1178. Rapidly Growing Mycobacteria (RGM) Bacteremia in Immunocompromised patients, Clinical Experience of 74 patients at MD Anderson Cancer Center
Session: Poster Abstract Session: Mycobacteria Other Than Tuberculosis
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • 1178_LauraClaburn_sm.pdf (2.0 MB)
  • Background: Rapidly growing mycobacteria (RGM) are capable of causing a wide spectrum of infections including bacteremia. RGM bloodstream infection has been described in patients with cancer. However, risk factors and management of patients with RGM remains unclear. 

    Methods:  We searched the microbiology laboratory database at MDACC to identify all cancer patients with RGM from January 2003 through December 2010. Patients were considered eligible if they have positive blood culture for RGM. We reviewed their medical records for demographic, microbiological, RGM species, clinical characteristics, antimicrobial therapy, drug susceptibilities, and outcomes.

    Results:  We identified 74 patients with RGM bacteremia during the study period. Forty patients (54%) had hematologic malignancy, 34 (46%) had solid tumor, and 20 (27%) had underwent stem cell transplantation. Mycobacterium mucogenicum was the leading cause of RGM 30 patients (41%), followed by M. abscessus16 (22%), M. fortuitum 13 (18%), M. neoaurum 5 (7%), M. chelonae 3(4%), and M. smegmatis 1(1%).The majority of patients 57(77%) had central line associated bacteremia of whom 74% had their catheter removed and 10% exchanged. The susceptibility rates of the isolates were as follow: amikacin (96%), clarithromycin (84%), linezolid (81%), trimethoprim/sulfamethoxazole (71%), ciprofloxacin (70%), and imipenem (59%). Clinical response within 72 hours of initiation of therapy was seen in 96% of the patients with100% microbiological eradication by the end of therapy. Relapse occurred only in 3% of the patients. Median duration of therapy was 4 weeks with inter quintile range 18-40 days.

    Conclusion: M. mucogenicum and M. abscessus were the leading causes of RGM which is mostly catheter related in cancer patients. A favorable outcome was achieved with line removal and four weeks of antimycobacterial therapy. 


    Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

    Gilbert El Helou, MD1, Ray Hachem, MD1, Anne-Marie Chaftari, MD1, Ying Jiang, MS1, Jeffrey Tarrand, MD2 and Issam Raad, MD1, (1)Infectious Diseases, Infection Control & Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, (2)Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, TX

    Disclosures:

    G. El Helou, None

    R. Hachem, None

    A. M. Chaftari, None

    Y. Jiang, None

    J. Tarrand, None

    I. Raad, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.