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Category: Clinical Microbiology; Bacterial Pathogenesis
Mycobacterium marinum, Page 1 of 2
< Previous page | Next page > /docserver/preview/fulltext/10.1128/9781555817138/9781555815134_Chap39-1.gif /docserver/preview/fulltext/10.1128/9781555817138/9781555815134_Chap39-2.gifAbstract:
Mycobacterium marinum is a pathogenic mycobacterium, which makes it, along with its related species M. ulcerans, distinct from the other nontuberculous mycobacterium (NTM) that are opportunistic pathogens. The Esx secretion system is critical for virulence of both Mycobacterium tuberculosis and M. marinum and is highly conserved between the two species. When multilocus sequence analysis applied to 22 M. marinum strains, it was found that significant molecular differences separated clinical isolates from the piscine isolates. Molecular biology techniques have been successfully applied to identification of mycobacteria. Scarce cases of M. marinum infection occurring in patients treated with tumor necrosis factor alpha inhibitor therapy have been reported since 2002. Therefore, it is not possible to draw any conclusions regarding the frequency or the severity of M. marinum infection in this population. Instead, preventive strategies are recommended especially for those patients. Distal aspects of the upper limbs, such as the finger/hand, are the most common sites of infection in relation to fish/water animal exposure. From the studies dealing with a large number of strains and applying a standard method of testing, M. marinum has a natural multidrug resistance pattern. Broth microdilution susceptibility testing is recommended by CLSI and may use the commercially available Sensititre MIC plates. Patients infected with M. marinum are usually treated with antibiotics. A variety of antibiotics have been used, including tetracyclines, co-trimoxazole, rifampin plus ethambutol, and more rarely clarithromycin, levofloxacin, and amikacin. The chapter describes epidemiology and prevention of M. marinum.
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Typical photochromogenic colonies of Mycobacterium marinum grown on Löwenstein-Jensen solid medium.
Sporotrichoid form of skin lesions typical of M. marinum infection. (Courtesy of Hervé Darie, Noisy le Grand, France.)
Active disease histopathologic section of tissue from a patient with an M. marinum infection. The lesion shows granulomatous infiltrate with epithelioid and giant cells. (Courtesy of Bernard Cribier, Strasbourg, France.)
Microbiological diagnosis of human infection due to M. marinum.
Published studies of M. marinum infections that include more than 10 patients
MICs of 17 antibiotics against 54 strains of Mycobacterium marinum determined by the agar dilution method