The following is a summary of “Clinical features and treatment outcomes of bone and joint nontuberculous mycobacterial infections according to immune status: a 9-year retrospective observational cohort,” published in the May 2024 issue of Infectious Disease by Bémer et al.

Bone and joint infections (BJIs) caused by nontuberculous mycobacteria (NTM) are rare.

Researchers conducted a retrospective study investigating the characteristics of NTM BJI to identify variations based on patients’ immune status.

They conducted a multicenter study in France over 9 years, focusing on patients with documented NTM BJI. The Clinical and microbiological characteristics, management strategies, and clinical outcomes were collected and analyzed.

The result showed 95  NTM BJI with distinct characteristics based on immune status. Half the patients, 50.5% (48/95), were immunosuppressed and exhibited a higher prevalence of native arthritis than the immunocompetent group, where tenosynovitis was more common. The infecting Mycobacterium species also differed significantly, with M. marinum and M. abscessus complex found more frequently in patients with immunocompetent. At the same time, M. avium and M. xenopi dominated in the immunosuppressed group. Treatment strategies also revealed a higher frequency of combined antibiotic therapy and surgery in the immunocompetent group (63.8%, 30/47) compared to the immunosuppressed group (47.8%, 22/46). Within the immunosuppressed group, a larger proportion received antibiotic therapy alone (45.7%, 21/46) compared to the immunocompetent group (23.4%, 11/47). Despite similar median durations of antibiotic use (11 months), mortality was significantly higher in the immunosuppressed group, highlighting the vulnerability of immunocompromised patients to poorer outcomes from BJIs.

Investigators concluded that NTM BJI showed variations in presentation and causative Mycobacterium based on immune status, but most patients achieved complete recovery with treatment.

Source: ijidonline.com/article/S1201-9712(24)00193-0/fulltext#%20