Clinical Outcome of Mycobacterium abscessus Infection and Antimicrobial Susceptibility Testing

Background/Purpose Mycobacterium abscessus is the most resistant and rapidly growing mycobacterium and causes a wide range of clinical infectious diseases. The relationship between antimicrobial susceptibility and clinical outcome needs to be further evaluated. Methods Forty M. abscessus isolates we...

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Published in:Journal of microbiology, immunology and infection immunology and infection, 2010-10, Vol.43 (5), p.401-406
Main Authors: Huang, Yi-Ching, Liu, Meei-Fang, Shen, Gwan-Han, Lin, Chin-Fu, Kao, Chih-Chuan, Liu, Po-Yu, Shi, Zhi-Yuan
Format: Article
Language:English
Subjects:
Amikacin - pharmacology
Amikacin - therapeutic use
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Clarithromycin - pharmacology
Clarithromycin - therapeutic use
Drug Resistance, Bacterial
Humans
Infectious Disease
Lung Diseases - diagnosis
Lung Diseases - drug therapy
Lung Diseases - microbiology
Medical Education
Microbial Sensitivity Tests
Mycobacterium
Mycobacterium abscessus
Mycobacterium Infections, Nontuberculous - diagnosis
Mycobacterium Infections, Nontuberculous - drug therapy
Mycobacterium Infections, Nontuberculous - microbiology
Nontuberculous Mycobacteria - drug effects
Nontuberculous Mycobacteria - isolation & purification
rapidly growing mycobacteria
susceptibility testing
Treatment Outcome
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Summary:Background/Purpose Mycobacterium abscessus is the most resistant and rapidly growing mycobacterium and causes a wide range of clinical infectious diseases. The relationship between antimicrobial susceptibility and clinical outcome needs to be further evaluated. Methods Forty M. abscessus isolates were obtained from clinical specimens of 40 patients at the Taichung Veterans General Hospital from January 2006 to December 2008. Antimicrobial susceptibility testing was performed using the broth microdilution method according to the recommendations of the National Committee for Clinical Laboratory Standards. The clinical manifestations and outcomes were reviewed from medical records. Results Twenty-two patients were diagnosed with M. abscessus infection. Cough (86.3%), hemoptysis (31.8%) and fever (18.1%) were the most common symptoms. The radiographic findings included reticulonodular opacities (50.0%), consolidation (31.8%) and cavitary lesions (18.1%). The 40 isolates were susceptible to amikacin (95.0%), cefoxitin (32.5%), ciprofloxacin (10.0%), clarithromycin (92.5%), doxycycline (7.5%), imipenem (12.5%), moxifloxacin (22.5%), sulfamethoxazole (7.5%) and tigecycline (100%). The rate of treatment failure was 27.3% at the end of the 12th month after the start of treatment, although these patients were treated with a combination of clarithromycin and other antimicrobial agents. Conclusion M. abscessus is naturally susceptible to clarithromycin and amikacin, variably susceptible to cefoxitin and imipenem, and resistant to most other antimicrobial drugs. Combination therapy with clarithromycin, amikacin and other active antimicrobial agents may lead to clinical improvement; however, the rate of treatment failure is still high.
ISSN:1684-1182
1995-9133
DOI:10.1016/S1684-1182(10)60063-1