Biggs H M, Chudgar S M, Pfeiffer C D, Rice K R, Zaas A K, Wolfe C R
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
Transpl Infect Dis. 2012 Aug;14(4):415-21. doi: 10.1111/j.1399-3062.2012.00730.x. Epub 2012 May 1.
Mycobacterium immunogenum is a relatively new species within the Mycobacterium chelonae-Mycobacterium abscessus group of rapidly growing mycobacteria (RGM). M. immunogenum was first characterized in 2001 and, similar to other RGM, is an ubiquitous environmental organism. This organism has most commonly been implicated in cutaneous infection in both healthy and immunosuppressed patients. To our knowledge, this is the first reported case of septic shock in the setting of disseminated M. immunogenum infection. Definitive identification of this organism requires gene sequencing at specialized centers, which may limit its detection. M. immunogenum is resistant to many anti-mycobacterial agents, and treatment can be especially challenging in transplant patients, given potential drug interactions and added toxicities. It is important to distinguish M. immunogenum from other RGM and determine the susceptibility profile to devise a successful treatment plan, particularly in the transplant population in which it can potentially cause severe, disseminated disease.
免疫分枝杆菌是快速生长分枝杆菌（RGM）中龟分枝杆菌-脓肿分枝杆菌菌群内的一个相对较新的菌种。免疫分枝杆菌于2001年首次被鉴定，与其他快速生长分枝杆菌一样，是一种广泛存在于环境中的微生物。这种微生物最常与健康和免疫抑制患者的皮肤感染有关。据我们所知，这是首例关于播散性免疫分枝杆菌感染导致感染性休克的报道病例。对这种微生物的明确鉴定需要在专业中心进行基因测序，这可能会限制其检测。免疫分枝杆菌对许多抗分枝杆菌药物耐药，鉴于潜在的药物相互作用和额外的毒性，在移植患者中进行治疗可能尤其具有挑战性。区分免疫分枝杆菌与其他快速生长分枝杆菌并确定其药敏谱以制定成功的治疗方案非常重要，特别是在可能导致严重播散性疾病的移植人群中。
