Mycobacterium chelonae

Nikaido H., Kim S.-H. Rosenberg E.Y. (1993) Physical organization of lipids in die cell wall of Mycobacterium chelonae. Mol Microbiol, 8, 1025-1030. 

This can be degraded by several mycobacteria including Mycobacterium aurum strain MOl (Combourieu et al. 1998), Mycobacterium strain RPl (Poupin et al. 1998), and Mycobacterium chelonae (Swain et al. 1991). The reaction is initiated by a cytochrome P450 monooxygenase that is also active against pyrrolidine and piperidine (Poupin et al. 1998). 

Mycobacteria such as Mycobacterium tuberculosis, Mycobacterium avium, Myco-bac-terium leprae, Mycobacterium kansasii, Mycobacterium fortuitum-M, Mycobacterium chelonae, and a few others are pathogenic organisms that cause very serious diseases in humans. The characteristic feature of mycobacteria is their high content of lipids (about 40% of their mass), and they are primarily located on the outer bacterial membrane. 

A 43-year-old woman with a 23-year history of poorly controlled diabetes (HbAic 14%) developed abscesses at injection sites on the thighs and abdomen (165). Repeated treatment with flucloxacillin had no effect and cultures were sterile. From aspirated pus, cultured for 6 weeks, Mycobacterium chelonae was isolated and clarithromycin and ciprofloxacin were effective. 

Although cholestatic hepatitis has been typically described in association with erythromycin, newer macro-lides are not totally free of this risk. A gradual increase in bilirubin and transaminases has been reported during treatment of a Mycobacterium chelonae infection with clarithromycin. These alterations were quickly reversible after withdrawal, but re-appeared on re-exposure to clarithromycin 1 g (38). 

Yew WW, Chau CH, Lee J, Leung CW. Cholestatic hepatitis in a patient who received clarithromycin therapy for a Mycobacterium chelonae lung infection. Clin Infect Dis 1994 18(6) 1025-6. 

Microbiologists from Hong Kong have reported fonr cases of mycobacterial infections within 2 years (91). AH the patients had lesions at acnpnnctnre points. Acid-fast bacUh were present in two cases. Gene seqnencing identified the strain from two patients as Mycobacterium chelonae and from two patients as Mycobacterium nonchromogenium. 

A 79-year-old woman presented with induration of the right leg three months after receiving acupuncture in this area (94). Radiography showed a focal dystrophic calcification at this point and histological studies showed suppurative granulomatous inflammation with microabscesses and caseous necrosis due to infection with Mycobacterium chelonae. She made a full recovery after antibiotic treatment. 

Bordet, A. L., Machet, L., De Muret, A., Francois-Ramanantsoa, C., Lorette, G., and Vaillant, L. (1997). Mycobacterium chelonae cutaneous infection Efficacy of prolonged treatment by clarithromycin. Aran. Dermatol. Venereal. 124, 251-253. 

Saluja, A., Peters, N. T., Lowe, L., and Johnson, T. M. (1997). A surgical wound infection due to Mycobacterium chelonae successfully treated with clarithromycin. Dermatol. Surg. 23, 539-543. 

Engelhard , E., Feldmann, R., Skaria, A., and Salomon, D. (1996). [Postoperative infection with Mycobacterium chelonae]. Hautarzt 47, 863-866. 

Forslund, T., Rummukainen, M., Kousa, M., Krees, R., Relander, A., and Katila, M. L. (1995). Disseminated cutaneous infection due to Mycobacterium chelonae in a patient with rheumatoid arthritis, amyloidosis, and renal failure. Nephrol. Dial. Transplant. 10, 1234-1236. 

A combination of rifampin and ethambutol is probably effective minocycline or tetracycline is active in vitro and is used by some physicians. M. scrofulaceum is an uncommon cause of cervical lymphadenitis that is treated with surgical excision. Microbes of the M. fortuitum complex (including Mycobacterium chelonae) may cause chronic lung disease and infections of skin and soft tissues. The microorganisms are highly resistant to most drugs, but amikacin, cefoxitin, and tetracyclines are active in vitro. 

Theis and Leder (1993) demonstrated in aerobic biofilm experiments with an oil field isolate of aerobic bacteria, containing predominantly Pseudomonas species, that OPA is more effective than formaldehyde (FA, 2.1a.) or glutaraldehyde (GA, 2.5.) in killing or inhibiting the growth of sessile microorganisms (see Table 16). OPA is effective without activation and is able to inactivate GA-restistant strains of Mycobacterium chelonae. On the other hand OPA unlike GA acts not sporicidal at its in-use concentration of 0.5% (w/v) and normal pH (6.5.). 

HOEL K, LILLEHAUG A. Adjuvant activity of polar glycopeptidolipids from Mycobacterium chelonae in experimental vaccines against Aeromonas salmonicida in sal-monid fish. Fish Shellfish Immunol 1997,7, 365-376. 

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