Amikacin exposure and susceptibility of macrolide-resistant Mycobacterium abscessus
| Autor: | Nabila Azeem, D. Rebecca Prevots, Shamira J. Shallom, Kenneth N. Olivier, Shelby Daniel-Wayman, Adrian M. Zelazny |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Pulmonary and Respiratory Medicine 030106 microbiology lcsh:Medicine Mycobacterium abscessus Microbiology 03 medical and health sciences Minimum inhibitory concentration 0302 clinical medicine Antibiotic resistance Clarithromycin medicine biology business.industry lcsh:R Broth microdilution Original Articles 16S ribosomal RNA biology.organism_classification bacterial infections and mycoses 030228 respiratory system Amikacin Genetic marker Respiratory Infections business medicine.drug |
| Zdroj: | ERJ Open Research ERJ Open Research, Vol 5, Iss 2 (2019) |
| ISSN: | 2312-0541 |
| Popis: | Mycobacterium abscessus is associated with antibiotic resistance and poor treatment outcomes. We described within-patient changes in M. abscessus resistance to clarithromycin and amikacin. Patients with amikacin exposure and a >50-month interval between M. abscessus isolates were identified. Antimicrobial susceptibility testing was performed on the first and last isolates by broth microdilution, and genetic markers of resistance were identified. 16 patients were identified with a median amikacin exposure of 2.3 years (range 0.6–8.6 years). 15 patients also received macrolides (median 7.2 years, range 1.3–10.7 years). All initial isolates were resistant to clarithromycin (minimum inhibitory concentration (MIC) ≥8 µg·mL−1). Two patients had later susceptible isolates, which were of a different subspecies (M. abscessus subsp. massiliense) than the initial isolates (M. abscessus subsp. abscessus). All initial isolates were susceptible or intermediately resistant to amikacin, and only one patient had a resistant final isolate (MIC >64 µg·mL−1), accompanied by an A→G mutation at position 1408 of the 16S ribosomal RNA. Forced expiratory volume in 1 s decreased significantly over the study period, while smear quantity and the proportions of patients with elevated C-reactive protein or cavitary lesions all increased significantly. Despite prolonged, mostly inhaled amikacin exposure, development of amikacin resistance was uncommon in this patient population; however, disease progression continued. Patients with long-term amikacin treatment rarely develop resistance but their disease continues to progress http://bit.ly/2V7k0kH |
| Databáze: | OpenAIRE |
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