Mycobacteriological characteristics and treatment outcomes in extrapulmonary Mycobacterium abscessus complex infections

Suk Hyeon Jeong, Su Young Kim, Hee Jae Huh, Chang Seok Ki, Nam Yong Lee, Cheol In Kang, Doo Ryeon Chung, Kyong Ran Peck, SungJae Shin, Won Jung Koh

Research output: Contribution to journalArticle

17 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)49-56
Number of pages8
JournalInternational Journal of Infectious Diseases
Volume60
DOIs
Publication statusPublished - 2017 Jul 1

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Mycobacterium
Infection
Clarithromycin
Macrolides
Genes

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Jeong, Suk Hyeon ; Kim, Su Young ; Huh, Hee Jae ; Ki, Chang Seok ; Lee, Nam Yong ; Kang, Cheol In ; Chung, Doo Ryeon ; Peck, Kyong Ran ; Shin, SungJae ; Koh, Won Jung. / Mycobacteriological characteristics and treatment outcomes in extrapulmonary Mycobacterium abscessus complex infections. In: International Journal of Infectious Diseases. 2017 ; Vol. 60. pp. 49-56.
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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.",
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Mycobacteriological characteristics and treatment outcomes in extrapulmonary Mycobacterium abscessus complex infections. / Jeong, Suk Hyeon; Kim, Su Young; Huh, Hee Jae; Ki, Chang Seok; Lee, Nam Yong; Kang, Cheol In; Chung, Doo Ryeon; Peck, Kyong Ran; Shin, SungJae; Koh, Won Jung.

In: International Journal of Infectious Diseases, Vol. 60, 01.07.2017, p. 49-56.

Research output: Contribution to journalArticle

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AU - Jeong, Suk Hyeon

AU - Kim, Su Young

AU - Huh, Hee Jae

AU - Ki, Chang Seok

AU - Lee, Nam Yong

AU - Kang, Cheol In

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AU - Peck, Kyong Ran

AU - Shin, SungJae

AU - Koh, Won Jung

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N2 - 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.

AB - 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.

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