Abstract

Background: Rapidly growing mycobacteria (RGM) have become very important organisms responsible for surgical site infections (SSIs). Aim: We retrospectively studied the occurrence of SSIs due to RGM seen in the western part of India, over a period of 3 years. Methods: This retrospective study was done at six centers from January 2014 to December 2016, which included 73 patients aged 22–78 years, who had undergone open surgeries (coronary artery bypass grafting [CABG], caesarean section, hernioplasty, open cholecystectomy, breast surgery) and scope related surgeries (diagnostic laparoscopy, percutaneous nephrolithotomy, lap cholecystectomy), and had non-healing ulcers of >30 days. Gram stain and modified Ziehl–Neelsen staining methods were used for microbial examination. Culture media included sheep blood agar, chocolate agar, MacConkey agar and Sabourad dextrose agar. Isolates were identified using biochemical tests or molecular methods and the antimicrobial susceptibility pattern was studied by standard microbiologic procedures. Findings: Mycobacterium fortuitum (42.5%), Mycobacterium chelonae (30.1%) and Mycobacterium abscessus (27.4%) were isolated by routine microbiological techniques. Amikacin, moxifloxacin and clarithromycin were given to all the patients. Overall, cure rate was achieved in 70 (95.9%) out of 73 patients; 3 were not cured - one with CABG having M. fortuitum, one with hernioplasty having M. chelonae and one lost to follow-up. Conclusion: This study confirms the association of RGM with nonhealing SSIs. Treatment with combination of antibiotics such as clarithromycin, amikacin and moxifloxacin may be an ideal choice, and require at least six months of treatment for complete cure.

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