Mycobacterium Xenopi 

  • Author: Mansoor Arif, MD, MBBS; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Oct 22, 2010
 

Background

Researchers first described Mycobacterium xenopi in 1959 after isolating it from skin lesions of the South African toad Xenopus laevis.M xenopi, a slow-growing, nontuberculous mycobacterium, is often considered to be a saprophyte or an environmental contaminant. It grows optimally at 45°C (113°F) and has been found, occasionally in large numbers, in hospital hot water supplies at the outlet valves of water heaters.[1, 2]M xenopi colonization occurs from ingestion or inhalation of, or cutaneous exposure to, organisms in water, soil, or airborne particles. Colonization of hospital water systems is associated with infection, disease, and nosocomial isolation.

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Pathophysiology

M xenopi has low pathogenicity, and host impairment is required to contract disease from the organism. Most M xenopi infections occur in the lungs, usually in patients with preexisting lung disease or with predisposing conditions (eg, extrapulmonary malignancy, alcoholism, diabetes mellitus, HIV infection). Extrapulmonary and disseminated disease may develop in patients with AIDS or other immunodeficiencies.

For pulmonary disease, inhalation of infected airborne particles is the usual route of infection. For skin and soft tissue infections, direct contact through penetrating injuries and surgical procedures provide the route. Person-to-person transmission of nontuberculous mycobacterial disease has never been documented.

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Epidemiology

Frequency

United States

Surveillance data for M xenopi infection are not available because such infection is not a reportable disease. More than 500 cases have been reported, but only approximately 70 cases seem to document true disease.

International

Prevalence is unknown.

Mortality/Morbidity

Subjects with documented M xenopi infections are divided into the following broad categories:

  • The first group comprises young, severely immunocompromised individuals in whom M xenopi infection occurs as an opportunistic infection that may then become disseminated, conferring a high risk of mortality and morbidity. Persons with CD4+ cell counts of less than 50/µL are susceptible hosts for pathogens such as M xenopi. M xenopi can cause 2 patterns of disease in these patients: localized pulmonary disease that can mimic tuberculosis in persons with early-stage HIV infection and disseminated disease in those with advanced AIDS.
  • The second group comprises immunocompetent adults with chronic lung disease or chronic obstructive pulmonary disease (COPD) in whom M xenopi infection usually follows a long-term, indolent course.

Race

No racial predilection has been identified.

Sex

No predilection for either sex has been demonstrated.

Age

No age predilection has been reported.

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Contributor Information and Disclosures
Author

Mansoor Arif, MD, MBBS  Research Associate, Department of Research, Indus Hospital, Pakistan

Disclosure: Nothing to disclose.

Coauthor(s)

Syed Faisal Mahmood, MBBS  Assistant Professor of Infectious Diseases, Department of Medicine, Aga Khan Univerity Hospital, Pakistan

Disclosure: Nothing to disclose.

Specialty Editor Board

Wesley W Emmons, MD, FACP  Assistant Professor, Department of Medicine, Thomas Jefferson University; Consulting Staff, Infectious Diseases Section, Department of Internal Medicine, Christiana Care, Newark, DE

Wesley W Emmons, MD, FACP is a member of the following medical societies: American College of Physicians, American Medical Association, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, and International AIDS Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Aaron Glatt, MD  Professor of Clinical Medicine, New York Medical College; President and CEO, Former Chief Medical Officer, Departments of Medicine and Infectious Diseases, New Island Hospital

Aaron Glatt, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physician Executives, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, American Thoracic Society, American Venereal Disease Association, Infectious Diseases Society of America, International AIDS Society, and Society for Healthcare Epidemiology of America

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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