title: Surgical site infections due to rapidly growing mycobacteria in puducherry, India.
abstract: BACKGROUND
  Rapidly growing Mycobacteria are increasingly recognized, nowadays as an important pathogen that can cause wide range of clinical syndromes in humans. We herein describe unrelated cases of surgical site infection caused by Rapidly growing Mycobacteria (RGM), seen during a period of 12 months.
  
  
  METHODS
  Nineteen patients underwent operations by different surgical teams located in diverse sections of Tamil Nadu, Pondicherry, Karnataka, India. All patients presented with painful, draining subcutaneous nodules at the infection sites. Purulent material specimens were sent to the microbiology laboratory. Gram stain and Ziehl-Neelsen staining methods were used for direct examination. Culture media included blood agar, chocolate agar, MacConkey agar, Sabourauds agar and Lowenstein-Jensen medium for Mycobacteria. Isolated microorganisms were identified and further tested for antimicrobial susceptibility by standard microbiologic procedures.
  
  
  RESULTS
  Mycobacterium fortuitum and M.chelonae were isolated from the purulent drainage obtained from wounds by routine microbiological techniques from all the specimens. All isolates analyzed for antimicrobial susceptibility pattern were sensitive to clarithromycin, linezolid and amikacin but were variable to ciprofloxacin, rifampicin and tobramycin.
  
  
  CONCLUSIONS
  Our case series highlights that a high level of clinical suspicion should be maintained for patients presenting with protracted soft tissue lesions with a history of trauma or surgery as these infections not only cause physical but also emotional distress that affects both the patients and the surgeon.
authors.affiliation: Assistant Professor, Department of Microbiology, Aarupadai Veedu Medical College , Puducherry, India .
authors.forename: Kavitha
authors.initials: K
authors.lastname: Kannaiyan
authors.affiliation: Professor, Department of Microbiology, Aarupadai Veedu Medical College , Puducherry, India .
authors.forename: Latha
authors.initials: L
authors.lastname: Ragunathan
authors.affiliation: Assistant Professor, Department of Anatomy, Aarupadai Veedu Medical College , Puducherry, India .
authors.forename: Sulochana
authors.initials: S
authors.lastname: Sakthivel
authors.affiliation: Managing Director, Department of General Surgery, ARR Hospital , Cuddalore, India .
authors.forename: A R
authors.initials: AR
authors.lastname: Sasidar
authors.affiliation: Managing Director, Department of General Surgery, S.M Hospital Cuddalore Tamil Nadu, India .
authors.lastname: Muralidaran
authors.affiliation: Associate Professor, Department of General Surgery, Aarupadai Veedu Medical College , Puducherry, India .
authors.forename: G K
authors.initials: GK
authors.lastname: Venkatachalam
keywords: Atypical mycobacteria; Early diagnosis; Soft tissue infections