Mycobacterium abscessus and massiliense lung infection during macrolide treatment for bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation

J Infect Chemother. 2018 Jan;24(1):78-81. doi: 10.1016/j.jiac.2017.08.011. Epub 2017 Oct 6.

Abstract

In patients undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT), post-transplant lung infection is critical for their prognosis. Mycobacterium abscessus complex is not fully recognized as a nontuberculous mycobacteria (NTM) pathogen of post-SCT lung infection. Here, we present three post-allogeneic SCT patients who developed pulmonary infection caused by M. abscessus complex including M. abscessus and M. massiliense. In all three cases, macrolide antibiotics had been administered for bronchiolitis obliterans syndrome (BOS) before the confirmation of their infection, and macrolide resistance was noted in the M. abscessus isolates, one of which resulted in an unfavorable treatment outcome. It is important to consider M. abscessus lung infection as well as other NTM in patients receiving allo-SCT, particularly those receiving macrolide therapy for BOS.

Keywords: Allogeneic hematopoietic stem cell transplantation; Bronchiolitis obliterans; Lung infection; Macrolide resistance; Mycobacterium abscessus; Mycobacterium massiliense.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Bronchiolitis Obliterans / drug therapy*
  • Bronchiolitis Obliterans / etiology
  • Drug Therapy, Combination
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Macrolides / therapeutic use*
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / etiology*
  • Mycobacterium abscessus*
  • Pneumonia, Bacterial / etiology*
  • Postoperative Complications / microbiology*
  • Prognosis
  • Sputum / microbiology
  • Transplantation, Homologous / adverse effects

Substances

  • Anti-Bacterial Agents
  • Macrolides