Epidemiology and Infection

Original Papers

Tuberculosis

Skin and soft-tissue infection caused by non-tuberculous mycobacteria in Taiwan, 1997–2008

H.-Y. CHENa1, C.-Y. CHENa1, C.-T. HUANGa1, S.-Y. RUANa1, C. H. CHOUa1, C. C. LAIa2, C. H. LIAOa3, C. K. TANa4, Y. T. HUANGa5, C.-J. YUa6 and P. R. HSUEHa5a6 c1

a1 Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan

a2 Department of Internal Medicine, Cardinal Tien Hospital, Taipei

a3 Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei County, Taiwan

a4 Department of Intensive Care Medicine, Chi-Mei Medical Centre

a5 Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

a6 Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

SUMMARY

The aim of this study was to investigate the clinical, microbiological, and pathological characteristics and the outcomes of skin and soft-tissue infection (SSTI) caused by non-tuberculous mycobacteria (NTM). Medical records of 50 patients with SSTI caused by NTM identified from 2005 to 2008 and 63 patients previously reported in a medical centre from 1997 to 2004 were reviewed. The annual incidence (per 100 000 outpatients and in-patients) ranged from 0·57 in 2005, 0·38 in 2007, to 1·1 in 2008, with an average of 0·62/100 000. From 1997 to 2008, the average incidence was 1·39/100 000 patients. The average annual incidence of SSTI caused by NTM was 0·62/100 000 outpatients and in-patients during 2005 and 2008. Of the total of 113 patients identified during the 12-year period, patients infected with Mycobacterium fortuitum and M. marinum were younger than those infected with M. avium-intracellulare complex (MAC) (36 and 44 years vs. 55 years, P=0·004 and P=0·056, respectively), and were more likely to have previous invasive procedures than those infected with MAC and M. abscessus (81·8% and 72·0% vs. 27·8% and 54·8%, P=0·007), and less likely to have associated immunosuppression (9·1% and 24% vs. 66·7% and 45·2%, P=0·006). Granuloma was more often observed in immunocompetent patients (60·1% vs. 40%, P=0·019), and in M. marinum-infected specimens (78·3%). There were significant differences in the demographic and clinical features of patients with NTM SSTI, including immunosuppression, trauma experience, and depth of tissue infections.

(Accepted June 07 2010)

(Online publication July 02 2010)

Correspondence:

c1 Author for correspondence: Dr P. R. Hsueh, Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan. (Email: hsporen@ntu.edu.tw)

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