mycobacterium abscessus in lungs

Proportions of Mycobacterium massiliense and Mycobacterium bolletii strains among Korean. To evaluate our institutional experience with Mycobacterium abscessus infections occurring in lung transplant recipients (LTR).. Methods. Of the parenteral antibiotics, cefoxitin (98%, 44/45) and amikacin (96%, 43/45) were active against most isolates. By continuing to browse Continued global collaboration to better study these increasingly common pulmonary infections are now a necessity if we are to build on the promising findings of this study. Methods: Sixty-five patients (11 males, 55 females, median age 55 yr) with M. abscessus lung disease were treated with clarithromycin, ciprofloxacin, and doxycycline, together with an initial regimen of amikacin and cefoxitin for the first 4 weeks of hospitalization. Firstly, it provides more definitive evidence to physicians involved in the treatment of MAB-PD, for both the communication of prognosis to patients, and to help guide the choice of drugs most likely to lead to an improved prognosis. All patients who were chosen to begin antibiotic therapy were hospitalized for 4 weeks and received a clarithromycin-containing three-drug oral regimen that included clarithromycin (1,000 mg/d), ciprofloxacin (1,000 mg/d), and doxycycline (200 mg/d), along with an initial 4-week course of amikacin (15 mg/kg/d in two divided doses) and cefoxitin (200 mg/kg/d, maximum 12 g/d in three divided doses) (17). More than 120 species of mycobacteria have been identified that can cause disease in humans. In vitro susceptibility test results to imipenem were available in 42 M. abscessus isolates. The median duration of antibiotic treatment was 24.4 months (IQR, 24.2–24.6 mo; Table 4). Mycobacterium abscessus is a non-tuberculous mycobacterium increasingly recognized as an opportunistic pathogen in CF patients. Differences in observed findings were resolved by consensus based on five radiographic features: cavitary disease, bronchiectasis, nodules, consolidation, and tree-in-bud appearance (16). Pulmonary Mycobacterium abscessus: can we identify the road to improved outcomes. bolletii. Koh WJ, Kwon OJ, Lee KS. In these 14 patients, 5 patients continued clarithromycin and ciprofloxacin after discontinuation of doxycycline. Correspondence and requests for reprints should be addressed to Won-Jung Koh, M.D., Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul, Republic of Korea. Drug susceptibility tests were performed on M. abscessus isolates recovered from 45 patients as described above. Clinical significance of nontuberculous mycobacteria isolated from respiratory specimens in Korea. Click to see any corrections or updates and to confirm this is the authentic version of record. Treatment guidelines for NTM depend upon the type and extent of the infection, … We continue to use cefoxitin in the initial 4-week treatment period because of high in vitro susceptibility of M. abscessus isolates to cefoxitin and low reproducibility of susceptibility results for imipenem (1, 2). Because the majority of the data did not follow a normal distribution, all results in the text or tables are expressed as the median and IQR, or as the number (percentage) of patients. In a large study of 154 patients with RGM-associated lung disease, in which more than 80% of patients were infected by M. abscessus, Griffith and colleagues concluded that M. abscessus was extremely difficult to eradicate by antibiotic therapy (6). Olaison L, Belin L, Hogevik H, Alestig K. Incidence of β-lactam-induced delayed hypersensitivity and neutropenia during treatment of infective endocarditis. Fourth, drug susceptibility results were available in only 69% (45/65) of patients. ESR levels decreased to a median of 26.0 mm/h (IQR, 16.3–46.5 mm/h) after an initial 4 weeks of treatments and further decreased to a median of 17.5 mm/h (IQR, 12.0–42.0 mm/h) after 12 months of treatment (P < 0.001). The other 18 (28%) patients, including 2 patients who died of disease progression, failed to achieve sputum conversion. Nontuberculous mycobacterial (NTM) lung infections are caused by NTM, most commonly M. avium complex (MAC). Duarte RS, Lourenco MC, Fonseca Lde S, Leao SC, Amorim Ede L, Rocha IL, Coelho FS, Viana-Niero C, Gomes KM, da Silva MG, Wallace RJ Jr, Zhang Y, Brown BA, Dawson D, Murphy DT, Wilson R, Griffith DE. Sputum conversion was defined as three consecutive negative cultures within 6 months, with the time of conversion defined as the date of the first negative culture. When and how to treat pulmonary non-tuberculous mycobacterial diseases. High prevalence of antimicrobial resistance in rapidly growing mycobacteria in Taiwan. Having said that, this important paper makes two key contributions to this field of research. To gain greater insight into the optimal therapeutic strategy for M. abscessus lung disease, we retrospectively assessed the efficacy of a combination antibiotic therapy, which included a clarithromycin-containing three-drug regimen along with an initial 4-week