title: Skin and soft tissue infections due to rapidly growing mycobacteria: comparison of clinical features, treatment, and susceptibility.
abstract: OBJECTIVE
  To compare the demographics, clinical features, susceptibility patterns, and treatment for skin and soft tissue infections due to Mycobacterium fortuitum and Mycobacterium chelonae or Mycobacterium abscessus.
  
  
  METHODS
  Retrospective medical record review.
  
  
  METHODS
  Mayo Clinic, Rochester, Minn.
  
  
  METHODS
  All patients seen at our institution with a positive culture for M chelonae, M abscessus, or M fortuitum from skin or soft tissue sources between January 1, 1987, and October 31, 2004.
  
  
  METHODS
  Patient demographics, clinical characteristics, therapeutic data, microbiological data, and outcomes.
  
  
  RESULTS
  The medical records of 63 patients with skin or soft tissue infections due to rapidly growing mycobacteria were reviewed. Patients with M chelonae or M abscessus were older (61.5 vs 45.9 years, P<.001) and more likely to be taking immunosuppressive medications (60% vs 17%, P = .002) than patients with M fortuitum. Mycobacterium fortuitum tended to manifest as a single lesion (89% vs 38%, P<.001), while most M chelonae or M abscessus manifested as multiple lesions (62% vs 11%, P<.001). More patients with M fortuitum had a prior invasive surgical procedure at the infected site (56% vs 27%, P = .04). Patients with multiple lesions were more likely to be taking immunosuppressive medications than those with single lesions (67% vs 30%, P = .006). Seven patients failed treatment, several of whom were immunocompromised and had multiple comorbidities.
  
  
  CONCLUSIONS
  Skin and soft tissue infections due to rapidly growing mycobacteria are associated with systemic comorbidities, including the use of immunosuppressive medications. There are significant differences in the demographic and clinical features of patients who acquire specific organisms, including association with immunosuppression and surgical procedures.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. uslan.daniel@mayo.edu
authors.forename: Daniel Z
authors.initials: DZ
authors.lastname: Uslan
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Kowalski
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Wengenack
authors.forename: Abinash
authors.initials: A
authors.lastname: Virk
authors.forename: John W
authors.initials: JW
authors.lastname: Wilson
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008499:Medical Records; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009161:Mycobacterium / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D009164:Mycobacterium Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology*; D015995:Prevalence; D012189:Retrospective Studies; D017192:Skin Diseases, Bacterial / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents