Gao Xusheng, Ding Caihong, Xie Dan, Wang Qing, Jiang Peipei, Wang Yuyu, Xiong Yu
Department of Tuberculosis, Shandong Public Health Clinical Center, Shandong University, Jinan, Shandong, People's Republic of China.
Infect Drug Resist. 2024 Mar 27;17:1243-1249. doi: 10.2147/IDR.S453541. eCollection 2024.
In recent decades, there has been a substantial surge in the incidence of non-tuberculous Mycobacteria (NTM) infections. However, the diagnosis and management of NTM globally present significant challenges, particularly in cases involving (MABC) infection where effective therapeutic options are limited.
We reported a 38-year-old female patient who was infected with MABC of skin due to "beauty needle" at a beauty salon, with mass on both cheeks, accompanied by redness, and pain, and some of them was ulcered and effused. Puncture pumping pus from bilateral cheek mass for many times, rinsed with "metronidazole", and oral "cephalosporin" treatment did not work. Therefore, she came to our hospital. MABC was detected in abscess paracentesis pus by nucleic acid mass spectrometry, and was proved by the cultured result of the pus. Thus, the patient was diagnosed as skin MABC infection, and anti-NTM treatment was taken. However, adverse reactions such as tinnitus, hepatotoxicity and neurovirulence occurred during the initial treatment. After adjusting to the contezolid-containing regimen, these adverse reactions improved. After nearly 6 months of treatment, the cheek mass was gradually reduced and the skin ruptures were gradually healed. Follow-up for 10 months showed that the patient's facial symptoms were significantly improved, and no drug-related adverse reactions happened.
This was the first successful case of multiple drug resistance MABC infection of skin treated with contezolid-containing antibiotic management strategies, which exhibited remarkable efficacy and good safety in this intractable disease.
近几十年来，非结核分枝杆菌（NTM）感染的发病率大幅上升。然而，全球范围内NTM的诊断和管理面临重大挑战，特别是在涉及马尔尼菲篮状菌（MABC）感染的病例中，有效的治疗选择有限。
我们报告了一名38岁女性患者，她在一家美容院因“美容针”感染了皮肤MABC，双侧脸颊有肿块，伴有红肿和疼痛，部分出现溃疡和渗出。多次从双侧脸颊肿块穿刺抽脓，用“甲硝唑”冲洗，并口服“头孢菌素”治疗均无效。因此，她来到我院。通过核酸质谱法在脓肿穿刺脓液中检测到MABC，并经脓液培养结果证实。于是，该患者被诊断为皮肤MABC感染，并接受了抗NTM治疗。然而，初始治疗期间出现了耳鸣、肝毒性和神经毒性等不良反应。调整为含康替唑胺的治疗方案后，这些不良反应有所改善。经过近6个月的治疗，脸颊肿块逐渐缩小，皮肤破溃逐渐愈合。随访10个月显示，患者面部症状明显改善，未发生与药物相关的不良反应。
这是首例采用含康替唑胺抗生素管理策略成功治疗皮肤多重耐药MABC感染的病例，该策略在这种难治性疾病中显示出显著疗效和良好安全性。
