• Humans
• Mycobacterium Infections, Nontuberculous/diagnosis
• Mycobacterium Infections, Nontuberculous/epidemiology
• Mycobacterium Infections, Nontuberculous/therapy
• Mycobacterium Infections, Nontuberculous/etiology
• Orthopedic Procedures/adverse effects
• Anti-Bacterial Agents/therapeutic use
• Practice Guidelines as Topic

• Antibiotic resistance
• Joint infections
• Mycobacterium
• Rapid growing mycobacterium

• Bone and joint infection
• Clinical characteristics
• Immune status
• Non-tuberculous mycobacteria
• Outcomes

• Humans
• Mycobacterium Infections, Nontuberculous/drug therapy
• Mycobacterium Infections, Nontuberculous/immunology
• Mycobacterium Infections, Nontuberculous/mortality
• Mycobacterium Infections, Nontuberculous/microbiology
• Retrospective Studies
• Male
• Female
• Aged
• Middle Aged
• Nontuberculous Mycobacteria/immunology
• Treatment Outcome
• Anti-Bacterial Agents/therapeutic use
• France/epidemiology
• Immunocompromised Host
• Aged, 80 and over
• Adult
• Arthritis, Infectious/microbiology
• Arthritis, Infectious/drug therapy
• Arthritis, Infectious/immunology
• Arthritis, Infectious/mortality

• Antibiotic resistance
• M. abscessus subsp. abscessus
• Nontuberculous mycobacteria
• Prosthetic joint infection

• Mycobacterium flavescent
• erythema and swelling.
• post-surgical interventions
• prosthetic joint infections
• sputum cultures
• traumas

• Humans
• Male
• Aged
• Prosthesis-Related Infections/microbiology
• Prosthesis-Related Infections/drug therapy
• Prosthesis-Related Infections/diagnosis
• Mycobacterium Infections, Nontuberculous/diagnosis
• Mycobacterium Infections, Nontuberculous/drug therapy
• Mycobacterium Infections, Nontuberculous/microbiology
• Anti-Bacterial Agents/therapeutic use
• Arthroplasty, Replacement, Knee/adverse effects
• Knee Prosthesis/adverse effects
• Knee Prosthesis/microbiology
• Reoperation
• Knee Joint/surgery
• Knee Joint/microbiology
• Nontuberculous Mycobacteria/isolation & purification

• Mycobacterium avium complex
• arthroplasty
• infection
• treatment

• Humans
• Mycobacterium avium Complex
• Arthroplasty, Replacement, Knee/adverse effects
• Arthroplasty, Replacement, Hip/adverse effects
• Mycobacterium avium-intracellulare Infection/diagnosis
• Mycobacterium avium-intracellulare Infection/epidemiology
• Mycobacterium avium-intracellulare Infection/therapy
• Prostheses and Implants/adverse effects
• Anti-Bacterial Agents/therapeutic use
• Arthritis, Infectious/diagnosis
• Arthritis, Infectious/epidemiology
• Arthritis, Infectious/therapy
• Recurrence
• Prosthesis-Related Infections/diagnosis
• Prosthesis-Related Infections/epidemiology
• Prosthesis-Related Infections/therapy
• Retrospective Studies

• Antibiotic Therapy
• Arthroplasty
• Nontuberculosis Mycobacterium
• Periprosthetic Joint Infection
• Surgical Treatment

• Male
• Female
• Humans
• Middle Aged
• Arthroplasty, Replacement, Knee/adverse effects
• Retrospective Studies
• Arthroplasty, Replacement, Hip/adverse effects
• Mycobacterium
• Arthritis, Infectious/diagnosis
• Arthritis, Infectious/drug therapy
• Arthritis, Infectious/etiology
• Prosthesis-Related Infections/diagnosis
• Prosthesis-Related Infections/etiology
• Prosthesis-Related Infections/therapy

• 2020YFC2004900 National Key R&D Program of China
• 82002323 National Natural Science Foundation of China
• 82102585 National Natural Science Foundation of China
• National Natural Science Foundation of China

• nontuberculous mycobacteria
• periprosthetic joint infection
• two stage exchange arthroplasty

Nontuberculous mycobacterial hardware infections are extremely challenging to treat. Multidisciplinary care involving removal of infected hardware, thorough debridement, and durable soft tissue coverage in conjunction with antibiotic therapy is essential for successful management. This case report presents a patient with chronic mycobacterial spinal hardware infection that underwent successful treatment with aggressive serial debridements and reconstruction with a large pedicled superior gluteal artery perforator flap coverage.

