AN OUTBREAK OF NON TUBERCULOUS MYCOBACTERIA IN POST SURGICAL WOUND INFECTION IN A TERTIARY CARE CENTRE IN WESTERN UTTAR PRADESH

Dr Ruchi Kotpal; Dr. Neetika Agarwal; Dr. Savita Yadav

Volume : X, Issue : I, January - 2020

AN OUTBREAK OF NON TUBERCULOUS MYCOBACTERIA IN POST SURGICAL WOUND INFECTION IN A TERTIARY CARE CENTRE IN WESTERN UTTAR PRADESH

Dr Ruchi Kotpal, Dr. Neetika Agarwal, Dr. Savita Yadav

Abstract :

Purpose – Non tuberculous mycobacteria (NTM) are environmental organisms that can cause skin and soft tissue infections at incision site in patients undergoing surgical procedures. Most of the NTM causing these infections are not treated by first line standard antitubercular drugs. Methods – it is a case series of 30 patients who presented to our hospital with nodular swelling followed by discharging sinus at the site of incision almost one month after they underwent surgery all over the period of 6 month from May to October 2018,. Pus was collected and examined for isolation and identification of the causative agents. Deided sinus tract was also sent for histopathological examination. Result – Of the 30 patients examined, all presented with discharging sinus, with no systemic symptoms, none of them responded to pyogenic antibiotics. None of the pus sample was positive for gram staining and all were sterile for pyogenic culture, 60% positivity for ZN staining, 80% grew Mycobacteria on LJ media and 100% showed granulomatous inflammation on histopathology. All responded to oral clarithromycin for 4–6 weeks Conclusion – Present study indicate that non–tuberculous mycobacterial infections should be considered in wounds that show delayed healing, do not respond to antibiotics used for pyogenic infections and have sterile aerobic cultures. Empirical therapy should be initiated immediately. Also smear positivity and culture positivity are not the sole criteria for considering mycobacterial infections.