Tian, Yongfu
Han, Yongguang
Wang, Shanmei
Wang, Baoya
Yan, Wenjuan
Zhang, Qi
Jing, Nan
Ma, Bing
Wang, Zhen
Li, Yi
Li, Yongjun
author_facet Ma, Qiong
Chen, Rende
Yang, Enhui
Yuan, Youhua
Tian, Yongfu
Han, Yongguang
Wang, Shanmei
Wang, Baoya
Yan, Wenjuan
Zhang, Qi
Jing, Nan
Ma, Bing
Wang, Zhen
Li, Yi
Li, Yongjun
author_sort Ma, Qiong
collection PubMed
description Non-tuberculous mycobacterial (NTM) infection of the musculoskeletal system is rare but poses a grave threat to public health. These infections yield non-specific symptoms that remain undetected until the development of the later stages of the disease. In this study, we performed a retrospective review of 25 cases of musculoskeletal NTM infection at two tertiary medical centres over a 5-year period to determine the clinical features and improve the current clinical diagnosis and treatment. The most common mycobacterial species detected were Mycobacterium fortuitum in eleven patients, Mycobacterium abscessus in eight patients, Mycobacterium houstonense in three patients, Mycobacterium avium in two patients, and Mycobacterium smegmatis in one patient. The sites of infection included the limbs and joints, most commonly the knee (ten patients) and foot (six patients). The median duration from the onset of symptoms to diagnosis was 2.5 months (0.8–13.5 months). Deep sinus tracts extending to the surgical site were observed in 60% of the patients (15/25), and granulomatous inflammation and granulomatous inflammation with necrosis occurred in 60% of the patients (15/25). All patients underwent surgical treatment for infection control, and all patients, except one, received antimycobacterial therapy based on drug sensitivity assays. The median duration of the antimicrobial chemotherapy was 5 months (range: 3–20 months). At the final follow-up, 24 patients presented with absence of recurrence and one patient succumbed owing to heart failure after debridement. Our findings highlight the importance of vigilance and improvements in the diagnostic methods for musculoskeletal NTM infection. Aggressive surgical treatment and antimycobacterial drug treatment can help achieve satisfactory results.
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spelling pubmed-87181002021-12-31 Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020 Ma, Qiong Chen, Rende Yang, Enhui Yuan, Youhua Tian, Yongfu Han, Yongguang Wang, Shanmei Wang, Baoya Yan, Wenjuan Zhang, Qi Jing, Nan Ma, Bing Wang, Zhen Li, Yi Li, Yongjun Front Microbiol Microbiology Non-tuberculous mycobacterial (NTM) infection of the musculoskeletal system is rare but poses a grave threat to public health. These infections yield non-specific symptoms that remain undetected until the development of the later stages of the disease. In this study, we performed a retrospective review of 25 cases of musculoskeletal NTM infection at two tertiary medical centres over a 5-year period to determine the clinical features and improve the current clinical diagnosis and treatment. The most common mycobacterial species detected were Mycobacterium fortuitum in eleven patients, Mycobacterium abscessus in eight patients, Mycobacterium houstonense in three patients, Mycobacterium avium in two patients, and Mycobacterium smegmatis in one patient. The sites of infection included the limbs and joints, most commonly the knee (ten patients) and foot (six patients). The median duration from the onset of symptoms to diagnosis was 2.5 months (0.8–13.5 months). Deep sinus tracts extending to the surgical site were observed in 60% of the patients (15/25), and granulomatous inflammation and granulomatous inflammation with necrosis occurred in 60% of the patients (15/25). All patients underwent surgical treatment for infection control, and all patients, except one, received antimycobacterial therapy based on drug sensitivity assays. The median duration of the antimicrobial chemotherapy was 5 months (range: 3–20 months). At the final follow-up, 24 patients presented with absence of recurrence and one patient succumbed owing to heart failure after debridement. Our findings highlight the importance of vigilance and improvements in the diagnostic methods for musculoskeletal NTM infection. Aggressive surgical treatment and antimycobacterial drug treatment can help achieve satisfactory results. Frontiers Media S.A. 2021-12-16 /pmc/articles/PMC8718100/ /pubmed/34975815 http://dx.doi.org/10.3389/fmicb.2021.791918 Text en Copyright © 2021 Ma, Chen, Yang, Yuan, Tian, Han, Wang, Wang, Yan, Zhang, Jing, Ma, Wang, Li and Li. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Microbiology
Ma, Qiong
Chen, Rende
Yang, Enhui
Yuan, Youhua
Tian, Yongfu
Han, Yongguang
Wang, Shanmei
Wang, Baoya
Yan, Wenjuan
Zhang, Qi
Jing, Nan
Ma, Bing
Wang, Zhen
Li, Yi
Li, Yongjun
Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020
title Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020
title_full Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020
title_fullStr Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020
title_full_unstemmed Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020
title_short Non-tuberculous Mycobacterial Infection of the Musculoskeletal System Detected at Two Tertiary Medical Centres in Henan, China, 2016–2020
title_sort non-tuberculous mycobacterial infection of the musculoskeletal system detected at two tertiary medical centres in henan, china, 2016–2020
topic Microbiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718100/
https://www.ncbi.nlm.nih.gov/pubmed/34975815
http://dx.doi.org/10.3389/fmicb.2021.791918
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