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Rapidly growing mycobacteria associated with laparoscopic gastric banding, Australia, 2005-2011
Abstract:
Laparoscopic gastric banding is a common bariatric procedure worldwide. Rapidly growing mycobacteria are environmental organisms increasingly seen as pathogens,often in infected prosthetic material. We report 18 cases of infection associated with laparoscopic gastric banding caused by Mycobacterium fortuitum and M. abscessus in Australia during 2005–2011. We identified cases by reviewing positive cultures at the Queensland state reference laboratory or through correspondence with clinicians, and we obtained clinical and epidemiologic data. Eleven cases of M. fortuitum and 7 cases of M. abscessus infection were identified. The port was thought to be the primary site of infection in 10 of these cases. Complications included peritonitis,band erosion, and chronic ulceration at the port site.Rapidly growing mycobacteria can infect both port and band and can occur as either an early perioperative or late infection.Combination antimicrobial therapy is used on the basis of in vitro susceptibilities. Device removal seems to be vital to successful therapy.
Insights
Infections from rapidly growing mycobacteria, like Mycobacterium fortuitum and M. abscessus, can complicate laparoscopic gastric banding. Successful treatment often requires combination antimicrobial therapy and removal of the infected medical device.
Area of Science:
- Infectious Diseases
- Bariatric Surgery
- Microbiology
Background:
- Laparoscopic gastric banding is a prevalent bariatric procedure globally.
- Rapidly growing mycobacteria are environmental pathogens frequently associated with prosthetic material infections.
Purpose of the Study:
- To report cases of laparoscopic gastric banding infection caused by rapidly growing mycobacteria.
- To describe the clinical and epidemiological features of these infections.
Main Methods:
- Review of positive cultures from a state reference laboratory.
- Analysis of clinical and epidemiological data from 18 identified cases.
- Identification of causative agents as Mycobacterium fortuitum and M. abscessus.
Main Results:
- Eighteen cases of infection were identified between 2005–2011 in Australia.
- Infections involved Mycobacterium fortuitum (11 cases) and M. abscessus (7 cases).
- Common complications included peritonitis, band erosion, and chronic port site ulceration.
Conclusions:
- Rapidly growing mycobacteria can infect both the port and band of gastric banding devices.
- Infections can occur early perioperatively or as late complications.
- Successful therapy necessitates combination antimicrobial treatment and often device removal.