• Mycobacterium massiliense
• SGAP flaps
• debridement
• implant-associatedinfections

• Animals
• Anti-Bacterial Agents/therapeutic use
• Arthritis, Infectious/drug therapy
• Arthroplasty, Replacement, Hip/adverse effects
• Cattle
• Hip Joint
• Humans
• Male
• Mycobacteriaceae

• Healthcare-associated infections
• M. wolinskyi
• Non-tuberculosis mycobacteria
• Outbreak investigation
• Surgical site infection

• Mycobacterium abscessus
• Mycobacteroides abscessus
• T405
• dual β-lactam
• efficacy
• penem
• β-lactam

Mycobacterium species (Mycobacterium sp) is an emerging cause of hip and knee prosthetic joint infection (PJI), and different species of this organism may be responsible for the same.

To evaluate the profile of hip and knee Mycobacterium PJI cases as published in the past 30 years.

A literature search was performed in PubMed using the MeSH terms “Prosthesis joint infection” AND “Mycobacterium” for studies with publication dates from January 1, 1990, to May 30, 2021. To avoid missing any study, another search was performed with the terms “Arthroplasty infection” AND “Mycobacterium” in the same period as the previous search. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses chart was used to evaluate the included studies for further review. In total, 51 studies were included for further evaluation of the cases, type of pathogen, and treatment of PJI caused by Mycobacterium sp.

Seventeen identified Mycobacterium sp were reportedly responsible for hip/knee PJI in 115 hip/knee PJI cases, whereas in two cases there was no mention of any specific Mycobacterium sp. Mycobacterium tuberculosis (M. tuberculosis) was detected in 50/115 (43.3%) of the cases. Nontuberculous mycobacteria (NTM) included M. fortuitum (26/115, 22.6%), M. abscessus (10/115, 8.6%), M. chelonae (8/115, 6.9%), and M. bovis (8/115, 6.9%). Majority of the cases (82/114, 71.9%) had an onset of infection > 3 mo after the index surgery, while in 24.6% (28/114) the disease had an onset in ≤ 3 mo. Incidental intraoperative PJI diagnosis was made in 4 cases (3.5%). Overall, prosthesis removal was needed in 77.8% (84/108) of the cases to treat the infection. Overall infection rate was controlled in 88/102 (86.3%) patients with Mycobacterium PJI. Persistent infection occurred in 10/108 (9.8%) patients, while 4/108 (3.9%) patients died due to the infection.

At least 17 Mycobacterium sp can be responsible for hip/knee PJI. Although M. tuberculosis is the most common causal pathogen, NTM should be considered as an emerging cause of hip/knee PJI.

• Mycobacterium species
• Prosthetic joint infection
• Hip
• Knee
• Systematic review

• Infections
• Musculoskeletal
• Neglected diseases
• Rheumatic

• Arthritis, Rheumatoid
• Autoimmunity
• Humans
• Lupus Erythematosus, Systemic
• Rheumatic Diseases/complications
• Rheumatic Diseases/diagnosis
• Rheumatologists

Prosthetic joint infection (PJI) is a devastating complication that can affect hip arthroplasty. Its treatment is extremely difficult, and issues regarding the optimal treatment remain unanswered. This study intended to show the effectiveness of the one-stage treatment of PJI.

A retrospective observational cohort study performed from July 2014- August 2018. All patients with suspected PJI were included. Major and minor criteria developed by the International Consensus on Periprosthetic Joint Infection (ICPJI) was used to define infection. Laboratory tests and image exams were performed, and all patients were followed for at least 2 years.

