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Non-tuberculous mycobacterial bone and joint infections - a case series from a tertiary referral centre in Australia.
- Source :
-
ANZ journal of surgery [ANZ J Surg] 2024 Nov; Vol. 94 (11), pp. 1942-1948. Date of Electronic Publication: 2024 Oct 20. - Publication Year :
- 2024
-
Abstract
- Background: Non-tuberculous mycobacteria (NTM) are rare causes of bone and joint infection (BJI) and there is limited evidence on which to base management decisions. This study describes 1 year of experience from a multi-disciplinary BJI team which collects data on all cases reviewed at a tertiary referral centre in Queensland, Australia.<br />Methods: The database was interrogated for all cases in which NTM were recovered from operative samples. Individual chart review was performed to collect the details of each case.<br />Results: A total of seven cases were managed between 1st February 2021 and 28th February 2022, comprising one patient with chronic osteomyelitis, three with fracture-related infections, two with prosthetic joint infections, and one with infection of a synthetic ligament graft. In contrast to pulmonary NTM infections, most patients were clinically well and immunocompetent, and most infections were propagated by direct inoculation. Time to diagnosis was unknown in three patients, with 1, 2, 2, and 5 months for the remaining four. Rapid growing NTM were diagnosed on routine cultures and specific mycobacterial cultures were confirmatory. Management was characterized by multiple stage surgical procedures and prolonged antimicrobial regimens.<br />Conclusions: Antimicrobial complications were common; however, all patients were infection free at their latest follow up. Despite the inherent limitations, these results suggest that routinely ordering mycobacterial culture is of low yield. There is potential for shorter-term oral antimicrobial treatments. Prospective research is required to optimize treatment regimens and durations.<br /> (© 2024 The Author(s). ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons.)
- Subjects :
- Humans
Male
Female
Middle Aged
Aged
Queensland epidemiology
Nontuberculous Mycobacteria isolation & purification
Adult
Prosthesis-Related Infections microbiology
Prosthesis-Related Infections therapy
Prosthesis-Related Infections diagnosis
Anti-Bacterial Agents therapeutic use
Arthritis, Infectious microbiology
Arthritis, Infectious diagnosis
Arthritis, Infectious therapy
Retrospective Studies
Australia epidemiology
Mycobacterium Infections, Nontuberculous diagnosis
Mycobacterium Infections, Nontuberculous therapy
Tertiary Care Centers
Osteomyelitis microbiology
Osteomyelitis diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1445-2197
- Volume :
- 94
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- ANZ journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 39428673
- Full Text :
- https://doi.org/10.1111/ans.19268