Delayed Port-Site Infections Caused by Nontuberculous Mycobacteria after Laparoscopic Procedures: Experience from a Tertiary Hospital in North India

Abiroo  Jan; Amina  Samreen; Iqra Hussain  Shah; Shahzana  Batool; Tufail Ahmed  Wani

doi:10.18502/jmb.v13i3.19513

Abiroo Jan Department of Microbiology, Government Medical College, Anantnag, India
Amina Samreen Department of Microbiology, Government Medical College, Anantnag, India
Iqra Hussain Shah Department of Microbiology, Government Medical College, Anantnag, India
Shahzana Batool Department of Management Studies, University of Kashmir, Hazratbal, India
Tufail Ahmed Wani Department of Microbiology, Government Medical College, Anantnag, India

DOI: https://doi.org/10.18502/jmb.v13i3.19513

Keywords: Antimicrobial therapy, Hospital acquired infection, Laparoscopy, Mycobacterial infection, Surgical wound infection.

Abstract

Background: Port-site infections caused by nontuberculous mycobacteria (NTM) following laparoscopic surgery represent a rare yet increasingly recognized complication in modern surgical practice. These infections, driven by environmental pathogens resistant to standard sterilization methods, pose significant diagnostic and therapeutic challenges due to their insidious onset and resistance to conventional treatments.

Methods: This retrospective study examined 20 patients who developed infection between May 2024 and August 2024, collecting data on demographics, clinical presentations, latency periods, diagnostic outcomes, and treatment results.

Results: The cohort, with a mean age of 36.5 years (range: 8–70) and 60% female predominance, most commonly presented with pus discharge (70%), with a median latency period of 39 days from surgery to symptom onset. Diagnostic efforts revealed excisional biopsy as the most effective method, yielding a 25% positivity rate, far surpassing pus swabs and aspirations at 5% each. Treatment involved prolonged combination antibiotic therapy—macrolides paired with linezolid or amikacin—resulting in complete resolution in all cases with no recurrences within a 6-month follow-up.

Conclusion: These findings underscore the necessity of heightened clinical suspicion, advanced diagnostic techniques, and adherence to extended treatment protocols to manage NTM infections effectively, offering critical insights into their prevention and management in laparoscopic surgery settings.