Emergence of Mycobacterium simiae: A retrospective study from a tertiary care center in Lebanon

Autor: Pierre Bou Khalil, Nathalie Kara, Houssam Tabaja, Nadim Kanj, George F. Araj, Imad Bou Akl, Amal Hamieh, Souha S. Kanj, Said El Zein, Zeina A. Kanafani, Ghina Berjaoui, Ralph Tayyar
Rok vydání: 2017
Předmět:
0301 basic medicine
Male
Pulmonology
Physiology
lcsh:Medicine
Diagnostic Radiology
Tertiary Care Centers
Geographical Locations
0302 clinical medicine
Moxifloxacin
Clarithromycin
Drug Resistance
Multiple
Bacterial
Prevalence
Medicine and Health Sciences
Lebanon
lcsh:Science
Tomography
Antiinfective agent
Multidisciplinary
biology
Radiology and Imaging
Nontuberculous Mycobacteria
Middle Aged
Body Fluids
Actinobacteria
Amikacin
Female
Radiography
Thoracic
medicine.symptom
Anatomy
medicine.drug
Research Article
medicine.medical_specialty
Asia
Imaging Techniques
Chronic Obstructive Pulmonary Disease
030106 microbiology
Neuroimaging
Research and Analysis Methods
Mycobacterium
03 medical and health sciences
Diagnostic Medicine
Internal medicine
medicine
Humans
Aged
Retrospective Studies
Mycobacterium Infections
Bronchiectasis
Bacteria
business.industry
lcsh:R
Organisms
Sputum
Biology and Life Sciences
Retrospective cohort study
biology.organism_classification
medicine.disease
Computed Axial Tomography
Mucus
030228 respiratory system
Specimen Preparation and Treatment
Respiratory Infections
People and Places
Mycobacterium simiae
lcsh:Q
business
Tomography
X-Ray Computed
Follow-Up Studies
Neuroscience
Zdroj: PLoS ONE
PLoS ONE, Vol 13, Iss 4, p e0195390 (2018)
ISSN: 1932-6203
Popis: Objective The objective of this study is to describe the clinical significance of Mycobacterium simiae at a major tertiary care center in Lebanon. Methods This is a retrospective study of patients with positive cultures for M. simiae isolated between 2004 and 2016 at the American University of Beirut Medical Center. Results This study included 103 M. simiae isolates recovered from 51 patients. Their mean age was 62.7 years. The majority were males and smokers. Specimens were mostly from respiratory sources (97%). Common comorbidities included chronic lung disease (such as chronic obstructive pulmonary disease), solid tumor, systemic disease, and diabetes mellitus. Productive cough and dyspnea were the most common symptoms. Frequent radiographic findings were infiltrates and nodules on chest X-ray and nodules, infiltrates, and bronchiectasis on chest computed tomography scan. Among 18 tested isolates, 5.8% were resistant to clarithromycin, 11.7% to amikacin, and 70–100% to other antimicrobials. Out of 13 patients receiving early treatment, 5 noted improvement, one had recurrence of symptoms, two received alternative diagnosis, and five died. Two of those deaths were related to M. simiae. Common treatment regimens included clarithromycin in different combinations with trimethoprim-sulfamethoxazole, moxifloxacin, and amikacin. Moreover, clofazimine was used in only two patients whose isolates were resistant to all but one agent. Duration of treatment ranged from 6–24 months. Conclusion In Lebanon, M. simiae is increasingly encountered with true infection rates of at least 47%. Furthermore, the prevalence of multidrug resistance among the Lebanese M. simiae isolates is very high limiting the treatment options.
Databáze: OpenAIRE
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