Success rate (2018 ICPJI definition to success) in treatment of PJI using one-stage revision method. Clinical and functional outcomes defined by Harris Hip Score (HHS).

Thirty-one patients were screened and 18 analyzed. 69.85 ± 9.76 years was the mean age. Mean follow-up time was 63.84 ± 18.55 months. Ten patients had acetabular defects and required bone graft reconstruction. Sixteen patients were classified as Tier 1, 1 as Tier 3D, and as 1 Tier 3E. Almost 90% of patients submitted to one-stage revision with acetabulum graft reconstruction were free of infection. The overall infection survival rate was 78.31±6.34 months. Candida albicans and sinus tract were statistically significant in univariate Cox’s analysis. The predictor of one-stage revision surgery failure that remained final Cox’s regression model was C. albicans (hazard ratio [HR]: 4.47).

Treatment through one-stage revision surgery associated with 6 months of antimicrobial is a viable option with acceptable results even when bone graft reconstruction is necessary. C. albicans was a strong predictor of failure in this cohort.

• Line probe assay
• Molecular diagnostics
• Mycobacterium fortuitum
• Mycobacterium smegmatis
• Non-tuberculous mycobacterial infection

• hip prosthesis implantation
• infections

• Anti-Bacterial Agents/therapeutic use
• Arthritis, Infectious/drug therapy
• Arthroplasty, Replacement, Hip/adverse effects
• Debridement
• Hip Prosthesis
• Humans
• Male
• Middle Aged
• Mycobacterium fortuitum
• Prostheses and Implants
• Prosthesis-Related Infections/drug therapy
• Prosthesis-Related Infections/surgery

• Blood cultures
• Diabetic nephropathy
• Mycobacterium abscessus subspecies Massiliense
• Prosthetic joint infection
• Sterile pyuria

• Aged
• Anti-Bacterial Agents/therapeutic use
• Azithromycin/therapeutic use
• Humans
• Male
• Mycobacterium Infections, Nontuberculous/drug therapy
• Mycobacterium abscessus
• Renal Dialysis/adverse effects

• Mycobacterium abscessus
• Mycobacterium chelonae
• prosthetic joint infections
• rapidly growing mycobacterium

Prosthetic joint infections (PJI) complicate up to 2% of arthroplasties and are usually caused by typical bacterial agents (e.g., staphylococci and streptococci). Although an infrequent cause of PJI, mycobacterial species are difficult to eradicate, as they adhere to hardware, form biofilms, and have high rates of antimicrobial resistance. Mycobacterium mageritense is a rapidly growing Mycobacterium that has been infrequently described as a cause of surgical and device-related infections. We herein described a case of prosthetic knee infection due to M. mageritense. The patient was treated with removal of hardware, antimicrobials, and prosthetic knee reimplantation with a good outcome. To our knowledge, M. mageritense has not been previously described as a cause of PJI in the medical literature.

Mycobacterium Fortuitum (M. Fortuitum) is a type of opportunistic pathogen commonly found in water/soil and belongs to the nontuberculosis mycobacteria (NTM) family. Prosthetic joint infection due to M. Fortuitum is extremely rare. We present a case of a 21-year-old female with an infection following a radical resection of the proximal tibia due to a parosteal osteosarcoma.

• Infection
• Mycobacterium Fortuitum
• Parosteal Osteosarcoma

Early identification and aggressive treatment are crucial for patients with these infections.

Nontuberculous mycobacteria represent an uncommon but important cause of infection of the musculoskeletal system. Such infections require aggressive medical and surgical treatment, and cases are often complicated by delayed diagnosis. We retrospectively reviewed all 14 nonspinal cases of nontuberculous mycobacterial musculoskeletal infections treated over 6 years by orthopedic surgeons at a university-affiliated tertiary referral center. All patients required multiple antimicrobial agents along with aggressive surgical treatment; 13 of 14 patients ultimately achieved cure. Four patients required amputation to control the infection. Half these patients were immunosuppressed by medications or other medical illness when they sought care at the referral center. Six cases involved joint prostheses; all ultimately required hardware removal and placement of an antimicrobial spacer for eradication of infection. Our findings highlight the importance of vigilance for nontuberculous mycobacterial musculoskeletal infection, particularly in patients who are immunosuppressed or have a history of musculoskeletal surgery.

