Bernardelli Andrea, Schena Alberto, Savoldi Alessia, Colato Chiara, Baretta Valentina, D'Alessandro Emiliano, Zamboni Giulia, Shoushtari Zadeh Naseri Mehrdad, Favaro Flavio, Peracchi Marta, Schena Donatella, Andreini Angelo, Cesaro Simone, Tecchio Cristina
Section of Hematology and Bone Marrow Transplant Unit, Department of Medicine, Verona University, 37134 Verona, Italy.
Infectious Diseases Unit, Department of Diagnostics and Public Health, Verona University, 37134 Verona, Italy.
J Clin Med. 2022 Apr 25;11(9):2410. doi: 10.3390/jcm11092410.
Mycobacterium abscessus complex, hereinafter Mab, is a taxonomic group of rapidly growing, nontuberculous mycobacteria (NTM). Despite major advances in understanding virulence, pathogenicity and mechanism of antibiotic resistance, Mab remains a significant cause of pulmonary and extra-pulmonary disease. Herein, we describe a disseminated, macrolide-resistant, Mab subspecies abscessus infection occurring in a severely immune-compromised 34-year-old allotransplanted female patient affected by pulmonary chronic graft versus host disease (cGVHD). The infection was characterized by hematogenous spread, and besides lungs, it involved skin, and soft tissues, resulting in a highly debilitating, painful, and finally fatal disease. Our case describes the severe impact of Mab infections in the setting of allogeneic hematopoietic stem cells transplant (alloHSCT) and related complications. It also highlights the unmet need of preventive and surveillance measures together with the urgency of developing effective vaccines and drugs against emerging NTM. The scarce literature regarding Mab infections in alloHSCT patients is also reviewed.
脓肿分枝杆菌复合群（以下简称Mab）是一类快速生长的非结核分枝杆菌（NTM）的分类学组。尽管在理解其毒力、致病性和抗生素耐药机制方面取得了重大进展，但Mab仍然是肺部和肺外疾病的重要病因。在此，我们描述了一例发生在一名34岁严重免疫受损的同种异体移植女性患者中的播散性、大环内酯耐药的Mab亚种脓肿感染，该患者患有肺部慢性移植物抗宿主病（cGVHD）。该感染的特征是血行播散，除肺部外，还累及皮肤和软组织，导致一种极度虚弱、疼痛并最终致命的疾病。我们的病例描述了Mab感染在异基因造血干细胞移植（alloHSCT）背景下的严重影响及相关并发症。它还强调了预防和监测措施的未满足需求，以及开发针对新兴NTM的有效疫苗和药物的紧迫性。同时也对关于alloHSCT患者中Mab感染的稀少文献进行了综述。
