Prevalence and epidemiologic features of nontuberculous mycobacteria causing persistent surgical site infections in Bangladesh

• Nontuberculous mycobacteria (NTM) in surgical site infections (SSI) were studied in a tertiary care hospital in Bangladesh. • NTM was detected in 7.7% in SSI, mostly following laparoscopic cholecystectomy and laparotomy • Sequence analysis of hsp65 revealed M. abscessus and M. fortuitum as common species. • Rare species, M. engbaekii, and M. kubicae were also identified. • Increased resistance rates to amikacin and ciprofloxacin were noted for M. abscessus. Nontuberculous mycobacteria (NTM) are an increasing cause of extrapulmonary infections affecting skin and soft tissue. This study aimed to determine the involvement of NTM in persistent surgical site infections (SSIs) in Bangladesh. Specimens of SSIs (wound swab, pus, sinus discharge) were collected from patients who attended a tertiary care hospital during a 6 month-period in 2024. NTM was detected by phenotypic methods (microscopic examination, culture, biochemical tests), immunochromatography and PCR. Species of NTM was identified by sequence analysis of hps65 gene. Antimicrobial susceptibility was determined by broth microdilution test. Among a total of 155 samples collected, NTM were detected in 12 samples (7.7%) which were identified to Mycobacterium abscessus (n=5), M. fortuitum (n=4), M. intracellulare, M. engbaekii , and M. kubicae (one specimen each). NTM was detected in patients with 0-50 years of age, showing variable durations of non-healing wound (3 to >14 weeks), more commonly after surgery of laparoscopic cholecystectomy and laparotomy. Resistance to amikacin, ciprofloxacin, and clarithromycin was noted for M. abscessus and M. fortuitum . NTM represented by M. abscessus and M. fortuitum was revealed to be a significant cause of persistent SSIs of various patient groups in Bangladesh, associated with specific types of surgery.