Rapidly growing mycobacterial infections after pedicures
Rapidly growing mycobacterial infections after pedicures
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DOI：
10.1001/archderm.139.5.629
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发表时间：
2003-05-01
影响因子：
--
通讯作者：
Winthrop, K
中科院分区：
文献类型：
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作者：
Sniezek, PJ;Graham, BS;Winthrop, K
背景：快速生长分枝杆菌（RGM）可引起多种皮肤和全身性疾病。致病微生物通常是偶发分枝杆菌或龟分枝杆菌（也称为分枝杆菌）。原发性皮肤病变可能在数周至数月的潜伏期后发生，通常是由创伤后直接接种、注射或手术期间通过受污染的医疗器械造成的。最近，来自佐治亚州亚特兰大市疾病控制和预防中心以及伯克利市加州卫生服务部的调查人员记录了一次前所未有的社区获得性RGM感染大爆发，在此期间，加州北方一家美甲沙龙的100多名顾客因暴露于被偶发性支原体污染的漩涡足浴而腿部感染了疖。观察结果：我们报告了3例下肢RGM感染的临床和流行病学调查结果，这些病例发生在加州南部几家不同的美甲沙龙的类似漩涡足浴器暴露后。这些感染通常表现为复发性疖，造成相当大的发病率，作为瘢痕形成的结果，延误诊断，并需要长期的polymicrobial therapy.Conclusions：快速增长的分枝杆菌感染相关的足疗可能会继续发生在一个零星的方式。临床医生应考虑RGM感染的可能性，并询问对常规抗生素治疗无反应的复发性下肢疖和脓肿患者最近的修脚情况。
Background: Rapidly growing mycobacteria (RGM) can cause a variety of cutaneous and systemic diseases. The causative organisms are typically Mycobacterium fortuitum or Mycobacterium chelonae (also known as Mycobacterium abscessus). Primary cutaneous lesions may develop after a variable latent period, from weeks to several months, and usually result from direct inoculation after trauma, from injections, or during surgery via contaminated medical instruments. Recently, investigators from the Centers for Disease Control and Prevention, Atlanta, Ga, and the California Department of Health Services, Berkeley, documented a large, unprecedented outbreak of community-acquired RGM infection, during which more than 100 patrons of a northern California nail salon contracted furunculosis in their legs as a result of exposure to whirlpool footbaths that were contaminated with M fortuitum.Observations: We report the clinical and epidemiological findings in 3 cases of lower extremity RGM infections,that occurred after similar whirlpool footbath exposure at several different nail salons in southern California. These infections typically presented as recurrent furunculosis, causing considerable morbidity as a result of scarring, delayed diagnosis, and the need for long-term polymicrobial therapy.Conclusions: Rapidly growing mycobacterial infections related to pedicures may continue to occur in a sporadic fashion. Clinicians should consider the possibility of RGM infection and inquire about recent pedicures in a patient with recurrent lower extremity furunculosis and abscesses that are unresponsive to conventional antibiotic therapy.