Table 2.
Demographic Characteristics and Laboratory Test Results of 25 Patients With 27 Episodes of Infection Caused by RGM
| Episode | Sex/Age (yrs) | Underlying Conditions | Site of Infection | Type of Catheter | Duration of Catheter Use* (months) | ANC /mm3 |
ALC /mm3 |
Organism | Antimicrobial Therapy (months) | Adjunctive Therapy | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | F/9 | RMS | Disseminated (blood, lung) | H2 | 8 | 700 | 170 | M abscessus | CLAR/AMK x 1; followed by CLAR x 5 | CVL removed | Cured |
| 2 | F/15 | OS | Disseminated (blood, lung) | H1 | 12 | 2000 | 731 | M mucogenicum | CLAR/IMP x 0.5; followed by CLAR x 5.5 | CVL removed | Cured |
| 3 | M/2 | RB | Probable disseminated (blood, lung) | H1 | 7 | 8200 | 4018 | M chelonae | CLAR/AMK x 1; followed by CLAR x 4 | CVL removed | Cured |
| 4 | F/3 | EP | Probable disseminated (blood, lung, tunnel) | H2 | 2 | 0 | 432 | M chelonae | CLAR/CIP x 12 | CVL removed | Cured |
| 5 | F/3 | AML, HSCT | CLABSI | H2 | 8 | 12 300 | 1950 | M mucogenicum | CLAR x 2 | CVL removed |
Cured |
| 6 | F/3 | RB | CLABSI | TID | 3 | 0 | 0 | M fluoranthenivorans | CLAR/MER x 1; followed by CLAR/LIN x 2 | CVL removed | Cured |
| 7 | M/1 | AST | CLABSI, tunnel | H2 | 3 | 900 | 550 | M fortuitum | CLAR/MER x 2 | CVL removed | Cured |
| 8 | M/3 | ALL | TID pocket | TID | 6 | 1500 | 252 | M fortuitum | CIP/LIN x 4 | CVL removed | Cured |
| 9 | M/6 | ALL | TID pocket | TID | 6 | 4800 | 1752 | M abscessus | CLAR/LIN x 4 | CVL removed, debridement |
Cured |
| 10 | F/5 | ALL | Tunnel | H1 | 8 | 858 | 1404 | M abscessus chelonae/fortuitum | CLAR x 2 | CVL removed, debridement |
Cured |
| 11 | M/2 | ALL | Tunnel | H1 | 7 | 506 | 1320 | M chelonae/fortuitum | CLAR/AMK x 0.5 | CVL removed, debridement |
Cured |
| 12 | M/5 | AML, HSCT | Tunnel | H2 | 23 | 6666 | 1414 | M fortuitum chelonae | CLAR x 1 | CVL removed | Death -progressive AML 6 months after diagnosis |
| 13 | M/3 | ALL | Tunnel | H1 | 6 | 1855 | 2337 | M chelonae | CLAR/AMK x 0.5, followed by CIP x 4 | CVL removed | Cured |
| 14 | M/2 | ALL | Tunnel | H1 | 7 | 432 | 1116 | M chelonae/fortuitum | CLAR x 6 | CVL removed, debridement |
Cured |
| 15 | F/2 | LCH | Tunnel | H1 | 15 | 3400 | 1368 | M chelonae/fortuitum | CLAR x 0.5 | CVL removed, debridement |
Cured |
| 16 | M/4 | ALL | Exit site | H1 | 16 | 4080 | 900 | M chelonae | CLAR x 6 | CVL removed, debridement |
Cured |
| 17 | M/2 | RB | Exit site | H1 | 18 | 5500 | NA† | M immunogenum | CLAR x 6 | CVL removed, debridement |
Cured |
| 18 | F/5 | NB | Exit site | H1 | 23 | 1800 | 448 | M smegmatis | CLAR x 6 | CVL removed, debridement |
Death - progressive NB 5 months after diagnosis |
| 19 | F/4 | ALL | Exit site | H1 | 3 | 1610 | 1715 | M chelonae | CLAR x 1.5 | CVL removed, debridement |
Cured |
| 20 | M/2 | MB | Exit site | H2 | 6 | 1900 | NA | M abscessus | CLAR x 6 | CVL removed, debridement |
Cured |
| 21 | M/4 | ALL | Exit site | H1 | 19 | 400 | 902 | M abscessus | AMK/TMP/SMX x 0.5, followed by TMP/SMX x 2.5 | CVL removed, debridement |
Cured |
| 22 | M/5 | ALL | Exit site | H1 | 7 | 1900 | 1596 | M fortuitum | CLAR/AMK x 1, followed by CLAR x 3 | CVL removed | Cured |
| 23 | F/17 | DES | Exit site | H1 | 1 | 4884 | 737 | M fortuitum | None | None | Distant soft tissue abscess‡ |
| 24 | F/18 | DES | Surgical wound infection | none | 5478 | 1056 | M fortuitum | CLAR/CIP + MIIN x 3; followed by CIP + MIN x 3 | Debridement | Persistent sinus tract | |
| 25 | M/1 | ALL | Cutaneous | H1 | 0.5 | 92 | 2208 | M chelonae | CLAR x 2 | Debridement | Cured |
| 26 | M/16 | 2° AML, HSCT, BOOP |
Pulmonary | H2 | 19 | 3200 | 111 | M chelonae | LIN/MER/AMK x 0.75 | None | Death - respiratory failure 2 months after diagnosis |
| 27 | F/13 | WT | Pulmonary | none | 7500 | 1632 | M abscessus | Multiple courses (including CLAR, LIN, AMK, MER) over 42 months | None | Relapse Death - progressive RGM infection 42 months after diagnosis |
Abbreviations: ALC, absolute lymphocyte count; ALL, acute lymphoblastic leukemia; AML, acute myelogenous leukemia; AMK, amikacin; ANC, absolute neutrophil count; AST, astrocytoma; BOOP, bronchiolitis obliterans-organizing pneumonia; CIP, ciprofloxacin; CLABSI, central line-associated bloodstream infection; CLAR, clarithromycin; CVL, central venous line; DES, desmoid tumor; EP, ependymoma; F, female; H1, single lumen Hickman catheter; H2, double lumen Hickman catheter; HSCT, hematopoietic stem cell transplant; IMP, imipenem; LCH, Langerhans cell histiocytosis; LIN, linezolid; M, male; M, Mycobacterium; MB, medulloblastoma; MER, meropenem; MIN, minocycline; NB, neuroblastoma; OS, osteosarcoma; RB, retinoblastoma; RGM, rapidly growing mycobacteria; RMS, rhabdomyosarcoma; TID, totally implantable device; TMP/SMX, trimethoprim-sulfamethoxazole; WT, Wilm's tumor.
*Duration of catheter use at time of infection.
†Not available.
‡Episode 24.