Nontuberculous mycobacteria infected wounds:case series study and literature review

JIANG Qi-xia; PENG Qing

doi:10.3969/j.issn.1009-4237.2016.10.002

Abstract：Objective To investigate the clinical characteristics , diagnostic and treatment methods of rare nontuberculous mycobacteria infected wounds .Methods The clinical data of two patients with nontuberculous myco-bacteria infected wounds confirmed by bacteriological detection was assessed and analyzed .Through literature review , their clinical features were summarized as follows:complicated full thickness wounds ,a large amount of purulent exu-dates,severe pain,inadequate drainage, long duration(more than 2 months),low positive rate of bacteria culture (less than 50%) ,being often accompanied with hypoimmunity ,and being hard to be cured by antibiotics and surgery .Indi-vidualized systemic nursing care protocols were made depending on the results of literature review and each patient ’s condition.Systemic intervention focused on psychological care ,oral nutrition,aerobic exercise and keeping adequate and good sleep so as to enhance immunologic function and reduce stress reaction .Local intervention focused on de-bridement,adequate drainage,silver dressing combined with negative pressure wound therapy ,infrared and red light therapy.Results of each patient were evaluated and regulated dynamically until healed .After healing, each patient was followed up for three months by telephone and WeChat for investigating recurrence and functional recovery .Re-sults The healing time of two patients with infected wounds was 98d and 48d,respectively.The male patient with di-abetes mellitus re-occurred an infected wound during the three-month follow up,who was healed after 35d of the second treatment.The female patient did not reoccur and her activity was normal during follow-up.Conclusion Nontuber-culous mycobacteria infected wounds are complicated and hard to be healed ,and need systemic intervention .It is ef-fective to use individualized systemic care combined with local wound management for those patients .