• Colorado
• Mycobacterium
• United States
• antimicrobial resistance
• infectious arthritis
• musculoskeletal diseases
• nontuberculous mycobacteria
• osteomyelitis
• prosthesis-related infections
• tuberculosis and other mycobacteria

• Adult
• Aged
• Aged, 80 and over
• Antitubercular Agents/pharmacology
• Antitubercular Agents/therapeutic use
• Colorado/epidemiology
• Female
• Humans
• Male
• Middle Aged
• Musculoskeletal Diseases/diagnosis
• Musculoskeletal Diseases/drug therapy
• Musculoskeletal Diseases/epidemiology
• Musculoskeletal Diseases/microbiology
• Mycobacterium Infections, Nontuberculous/diagnosis
• Mycobacterium Infections, Nontuberculous/drug therapy
• Mycobacterium Infections, Nontuberculous/epidemiology
• Mycobacterium Infections, Nontuberculous/microbiology
• Nontuberculous Mycobacteria
• Prosthesis-Related Infections/microbiology
• Public Health Surveillance
• Retrospective Studies
• Symptom Assessment
• Tertiary Care Centers
• Young Adult

• Colorado
• Mycobacterium
• United States
• antimicrobial resistance
• infectious arthritis
• musculoskeletal diseases
• nontuberculous mycobacteria
• osteomyelitis
• prosthesis-related infections
• tuberculosis and other mycobacteria

• Adult
• Aged
• Aged, 80 and over
• Antitubercular Agents/pharmacology
• Antitubercular Agents/therapeutic use
• Colorado/epidemiology
• Female
• Humans
• Male
• Middle Aged
• Musculoskeletal Diseases/diagnosis
• Musculoskeletal Diseases/drug therapy
• Musculoskeletal Diseases/epidemiology
• Musculoskeletal Diseases/microbiology
• Mycobacterium Infections, Nontuberculous/diagnosis
• Mycobacterium Infections, Nontuberculous/drug therapy
• Mycobacterium Infections, Nontuberculous/epidemiology
• Mycobacterium Infections, Nontuberculous/microbiology
• Nontuberculous Mycobacteria
• Prosthesis-Related Infections/microbiology
• Public Health Surveillance
• Retrospective Studies
• Symptom Assessment
• Tertiary Care Centers
• Young Adult

• Mycobacterium abscessus/chelonae complex
• nontuberculous mycobacteria

Prosthetic joint infections (PJI) caused by nontuberculous mycobacteria are very rare, and results of treatment can be unpredictable. A 72-year-old female underwent hip replacement after an accidental fall in a local hospital in Santo Domingo. The postoperative period was uneventful except for a traumatic wound near the surgical scar. PJI caused by Mycobacterium abscessus subsp. abscessus was diagnosed 6 months later. A two-stage reimplantation was performed after a 3-month period of aetiology-directed therapy, including amikacin, imipenem, and clarithromycin. M. abscessus isolate was reported to be resistant to clarithromycin when incubation was protracted for 14 days and to harbour the gene erm(41). The patient manifested major side effects to tigecycline. At reimplant, microbiologic investigations resulted negative. Overall, medical treatment was continued for a 7-month period. When discontinued and at 6-month follow-up, the patient was clinically well, inflammatory markers were normal, and the radiography showed well-positioned prosthesis. Mycobacterium abscessus subsp. abscessus is a very rare cause of PJI, yet it must be included in the differential diagnosis, especially when routine bacteria cultures are reported being negative. Further investigations are needed to determine any correlations between clinical results and in vitro susceptibility tests, as well as the clinical implications of M. abscessus subsp. abscessus harbouring the functional gene erm(41). Moreover, investigations are needed for determine optimal timings of surgery and lengths of medical therapy to improve patient outcome.

