M. abscessus

The Mycobacterium abscessus complex comprises a group of fast-growing, multidrug-resistant, nontuberculous mycobacteria responsible for a wide spectrum of pulmonary infections, of skin and soft tissue diseases, central nervous system infections, bacteremia, and ocular and other infections.

The M. abscessus complex is divided into 3 subspecies:

• M. abscessus subsp. abscessus
• M. abscessus subsp. massiliense and
• M. abscessus subsp. bolletii.

The two major subspecies, M. abscessus subsp. abscessus and M. abscessus subsp. massiliense, have different erm(41) gene patterns. This gene provides intrinsic resistance to macrolides, so the different patterns lead to different treatment outcomes.

Treatment of M. abscessus-related infections is difficult because of intrinsic resistance to several commonly used antibiotics. Clarithromycin, amikacin , and cefoxitin are the available antimicrobials of choice for treatment.

Currently, no vaccine against M. abscessus is in clinical development.

New treatments are urgently needed, as are rapid and cost-effective identification methods and measures to control nosocomial transmission.

Outbreaks of M. abscessus complex associated with cosmetic procedures and nosocomial transmission are not uncommon (Lee MR et al. 2015).

1. Gonzalez-Santiago TM et al (2015) Nontuberculous mycobacteria: skin and soft tissue infections. Dermatol Clin 33:563-577.
2. Johansen MD et al (2020) Nontuberculous mycobacteria and the rise of Mycobacterium abscessus. Nat Rev Microbiol 18:392-407.
3. Lee MR et al (2015) Mycobacterium abscessus complex infections in humans. Emerg Infect Dis 21:1638-1646.