Methods: A retrospective chart review of patients with NTM infections presenting to the University of Cincinnati Medical Center, Cincinnati VA Medical Center and West Chester Hospital, during 2000-2015 was conducted. Cases were identified utilizing the NTM database of the Hamilton County Public Health Department. All included cases met diagnostic criteria based on culture positivity and presence of clinical signs and symptoms of infection. Demographic information, clinical characteristics, and treatment outcomes were captured. Outcomes measures included cure of infection at the end of treatment and eventual outcome at 5 years. Study was approved by the University of Cincinnati IRB.
Results: During 2000-2015, 58 patient with non-pulmonary NTM infections were identified (n=58). 43 NTM infections involved skin and soft tissue (74.1%), 9 were osteo-articular (15.5%), 2 had multiple site involvement (3.4%) and 4 were categorized as others (7.0%). Median age at presentation was 52.90 years, (Range 24.83-84.93). Gender ratio was Male (30, 51.7%), Female, (28, 48.3%). 5 patients had HIV and 4 were transplant recipients. Rapid growing mycobacteria were the most commonly identified NTM species; with M. fortuitum causing 28 infections (48%), followed by M. chelonae 11 (20%) and M. abscessus 4 (7%). The majority of the patients received a combination of medical and surgical treatment (63%). The median duration of anti-mycobacterial therapy was 166.5 days. Outcome, at the end of treatment was known for 55 patients, among whom 43, 78.2% achieved cure.
Conclusion: Non tuberculous mycobacteria are a significant cause of skin, soft tissue and osteo-articular infections. High index of clinical suspicion is needed in diagnosing such infections which tend to have a more indolent course and often fail to respond to the usual antimicrobial agents.
L. Haglund, None