Intravesicular application of Bacillus Calmette-Guérin (BCG), a live attenuated strain of Mycobacterium bovis, is effective in the treatment of bladder cancer. However, systemic dissemination and subsequent infection of implants have been reported. We present a case of M. bovis infection of a total hip arthroplasty 5 years after BCG instillation for bladder cancer. He was treated with debridement, antibiotics, irrigation, and prosthesis retention with appropriate antituberculous therapy. At 4 years after surgery and 3 years after cessation of treatment, he has had no recurrence of infection with a good functional outcome. This case highlights the need to consider Mycobacteria infection in patients who have received intravesicular BCG. Debridement and retention of well-fixed implants can be successful in combination with appropriate antituberculous therapy.

• Bacillus Calmette-Guérin
• DAIR
• Mycobacterium bovis
• Prosthetic joint infection
• Total hip arthroplasty

• Knee Arthroplasty
• Mycobacterium abscessus
• Non-tuberculous mycobacterium.
• Prosthetic Joint Infections
• Rapidly Growing Mycobacteria

Non-tuberculous mycobacteria (NTM) are well-described pulmonary pathogens in patients with underlying lung disease. Extra-pulmonary infections with NTM are rare. We describe a prosthetic hip infection with Mycobacterium avium complex. Increased immunosuppressing medications and number of total joint replacements are expected to increase the prevalence of NTM infections in the future.

• MAC
• immunosuppression
• joint infection
• prosthetic joint

Non-tuberculous mycobacterial species are uncommon human pathogens. They are divided into slow and rapid growing mycobacteria (RGM) with Mycobacterium smegmatis group as an uncommon pathogen among the RGM.

A 19 years old male presented with a 1 month history of dyspnea, orthopnea, unintentional weight loss, palpitation, flu-like symptoms and dry cough. Physical examination revealed tachycardia, distended superficial chest veins with a decrease in breath sounds at the right lower lung with fine crepitations. CT of the chest showed a large anterior mediastinal mass infiltrating the pericardium and three chambers of the myocardium that was confirmed using echocardiography. Despite negative workup for tuberculosis, the patient was treated successfully using first-line anti-TB treatment, which was begun before the tissue culture grew M. smegmatis.

To our knowledge, this is the first case in the literature of M. smegmatis infection mimicking cardiomediastinal tuberculoma, and RGM should be suspected in similar presentations with negative TB workup, even in an immunocompetent patient. This is also the first patient to be treated using only first-line anti-tuberculous treatment successfully in the literature.

• Cardiac
• Granuloma
• Mycobacterium smegmatis
• Saudi Arabia

• Arthritis, Infectious/microbiology
• Arthroplasty, Replacement, Knee/adverse effects
• Humans
• Knee Prosthesis/microbiology
• Male
• Middle Aged
• Mycobacteriaceae/isolation & purification
• Prosthesis-Related Infections/microbiology

• Mycobacterium xenopi
• Osteoarticular infection
• Osteomyelitis
• Prosthetic joint infection
• Review

Periprosthetic joint infection (PJI) can be protracted, incapacitating, needing multiple interventions and could even lead to mortality. Early post-operative PJI has been ascribed to peri-operative introduction of highly virulent bacteria, while delayed post-operative to low-virulence bacteria. Non-tuberculous mycobacteria (NTM) do not figure in the usual list of etiological agents. We report a case of difficult diagnosis of bilateral PJI caused by Mycobacterium abscessus, following bilateral total knee arthroplasty in an elderly male, but treated successfully despite prolonged infection. M. abscessus complex comprises a group of rapidly growing, multidrug-resistant NTM, capable of forming biofilms on prostheses, responsible for wide spectrum of hospital acquired infections. M. abscessus as a cause of PJI is not reported widely. There are a few cases described in literature worldwide. There are no policy guidelines available for treating such cases. High clinical suspicion, with a concerted effort to grow and identify the causal pathogen is important. Standard anti-tubercular therapy is not recommended for treatment due to inherent resistance. Complete excision of infected tissues and removal of prosthesis along with prolonged combination antimicrobial regimen is the treatment of choice.

