Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Nat Commun. 2022 May 3;13(1):2313. doi: 10.1038/s41467-022-29689-4.
Mycobacterium chelonae is a rare cause of chronic disseminated cutaneous infections in immunocompromised patients. Multidrug-resistant M. chelonae infections present a challenge for treatment, and prolonged antimicrobial courses lead to significant toxicities and further antimicrobial resistance. We report a case of refractory cutaneous disseminated M. chelonae infection in a patient with seronegative arthritis on immunotherapy with tofacitinib that was treated with combination antimicrobial, surgical, and single bacteriophage therapy with excellent clinical response. The patient developed neutralizing antibodies against the bacteriophage but continues to have stable improvement of disease with negative biopsies and no evidence of bacterial resistance to the phage.
龟分枝杆菌是免疫功能低下患者慢性播散性皮肤感染的罕见病因。耐多药龟分枝杆菌感染给治疗带来了挑战，延长抗菌疗程会导致严重的毒性和进一步的抗菌耐药性。我们报告了一例接受托法替尼免疫治疗的血清阴性关节炎患者发生难治性播散性皮肤龟分枝杆菌感染的病例，该患者采用联合抗菌药物、手术和单噬菌体治疗，取得了极好的临床疗效。该患者产生了针对噬菌体的中和抗体，但仍持续改善疾病，活检阴性，无噬菌体耐药证据。
