Mycobacterium abscessus in Healthcare Settings

General information about Mycobacterium abscessus

Mycobacterium abscessus [mī–kō–bak–tair–ee–yum  ab–ses–sus] (also called M. abscessus) is a bacterium distantly related to the ones that cause tuberculosis and Hansen’s Disease (Leprosy). It is part of a group of environmental mycobacteria and is found in water, soil, and dust. It has been known to contaminate medications and products, including medical devices.

M. abscessus can cause a variety of infections. Healthcare-associated infections due to this bacterium are usually of the skin and the soft tissues under the skin. It is also a cause of serious lung infections in persons with various chronic lung diseases, such as cystic fibrosis.

People with open wounds or who receive injections without appropriate skin disinfection may be at risk for infection by M. abscessus.  Rarely, individuals with underlying respiratory conditions or impaired immune systems are at risk of lung infection.

Mycobacterium abscessus is a bacterium distantly related to the ones that cause tuberculosis and leprosy. It is part of a group known as rapidly growing mycobacteria and is found in water, soil, and dust. It has been known to contaminate medications and products, including medical devices.

Symptoms of Mycobacterium abscessus

Skin infected with M. abscessus is usually red, warm, tender to the touch, swollen, and/or painful. Infected areas can also develop boils or pus-filled vesicles. Other signs of M. abscessus infection are fever, chills, muscle aches, and a general feeling of illness. However, for a definite diagnosis, the organism has to be cultured from the infection site or, in severe cases, from a blood culture. A medical provider should evaluate the infection to determine if it may be due to M. abscessus.

Diagnosis is made by growing this bacterium in the laboratory from a sample of the pus or biopsy of the infected area. When the infection is severe, the bacterium can be found in the blood and isolated from a blood sample. To make the diagnosis, your healthcare provider will have to take a sample from the infected area and/or blood and send it to a laboratory for identification. It is important that persons who have any evidence of infection at a site where they received procedures, such as surgery or injections, let their doctors know so the appropriate tests can be done.

Transmission of Mycobacterium abscessus

Transmission of M. abscessus can occur in several ways. Infection with M. abscessus is usually caused by injections of substances contaminated with the bacterium or through invasive medical procedures employing contaminated equipment or material. Infection can also occur after accidental injury where the wound is contaminated by soil. There is very little risk of transmission from person to person.

Prevention of Mycobacterium abscessus

Anyone who touches or cares for the infected site should wash their hands carefully with soap and water. Patients should follow all instructions given by their healthcare provider following any surgery or medical procedure. Avoid receiving procedures or injections by unlicensed persons.

Treatment of Mycobacterium abscessus

Treatment of infections due to M. abscessus consists of draining collections of pus or removing the infected tissue and administering the appropriate combination of antibiotics for a prolonged period of time. Infection with this bacterium usually does not improve with the usual antibiotics used to treat skin infections. Testing the bacteria against different antibiotics is helpful in guiding doctors to the most appropriate treatment for each patient.

Recommendations and Guidelines

For more information about prevention and treatment of HAIs, see the resources below:

• CDC. Guidelines for preventing the transmission of mycobacterium tuberculosis in healthcare settings, 2005. MMWR 2005;54(RR17):1–141.
• CDC. Additional frequently asked questions (FAQ) for clarification of recommendations in the “Guidelines for preventing the transmission of mycobacterium tuberculosis in health-care settings, 2005.” [PDF 88 KB]
• CDC. Appendix B. tuberculosis (TB) risk assessment worksheet. 2006. [PDF 196 KB]
• CDC. Guidelines for the investigation of contacts of persons with infectious tuberculosis: recommendations from the national tuberculosis controllers association and CDC. [PDF 545 KB] MMWR 2005;54(RR15):1–47.
• WHO. Tuberculosis coalition for technical assistance, 2006: international standards for tuberculosis care (ISTC). [PDF 1.89 MB}
• WHO, CDC, International Union Against Tuberculosis and Lung Disease. Tuberculosis infection control in the era of expanding HIV care and treatment. 2006. [PDF 368 KB]