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  • Authors: Alexandra Aubry1, Faiza Mougari4, Florence Reibel7, Emmanuelle Cambau10
  • Editor: David Schlossberg13
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Centre National de Référence des mycobactéries et résistance des Mycobactéries aux antituberculeux; 2: Sorbonne Université, Université Pierre et Marie Curie, AP-HP Hôpital Pitié-Salpêtrière; 3: Centre d’Immunologie et des Maladies Infectieuses, Team 13, INSERM U1135, Paris, France; 4: Centre National de Référence des mycobactéries et résistance des Mycobactéries aux antituberculeux; 5: Laboratoire de Bactériologie, AP-HP Hôpital Lariboisière; 6: Université Paris Diderot, IAME UMR 1137 Inserm, Paris, France; 7: Centre National de Référence des mycobactéries et résistance des Mycobactéries aux antituberculeux; 8: Sorbonne Université, Université Pierre et Marie Curie, AP-HP Hôpital Pitié-Salpêtrière; 9: Centre d’Immunologie et des Maladies Infectieuses, Team 13, INSERM U1135, Paris, France; 10: Centre National de Référence des mycobactéries et résistance des Mycobactéries aux antituberculeux; 11: Laboratoire de Bactériologie, AP-HP Hôpital Lariboisière; 12: Université Paris Diderot, IAME UMR 1137 Inserm, Paris, France; 13: Philadelphia Health Department, Philadelphia, PA
  • Source: microbiolspec April 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0038-2016
  • Received 24 December 2016 Accepted 13 February 2017 Published 07 April 2017
  • Emmanuelle Cambau, emmanuelle.cambau@aphp.fr
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  • Abstract:

    is a well-known pathogenic mycobacterium for skin and soft tissue infections and is associated with fishes and water. Among nontuberculous mycobacteria (NTM), it is the leading cause of extrarespiratory human infections worldwide. In addition, there is a specific scientific interest in because of its genetic relatedness to and because experimental infection of in fishes mimics tuberculosis pathogenesis. Microbiological characteristics include the fact that it grows in 7 to 14 days with photochromogenic colonies and is difficult to differentiate from and other mycolactone-producing NTM on a molecular basis. The diagnosis is highly suspected by the mode of infection, which is related to the hobby of fishkeeping, professional handling of marine shells, or swimming in nonchlorinated pools. Clinics distinguished skin and soft tissue lesions (typically sporotrichoid or subacute hand nodules) and lesions disseminated to joint and bone, often related with the local use of corticosteroids. In clinical microbiology, microscopy and culture are often negative because growth requires low temperature (30°C) and several weeks to succeed in primary cultivation. The treatment is not standardized, and no randomized control trials have been done. Therapy is a combination of surgery and antimicrobial agents such as cyclines and rifampin, with successful outcome in most of the skin diseases but less frequently in deep tissue infections. Prevention can be useful with hand protection recommendations for professionals and all persons manipulating fishes or fish tank water and use of alcohol disinfection after contact.

  • Citation: Aubry A, Mougari F, Reibel F, Cambau E. 2017. . Microbiol Spectrum 5(2):TNMI7-0038-2016. doi:10.1128/microbiolspec.TNMI7-0038-2016.

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/content/journal/microbiolspec/10.1128/microbiolspec.TNMI7-0038-2016
2017-04-07
2017-05-30

Abstract:

is a well-known pathogenic mycobacterium for skin and soft tissue infections and is associated with fishes and water. Among nontuberculous mycobacteria (NTM), it is the leading cause of extrarespiratory human infections worldwide. In addition, there is a specific scientific interest in because of its genetic relatedness to and because experimental infection of in fishes mimics tuberculosis pathogenesis. Microbiological characteristics include the fact that it grows in 7 to 14 days with photochromogenic colonies and is difficult to differentiate from and other mycolactone-producing NTM on a molecular basis. The diagnosis is highly suspected by the mode of infection, which is related to the hobby of fishkeeping, professional handling of marine shells, or swimming in nonchlorinated pools. Clinics distinguished skin and soft tissue lesions (typically sporotrichoid or subacute hand nodules) and lesions disseminated to joint and bone, often related with the local use of corticosteroids. In clinical microbiology, microscopy and culture are often negative because growth requires low temperature (30°C) and several weeks to succeed in primary cultivation. The treatment is not standardized, and no randomized control trials have been done. Therapy is a combination of surgery and antimicrobial agents such as cyclines and rifampin, with successful outcome in most of the skin diseases but less frequently in deep tissue infections. Prevention can be useful with hand protection recommendations for professionals and all persons manipulating fishes or fish tank water and use of alcohol disinfection after contact.

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Figures

Image of FIGURE 1
FIGURE 1

Typical photochromogenic colonies of grown on Lowenstein-Jensen solid medium.

Source: microbiolspec April 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0038-2016
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Image of FIGURE 2
FIGURE 2

Sporotrichoid form of skin lesions typical of infection. (Courtesy of Hervé Darie, Noisy le Grand, France.)

Source: microbiolspec April 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0038-2016
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Image of FIGURE 3
FIGURE 3

Active-disease histopathologic section of tissue from a patient with a infection. The lesion shows granulomatous infiltrate with epithelioid and giant cells. (Courtesy of Bernard Cribier, Strasbourg, France.)

Source: microbiolspec April 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0038-2016
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FIGURE 4

Microbiological diagnosis of human infection due to .

Source: microbiolspec April 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0038-2016
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Tables

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TABLE 1

Published studies of infections that include more than 10 patients

Source: microbiolspec April 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0038-2016
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TABLE 2

MICs of 17 antibiotics against 54 strains of determined by the agar dilution method

Source: microbiolspec April 2017 vol. 5 no. 2 doi:10.1128/microbiolspec.TNMI7-0038-2016

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