The Clinical Management and Outcome of Nail Salon - Acquired Mycobacterium fortuitum Skin Infection

Epidemic Intelligence Service, Centers for Disease Control and Prevention at the California Department of Health Services, Berkeley, California 94704, USA.
Clinical Infectious Diseases (Impact Factor: 8.89). 02/2004; 38(1):38-44. DOI: 10.1086/380459
Source: PubMed


Nontuberculous mycobacterial infections are becoming more common. Recently, Mycobacterium fortuitum and other rapidly growing mycobacteria have been found to cause severe skin and soft-tissue infections in association with
nail salon whirlpool footbaths. We recently investigated a large outbreak of M. fortuitum furunculosis among women who received pedicures at a single nail salon. To better define the clinical course of such infections,
we collected clinical details from physicians who were treating outbreak patients. We constructed multivariable linear models
to evaluate the effect of antibiotic treatment on disease duration. Sixty-one patients were included in the investigation.
The mean disease duration was 170 days (range, 41–336 days). Forty-eight persons received antibiotic therapy for a median
period of 4 months (range, 1–6 months), and 13 persons were untreated. Isolates were most susceptible to ciprofloxacin and
minocycline. Early administration of therapy was associated with shorter duration of disease only in persons with multiple
boils (P < .01). One untreated, healthy patient had lymphatic disease dissemination.

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    • "Aquarien [28] [41] oder Muscheln [7] sowie Fußbäder bzw. Rasieren im Rahmen einer Pediküre [32] [37] [42] zu nennen. Aber auch medizinische Maßnahmen, wie z. "

    Full-text · Dataset · Dec 2012
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    • "Aquarien [28] [41] oder Muscheln [7] sowie Fußbäder bzw. Rasieren im Rahmen einer Pediküre [32] [37] [42] zu nennen. Aber auch medizinische Maßnahmen, wie z. "
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    ABSTRACT: Non-tuberculous mycobacteria are rarely responsible for skin and soft tissue infections. These infections are caused by different mycobacterial species originating from the environment (water, soil, plants, and animals). Various factors influence the clinical manifestation of the cutaneous infection: the immunological situation of the patient, the degree of cutaneous impairment, and the extent of the contact with the contaminated environment. The clinical manifestation is non-specific and often the cause of extensive diagnostic activities. The diagnosis is based on the cultural detection of the causative pathogen. The management of these skin and subcutaneous infections is a challenge for each physician. The treatment comprises administration of several antibiotics and antituberculosis drugs for many months. Surgical procedures are necessary in some patients.
    Full-text · Article · Jan 2011 · Wiener Medizinische Wochenschrift
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    • "In addition, an intermediate position is occupied by species opportunistic pathogens such as M. fortuitum, a rapidly growing mycobacteria that is ubiquitous in soil and water. This mycobacteria is known to cause cutaneous infection, typically in association with trauma or clinical procedures [1,2]. Due to its capacity to growth and to survive intracellularly, M. fortuitum has been previously used as a model for studying the intracellular killing of mycobacteria [3,4]. "
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    ABSTRACT: The ability of an intracellular pathogen to establish infection depends on the capacity of the organism to survive and replicate inside the host. Mycobacterium fortuitum is a bacteria that contains genes involved in the detoxification of the oxygen reactive species such as those produced by the host during the infection. In this work, we investigate the effects of hydrogen peroxide on the transcription and expression of these genes by developing a real time quantitative PCR technique (qRT-PCR) using the ribosomal promoter region (rrnA-P1) as reference product for quantification of the mRNA levels. M. fortuitum cultures were treated with different hydrogen peroxide concentrations (0.02 to 20 mM) during several periods of time (30 to 120 minutes). The activity of the enzymes KatGII and SodA, and the transcription of corresponding genes were evaluated. The transcriptional regulator furAII gene was also studied. The ribosomal promoter region rrnA-P1 was validated as referential product under the stress conditions checked by qRT-PCR. Minor changes were observed under the conditions tested except when bacteria were incubated in the presence of 20 mM hydrogen peroxide. Under those conditions, the levels of transcription of the three genes under study increased at 30 minutes of treatment. The viability of the bacteria was not influenced under the conditions tested. In this work, we have quantified transcriptional responses to stress suggesting that, the opportunistic pathogen M. fortuitum is more resistant and differs in behaviour in the presence of hydrogen peroxide, when compared to the major pathogen Mycobacterium tuberculosis and the saprophyte Mycobacterium smegmatis. Besides, we demonstrate the mycobacterial non-coding region rrnA-P1 to be a suitable reference product in the analysis of qRT-PCR transcriptional data of M. fortuitum.
    Full-text · Article · Feb 2008 · BMC Microbiology
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