IS IT IMPORTANT TO REQUEST SUBSPECIES IDENTIFICATION?Īlthough some laboratories still report M.
abscessus from a single, typically sterile site, body fluid, or tissue specimen is usually sufficient to meet diagnostic criteria. Of note, for extrapulmonary infection, isolation of M. For these reasons, fulfillment of microbiological criteria (per the ATS/IDSA guidelines) typically requires microbiological persistence (ie, multiple positives) and longitudinal clinical follow-up. Individuals with some pulmonary comorbidities, such as cystic fibrosis (CF), may be at increased risk for colonization, requiring additional consideration of other pathogens and clinical findings when determining the clinical significance of positive M. abscessus without associated clinical (including radiographic) features or a single positive sputum specimen, even with supporting clinical features, does not necessarily establish a diagnosis of pulmonary disease. abscessus, may be environmental organisms, care must be taken to distinguish between colonization, pseudo-outbreaks (eg, due to contaminated equipment such as bronchoscopes), lab or specimen contamination (eg, oral rinsing with contaminated tap water before specimen collection), and true disease. Microbiologic criteria comprise the identification of positive cultures from 2 separate sputum samples or 1 positive bronchial washing or lavage specimen (BAL), or pathologic features consistent with NTM disease in combination with a positive culture. Clinical criteria for pulmonary disease (warranting consideration of treatment) include pulmonary symptoms, nodular or cavitary opacities on chest radiograph, or multifocal bronchiectasis on chest computed tomography scan, along with appropriate exclusion of other diagnoses such as tuberculosis or malignancy. The American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines recommend assessment of clinical (including radiographic) and microbiological criteria to establish a diagnosis of pulmonary NTM disease. abscessus does not necessarily indicate a person has M. tuberculosis, a single culture from sputum or another nonsterile site that is positive for for M. ABSCESSUS DISEASE WITH A SINGLE POSITIVE SPUTUM CULTURE? Given its increasing prevalence and intrinsic multidrug resistance, to complement other review articles on this topic, this article will focus on common clinical questions that arise during the management of pulmonary M. abscessus) is part of a group of rapidly growing mycobacteria (RGM) that can be found in soil and water and accounts for the majority of pulmonary nontuberculous mycobacteria (NTM) infections due to RGM.
Bronchiectasis, drug resistance, lung disease, mycobacterium abscessus, non-tuberculous mycobacteria
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