Explanation : Mycobacterium chelonae is a distinct species of rapidly growing mycobacteria and is not a subspecies of Mycobacterium abscessus. The recognized subspecies of M. abscessus include M. abscessus subspecies abscessus, M. abscessus subspecies bolletii, and M. abscessus subspecies massiliense. It is important to differentiate the subspecies as it can impact treatment especially regarding presence of erm gene leading to inducible macrolide resistance.

References:
Int J Syst Evol Microbiol. 2016 Nov;66(11):4471-4479. doi: 10.1099/ijsem.0.001376. Epub 2016 Aug 4.

Explanation : Pulmonary infections are the most common manifestation of Mycobacterium abscessus infections. Especially in individuals with structural lung disease like bronchiectasis or cystic fibrosis, M. abscessus can lead to progressive and chronic lung disease. While it can also cause skin and soft tissue infections, particularly post-surgical or post-traumatic, the lungs remain the most frequently affected site.

Explanation : The erm gene, which is responsible for inducible resistance to macrolides, is typically found in M. abscessus subspecies abscessus and M. abscessus subspecies bolletii. This resistance has significant clinical implications as macrolides are commonly used in treatment regimens. Notably, M. abscessus subspecies massiliense generally lacks this gene, which can impact therapeutic decisions.

References:
Nash KA, Brown-Elliott BA, Wallace RJ Jr. (2009). "A novel gene, erm(41), confers inducible macrolide resistance to clinical isolates of Mycobacterium abscessus but is absent from Mycobacterium chelonae." Antimicrobial Agents and Chemotherapy. 53(4): 1367-1376. https://doi.org/10.1128/aac.01275-08

Explanation : Omadacycline has shown activity against Mycobacterium abscessus. This agent represent potential alternative or adjunctive therapies, especially given the intrinsic resistance of this organism to many traditional antimicrobials. Additionally, tedizolid has shown activity against M. abscessus complex in-vitro.

References:
Rizzo, A.R., Moniri, N.H. Omadacycline for management of Mycobacterium abscessus infections: a review of its effectiveness, place in therapy, and considerations for use. BMC Infect Dis 22, 874 (2022). [https://doi.org/10.1186/s12879-022-07857-7]

Tang YW, Cheng B, Yeoh SF, Lin RTP, Teo JWP. Tedizolid Activity Against Clinical Mycobacterium abscessus Complex Isolates-An in vitro Characterization Study. Front Microbiol. 2018 Sep 7;9:2095. doi: 10.3389/fmicb.2018.02095. PMID: 30245674; PMCID: PMC6137136. [https://doi.org/10.3389/fmicb.2018.02095]

Explanation : Infections with Mycobacterium abscessus of the skin and soft tissue have been associated with procedures like cosmetic surgery, acupuncture, and mesotherapy. Central venous catheter insertion, while potential risk factors for other infections, are not primary risk factors for skin and soft tissue infections with M. abscessus.

References:
https://doi.org/10.1128/cmr.00069-18

Explanation : Mycobacterium abscessus has the ability to produce biofilms, which are structured communities of bacteria encased in a self-produced polymeric matrix. This biofilm formation enhances the organism's resistance to disinfectants and allows it to survive in diverse environmental conditions.

References:
https://doi.org/10.3390/microorganisms7030090