Port-site Infection Due to Nontuberculous Mycobacteria following Laparoscopic Surgery: A Case Series and Literature Review

Abstract Background: Nontuberculous mycobacteria (NTM) have emerged as important pathogens in postlaparoscopic surgical site infections, particularly at port sites, often leading to delayed diagnosis and prolonged treatment and significant morbidity. We describe here a case series of culture-proven port-site infections by all the known species of rapidly growing NTM in the Indian context. Methods: A retrospective analysis of patients presenting with delayed wound healing postlaparoscopic surgery and later diagnosed to have NTM infections at port sites was conducted at a tertiary referral center. Patients with growth of NTM on acid-fast bacilli culture were included and subjected to line probe assay (LPA) speciation. A literature review was performed to compare the findings. Results: All cases were caused by rapidly growing NTM (Runyon Group IV) and presented 3–6 weeks postoperatively. LPA speciation revealed Mycobacterium abscessus in two patients; Mycobacterium chelonae and Mycobacterium fortuitum in one patient each. Empirical therapy was initiated based on known species-specific sensitivity patterns, and wound debridement was done in two patients. All patients responded to multidrug regimens administered over 4–6 months with good response. Therapy was tailored according to infection severity and clinical response. Conclusion: Early recognition, improved diagnostics, and species-guided multidrug therapy are critical for managing NTM port-site infections. Use of sterile water, orthophthaldehyde disinfectant, and strict asepsis sterilization protocols are vital for prevention.