Dermatologica Sinica

CORRESPONDENCE
Year
: 2019  |  Volume : 37  |  Issue : 1  |  Page : 56--57

Comment on report of two cases of cutaneous Mycobacterium abscessus infection complicating professional decorative tattoo


Masoud Keikha 
 Antimicrobial Resistance Research Center; Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Correspondence Address:
Masoud Keikha
Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad
Iran




How to cite this article:
Keikha M. Comment on report of two cases of cutaneous Mycobacterium abscessus infection complicating professional decorative tattoo.Dermatol Sin 2019;37:56-57


How to cite this URL:
Keikha M. Comment on report of two cases of cutaneous Mycobacterium abscessus infection complicating professional decorative tattoo. Dermatol Sin [serial online] 2019 [cited 2023 Feb 4 ];37:56-57
Available from: https://www.dermsinica.org/text.asp?2019/37/1/56/255035


Full Text



Dear Editor,

Wu et al. recently published their report on Report of two cases of cutaneous Mycobacterium abscessus infection complicating professional decorative tattoo.[1] Nontuberculosis mycobacteria (NTM) (or atypical mycobacteria) are Gram-positive, acid–fast bacteria which are present in the environmental resources including soil, dust, rivers, lakes, and swamps. Rapidly growing mycobacteria such as Mycobacterium fortuitum, Mycobacterium chelonae, and Mycobacterium abscessus are responsible for a wide spectrum of soft-tissue infections and disseminated infection in immunocompromised patients and healthy individuals.[2],[3]

Misdiagnosis of mycobacterial infections can be a life-threatening error, especially M. abscessus which is one of the most resistant organisms to chemotherapeutic agents. This bacterium is intrinsically resistant to classical antimycobacterial drugs and most of the antibiotics that are currently available.[3],[4] Detection and identification of NTM is necessary; NTM should be identified at the species level to determine their clinical significance, appropriate treatment, and epidemiological investigations. NTM species are usually identified using phenotypic and molecular methods; phenotypic tests include colony morphology; growth rate; pigment production; growth at 25°C, 37°C, and 42°C; growth on MacConkey agar; urease and niacin production; iron uptake; tellurite and nitrate reduction; tolerance to 5% NaCl; arylsulfatase; heat labile; and heat stable catalase which are cumbersome, labor, time-consuming, often difficult to standardize, and in some cases are confusing, while molecular tests such as direct sequencing and polymerase chain reaction-restriction fragment length polymorphism analysis using housekeeping genes (16S rRNA, hsp65, rpoB, and 16-23S rRNA internal transcribed spacer) are rapid, accurate, and reliable options for identification and differentiation of mycobacteria.[5],[6]

I request the authors attend to the following questions.

According to the reports, other geneses in the Actinomycetes family such as Mycobacterium tuberculosis, Nocardia, Rhodococcus, and Gordonia similar to NTM are same phenotypic features; please describe the mycobacterial isolation method, which was not stated in the reportPlease explain how Mycobacterium abscessus was identified to the species level.

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Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Wu CH, Thong HY, Huang CC, Chen PH. Report of two cases of cutaneous Mycobacterium abscessus infection complicating professional decorative tattoo. Dermatol Sinica 2017;35:40-3.
2Honarvar B, Movahedan H, Mahmoodi M, Sheikholeslami FM, Farnia P. Mycobacterium aurum keratitis: An unusual etiology of a sight-threatening infection. Braz J Infect Dis 2012;16:204-8.
3Nessar R, Cambau E, Reyrat JM, Murray A, Gicquel B. Mycobacterium abscessus: A new antibiotic nightmare. J Antimicrob Chemother 2012;67:810-8.
4Sanguinetti M, Ardito F, Fiscarelli E, La Sorda M, D'Argenio P, Ricciotti G, et al. Fatal pulmonary infection due to multidrug-resistant Mycobacterium abscessus in a patient with cystic fibrosis. J Clin Microbiol 2001;39:816-9.
5Hashemi-Shahraki A, Bostanabad SZ, Heidarieh P, Titov LP, Khosravi AD, Sheikhi N, et al. Species spectrum of nontuberculous mycobacteria isolated from suspected tuberculosis patients, identification by multi locus sequence analysis. Infect Genet Evol 2013;20:312-24.
6Adékambi T, Colson P, Drancourt M. RpoB-based identification of nonpigmented and late-pigmenting rapidly growing mycobacteria. J Clin Microbiol 2003;41:5699-708.