Fish tank granuloma caused by Mycobacterium marinum.
BACKGROUND
Mycobacterium marinum causes skin and soft tissue, bone and joint, and rare disseminated infections. In this study, we aimed to investigate the relationship between treatment outcome and antimicrobial susceptibility patterns. A total of 27 patients with M. marinum infections were enrolled.


METHODS
Data on clinical characteristics and therapeutic methods were collected and analyzed. We also determined the minimum inhibitory concentrations of 7 antibiotics against 30 isolates from these patients.


RESULTS
Twenty-seven patients received antimycobacterial agents with or without surgical debridement. Eighteen patients were cured, 8 failed to respond to treatment, and one was lost to follow-up. The duration of clarithromycin (147 vs. 28; p = 0.0297), and rifampicin (201 vs. 91; p = 0.0266) treatment in the cured patients was longer than that in the others. Surgical debridement was performed in 10 out of the 18 cured patients, and in 1 of another group (p = 0.0417). All the 30 isolates were susceptible to clarithromycin, amikacin, and linezolid; 29 (96.7%) were susceptible to ethambutol; 28 (93.3%) were susceptible to sulfamethoxazole; and 26 (86.7%) were susceptible to rifampicin. However, only 1 (3.3%) isolate was susceptible to doxycycline.


CONCLUSIONS
Early diagnosis of the infection and appropriate antimicrobial therapy with surgical debridement are the mainstays of successful treatment. Clarithromycin and rifampin are supposed to be more effective agents.
Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Ting-Shu
TS
Wu
Cheng-Hsun
CH
Chiu
Chih-Hsun
CH
Yang
Hsieh-Shong
HS
Leu
Ching-Tai
CT
Huang
Yi-Chieh
YC
Chen
Tsu-Lan
TL
Wu
Pi-Yueh
PY
Chang
Lin-Hui
LH
Su
An-Jing
AJ
Kuo
Ju-Hsin
JH
Chia
Chia-Chen
CC
Lu
Hsin-Chih
HC
Lai
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000188:drug therapy*; D019910:Mycobacterium marinum / Q000187:drug effects*; D012874:Skin Diseases, Infectious / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents