de Araújo Max Roberto Batista, da Silveira E Santos Débora Marques, da Silva Sousa Jailan, do Prado Gerson Fernandes, de Carvalho Castro Diogo Luiz, Soares Dias Júnior Moacir, Perini Hugo Felix, Minafra Cíntia, de Castro Soares Siomar, Rodrigues Evandro Bento, Lana Luan Freitas, Gonçalves Letícia Aparecida Caldeira, Andrade Bruno Silva, Gomes Talita, Azevedo Vasco
Operational Technical Nucleus, Microbiology, Hermes Pardini Institute (Fleury Group), Vespasiano, Minas Gerais, Brazil.
Department of Genetics, Ecology and Evolution, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Curr Microbiol. 2025 Jun 14;82(8):335. doi: 10.1007/s00284-025-04313-y.
Mycobacterium fortuitum, a nontuberculous mycobacterium (NTM), is known for causing opportunistic infections, particularly in immunocompromised individuals. Identification of NTM species requires precise diagnostic techniques. Here, we present a study of a systemic infection by M. fortuitum in an elderly patient, identified through MALDI-TOF MS and confirmed by gene sequencing. An 88-year-old Italian man developed an abscess at his pacemaker site, leading to acute infectious endocarditis caused by Staphylococcus capitis. During hospitalization, he experienced multiple complications, including jugular vein thrombosis, pulmonary thromboembolism, and gastrointestinal bleeding. Despite treatment with vancomycin, he developed bacteremia, allowing the isolation of M. fortuitum from blood culture. The strain was identified using MALDI-TOF MS and confirmed by Sanger sequencing of the 16S rRNA and hsp65 genes. Phylogenetic analysis supported the identification. The patient, after treatment with carbapenems and aminoglycosides, returned to Italy without further clinical complications. This case underscores the necessity of precise diagnostic tools for managing NTM infections. The combined application of MALDI-TOF MS and gene sequencing enabled accurate species identification, which is essential for guiding effective treatment of systemic M. fortuitum infections, especially in complex clinical scenarios involving immunosuppression.
偶然分枝杆菌是一种非结核分枝杆菌（NTM），以引起机会性感染而闻名，尤其是在免疫功能低下的个体中。鉴定NTM菌种需要精确的诊断技术。在此，我们报告一例老年患者由偶然分枝杆菌引起的全身感染病例，该病例通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）鉴定，并经基因测序证实。一名88岁的意大利男子在其起搏器部位出现脓肿，导致由头状葡萄球菌引起的急性感染性心内膜炎。住院期间，他出现了多种并发症，包括颈静脉血栓形成、肺血栓栓塞和胃肠道出血。尽管使用万古霉素进行了治疗，但他仍发生了菌血症，血培养分离出了偶然分枝杆菌。该菌株通过MALDI-TOF MS鉴定，并经16S rRNA和hsp65基因的桑格测序证实。系统发育分析支持了该鉴定结果。该患者在接受碳青霉烯类和氨基糖苷类药物治疗后返回意大利，未出现进一步的临床并发症。该病例强调了精确诊断工具对于管理NTM感染的必要性。MALDI-TOF MS和基因测序的联合应用能够实现准确的菌种鉴定，这对于指导偶然分枝杆菌全身感染的有效治疗至关重要，尤其是在涉及免疫抑制的复杂临床情况下。