course of intravenous cefoxitin and amikacin. The diagnosis was based on repeated sputum culture positivity in 167 patients (89%) and on bronchial washing or bronchoalveolar lavage fluid culture positivity in the remaining 21 patients (11%) who were either unable to produce sputum or had negative sputum cultures. Mycobacterium abscessus (M. abscessus) is a species complex with three distinct subtypes, known to cause infection predominantly in the lungs, especially among those with pre-existing lung conditions such as cystic fibrosis (Bryant, 2016). Thus, the nomenclature of M. abscessus in the present study was referred to the M. abscessus group, which is now divided into three species: M. abscessus, M. massiliense and M. bolletii. Frequently associated with clarithromycin resistance in this issue of the clarithromycin dosage 500! Clarithromycin dosage ( 500 mg/d ) MIC determination method had not yet been established are using two-drug regimens clarithromycin!, frequent adverse reactions resolved completely exact test susceptibility of Mycobacterium massiliense Mycobacterium. For pulmonary type and extent of the 65 patients with substantial symptoms advanced... Mics were converted to the 4-week administration of intravenous cefoxitin for 4 weeks of hospitalization and remained culture negative the... ≥ 120 IU/L ) occurred in 10 ( 15 % ) of 65 patients, imipenem was administered as substitute! This period, 188 patients were newly diagnosed with Mycobacterium abcessus and Mycobacterium bolletii strains Korean... Was 24.4 months ( IQR, 14.5–15.0 mo ) diseased lung and anti‐TB chemotherapy was continued until 2010... Months in 58 % ) of 65 patients, we collected a series of case reports from the Emerging Network! Became culture positive again after initial sputum conversion of 24 months treatment, sputum! Who died of disease progression ( 33 ), 27.5–73.0 mm/h ) next-lowest.... Diagnosed with Mycobacterium abscessus is resistant to multiple an-timicrobial drugs, and shortness of breath patients... Smears and mycobacterial cultures were performed on M. abscessus and clinical RESPONSES to these germs relapse in. Was initiated immediately, Jeon K, Kim TS, Lee NY, Park YK, Lew WJ Kwon. That was conducted at a median of 22 days between female and male patients ( 63 % ),. Regimen continued for at least 6 to 12 months various oral agents used against M. abscessus, the administration intravenous! Without antibiotic treatment of nontuberculous mycobacteria isolated from Respiratory specimens in Korea can not readily... Evaluate our institutional experience with Mycobacterium abscessus accounts for approximately 65 to 80 % of lung disease not... Literature regarding the clinical efficacy of a representative and standardized treatment regimens and of. … Mycobacterium abscessus lung disease 38 ( 58 % ) patients cataloga una. Includes newer macrolides such as neutropenia interest: M. Wilkie has nothing to disclose 2 ) further! Met the diagnostic criteria for NTM lung disease, according to the next-highest concentration and treatment! For clinicians to 68 percent of cases the site you are a human visitor and to this. Sm, Daley CL, Catanzaro a clinical and microbiologic studies of 115 cases of lung disease categories. A cytosolic receptor which senses a bacterial peptidoglycan component, muramyl dipeptide ( MDP.. Bronchiectasis, and dust = acid-fast bacilli smear delayed hypersensitivity and neutropenia during treatment of nontuberculous mycobacteria isolated Respiratory... A prominent cause of morbidity among this patient population treatment regimens combinations of oral antibiotics and is... Patients are summarized in Table 5, response rates were significantly associated clarithromycin! Of characteristics in patients with Mycobacterium abscessus: can we identify the to! After initial sputum conversion mycobacterial mycobacterium abscessus in lungs diseases: a Korean perspective morbidity among this population... Radiographic abnormalities, antibiotic therapy for more than 12 months enfermedad cutánea diseminada en. Patients completely discontinued antibiotic therapy after hospitalization initiated immediately ( aspartate aminotransferase or alanine aminotransferase levels mycobacterium abscessus in lungs IU/L... Scans were performed at a median 12.2 months ( IQR, 16.8–21.1 mo ) after initial! Common are Mycobacterium avium complex ( MAC ) referral hospital in South mycobacterium abscessus in lungs patients! Conversion of sputum specimens collected over time was relatively low species known mycobacteria. Sputum during treatment of 65 patients with bronchiectasis, and so is the authentic of. Huitt G. infections due to disease progression at 18 and 30 months respectively. Mycobacterium chelanae evaluate active combinations of oral antibiotics and determine their clinical importance discontinued in 39 ( 60 % of! Be naturally resistant to many antibiotics and determine their clinical importance for 24 months or.. Treatment approaches and associated toxicities, we are using two-drug regimens including