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Mycobacteriological characteristics and treatment outcomes in extrapulmonary Mycobacterium abscessus complex infections

Authors
 Suk Hyeon Jeong  ;  Su-Young Kim  ;  Hee Jae Huh  ;  Chang-Seok Ki  ;  Nam Yong Lee  ;  Cheol-In Kang  ;  Doo Ryeon Chung  ;  Kyong Ran Peck  ;  Sung Jae Shin  ;  Won-Jung Koh 
Citation
 International Journal of Infectious Diseases, Vol.60 : 49-56, 2017 
Journal Title
 International Journal of Infectious Diseases 
ISSN
 1201-9712 
Issue Date
2017
MeSH
Adult ; Aged ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use* ; Clarithromycin/pharmacology ; Clarithromycin/therapeutic use ; Drug Resistance, Bacterial/genetics ; Female ; Humans ; Male ; Methyltransferases/genetics ; Microbial Sensitivity Tests ; Middle Aged ; Mycobacterium Infections, Nontuberculous/drug therapy ; Mycobacterium Infections, Nontuberculous/microbiology* ; Mycobacterium abscessus/classification* ; Mycobacterium abscessus/drug effects ; Mycobacterium abscessus/genetics ; Retrospective Studies ; Treatment Outcome
Keywords
Drug resistance ; Macrolides ; Mycobacterium abscessus ; Mycobacterium massiliense ; Non-tuberculous mycobacteria
Abstract
OBJECTIVES: The differentiation between Mycobacterium abscessus subspecies abscessus (M. abscessus) and Mycobacterium abscessus subspecies massiliense (M. massiliense) and determination of the presence of inducible resistance to macrolide antibiotics are important factors in the management of patients with Mycobacterium abscessus complex (MABC) infections. Unlike pulmonary MABC infections, little information on extrapulmonary MABC infections is available. METHODS: The molecular identification of clinical isolates was performed, and the clinical characteristics and treatment outcomes of 20 consecutive patients with extrapulmonary MABC infections were assessed. RESULTS: M. abscessus and M. massiliense each caused 10 (50%) of the cases. Eight (80%) M. abscessus isolates that had inducible resistance to clarithromycin harbored an intact erm(41) gene of the T28 variant, whereas two (20%) M. abscessus isolates had the C28 erm(41) variant and were susceptible to clarithromycin. All M. massiliense isolates had a truncated erm(41) gene and were susceptible to clarithromycin. The drug susceptibility profiles other than clarithromycin were similar for the M. abscessus and M. massiliense isolates. Of the 20 patients, 17 (85%) showed a favorable outcome, including all patients with M. massiliense infection and 70% (7/10) of patients with M. abscessus infection. Favorable outcomes were associated with M. massiliense and M. abscessus isolates with a non-functional erm(41) gene (p=0.049). CONCLUSIONS: Precise species and subspecies identification and the determination of macrolide susceptibility are recommended for the optimal treatment of extrapulmonary MABC infections.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/160882
DOI
10.1016/j.ijid.2017.05.007
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Microbiology (미생물학교실)
Yonsei Authors
신성재(Shin, Sung Jae)
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