• Mycobacterium abscessus
• Periprosthetic joint infection
• Total knee replacement

• Atypical mycobacteria
• CVC infection
• Line infection
• M smegmatis
• Mycobacterium

• periprosthetic
• joint
• infection
• hip replacement
• arthroplasty

• C-reactive protein (CRP)
• Infectious Diseases Society of America guidelines (IDSA)
• antibiotic dose
• antibiotic duration
• antibiotic guidelines
• antibiotic indications
• antibiotic susceptibility
• antibiotic therapy
• antibiotic treatment monitoring
• antibiotic type
• antibiotics
• antibiotics for single-stage exchange
• antimicrobial treatment
• biofilm
• broad-spectrum antibiotics
• ceftriaxone
• combination antimicrobial therapy
• culture-negative periprosthetic joint infection (PJI)
• d-dimer
• daptomycin
• debridement and implant retention
• debridement, antibiotic, implant retention (DAIR)
• enterococcal periprosthetic joint infection (PJI)
• erythrocyte sedimentation rate (ESR)
• fluoroquinolone
• fosfomycin
• infective organism
• methicillin-resistant Staphylococcus aureus (MRSA)
• multidrug-resistant bacteria
• presepsin
• rifampin
• route of administration
• single-stage exchange
• staphylococcal periprosthetic joint infection (PJI)
• tigecycline
• vancomycin

• acid-fast bacilli (AFB)
• aerobic
• anaerobic
• antibiotic withholding
• culture
• fungal culture
• increase culture-positive yield
• number of cultures
• optimal culture processing
• optimal culture time to final report
• optimal sample containers
• optimal tissue sampling
• organism isolation
• organism typification
• pathogen isolation
• sample handling
• sample timing
• sample transport
• sinus tract swabbing
• sonication
• synovial cultures

• Mycobacterium tuberculosis
• Nontuberculous mycobacteria
• Osteomyelitis
• Pott’s disease
• Septic arthritis
• Tenosynovitis

• non-pigmented rapidly growing mycobacteria
• mycobacterium abscessus
• mycobacterium chelonae
• mycobacterium fortuitum
• clinical significance
• historical evolution
• epidemiology
• micobacterias no pigmentadas de crecimiento rápido
• significado clínico
• evolución histórica
• epidemiología.

Nontuberculous mycobacteria (NTM) diseases mainly manifest as pulmonary illnesses, but 20 -30% of NTM isolates originate from extrapulmonary diseases. These diseases cause a variety of clinical syndromes, including skin and soft-tissue infections, musculoskeletal infections, lymphadenitis, and disseminated disease. In skin and soft-tissue infections, musculoskeletal infections, prolonged treatment with combinations of antibiotics is effective in the treatment of NTM diseases, with surgery as an important complementary tool. The recommended duration of therapy for skin and soft-tissue infection is usually 2 – 4 months for mild disease and 6 months for severe disease, while treatment of musculoskeletal NTM disease usually requires at least 6 - 12 months. Management options of NTM lymphadenitis include surgical intervention, medical therapy, or observation. Treatment of disseminated NTM disease generally requires 6 to 12 months after immune restoration. However, despite a considerable increase in knowledge about NTM diseases, determining optimal treatment approaches remains a complex and challenging task.

• Extrapulmonary
• Musculoskeletal infections
• Nontuberculous mycobacteria
• Skin and soft-tissue infections

Cases of disseminated nontuberculous mycobacterial (NTM) infection are difficult to treat. We encountered an elderly man with disseminated Mycobacterium chelonae infection. The clinical evaluation and treatment of patients with this type of systemic infection pose unique challenges. Disseminated NTM infection with bone involvement often requires surgical intervention in addition to antimicrobial therapy.

• Disseminated infection
• Mycobacterium chelonae
• Necrotizing osteomyelitis
• Nontuberculous mycobacteria
• Skin nodules