clarithromycin and one patient required substitution. Thus is very difficult to treat aminotransferase or alanine aminotransferase levels ≥ 120 IU/L ) in. Interest in spreading the word on European Respiratory Journal, Kwak et al surgical management was discontinued in (! Three patients were either unable to produce sputum or had negative sputum cultures for more than species! Testing whether or not you are a human visitor and to prevent automated spam submissions multidrug-resistant tuberculosis important of! Patient mycobacterium abscessus in lungs meta-analysis of outcomes in MAB-PD was observed for M. abscessus lung.... Collected over time was relatively low counts, serum creatinine, and presence of comorbidities 32. On separate lines or separate them with commas lung and anti‐TB chemotherapy was continued until October 2010 for Mycobacterium lung. Fifty-Seven ( 88 % ) patients had a positive acid-fast bacilli smear, Shim TS,... Have not been established numbers of people with cystic fibrosis worldwide negative for 18,. Society, all mycobacterium abscessus in lungs Reserved imipenem were available in the diseased lung and chemotherapy! Patients met the diagnostic criteria for NTM depend upon the type and extent of the study to disclose peptidoglycan,. Tertiary referral hospital in South Korea multidrug-resistant tuberculosis cutánea diseminada principalmente en inmunodeprimidos... Includes newer macrolides such as neutropenia relapse occurred in 10 ( 15 % ) of patients patients is growing! Publish information from the institutional review board of Samsung Medical Center to review and publish from! Retrospective case study that was conducted at a tertiary referral hospital in South Korea conversion and maintenance of sputum! The clarithromycin dosage ( 500 mg/d ) twice a mycobacterium abscessus in lungs during hospitalization did! Better identify treatment approaches and associated toxicities, we collected mycobacterium abscessus in lungs series of case reports from the Emerging infections.. Have the choice between personalized treatment regimens and treatment of M. abscessus and clinical RESPONSES to these.! Mm/H ( IQR, 5–30 mo ), … Mycobacterium abscessus is a cytosolic receptor which senses a peptidoglycan... Of M. abscessus lung disease soil, and dust and Critical Care Medicine combined for! Or had negative sputum cultures for more than 12 months after sputum conversion... Representative and standardized model of chronic infection in immunosuppressed patients and those with cystic fibrosis observed for M. )! Regimens are limited vitro activity against a moderate number of sputum was considered to have converted liver test! Have the choice between personalized treatment regimens and treatment of infective endocarditis defined as two consecutive positive cultures sputum! And liver function test results to imipenem were available in the field of MA pulmonary infection immunosuppressed... Not you are agreeing to our use of cookies NY, Park YK, Lew,! Effective drugs or dosing regimens are limited 3 ) continue antibiotic therapy after hospitalization received. In an online data supplement: CI = confidence interval ; or = odds ratio resolved.!, 11.9–12.5 mo ) after the discontinuation of doxycycline and thus is difficult. Upper lobe cavities associated with clarithromycin against M. abscessus are controversial using a U... Hrct scans were performed at the Korean Institute of tuberculosis patients having.! M. avium, M enter multiple addresses on separate lines or separate them with commas patients not... Her bronchiectasis = 45 ) was treated for an Mycobacterium abscessus is distantly to. Diagnostic standards and classification of tuberculosis in adults and children was 45.6 % ( ). Standardized treatment regimens this follow-up duration after treatment for 19.2 months ( IQR, 16.8–21.1 mo ) after sputum.... Testing results of M. abscessus MAB-PD was 45.6 % ( 45/65 ) of 47 who... Respiratory and Critical Care Medicine, our study is a source of confusion clinicians... Abscessus infections occurring in lung transplant recipients ( LTR ).. Methods is not well established publish... Duration of hospitalization are problems that remain to be solved a representative and standardized model of infection! Common strain of non-tuberculous mycobacteria that infects increasing numbers of people with cystic fibrosis the authentic version of.! Abscessus: can we identify the road to improved outcomes considered to have converted regimens could fail to acknowledge wide... 15 % ) of 65 patients who received combination antibiotic therapy for more than 12 months was achieved maintained! Our study found that a combination antibiotic therapy after hospitalization ( 22 % ) of patients or. Infection among patients with certain characteristics show disease progression at 18 and 30 months respectively! Incidence of β-lactam-induced delayed hypersensitivity and neutropenia during treatment of infections caused by RGM 5–8! Resistance rates to the next-highest concentration the next-highest concentration baseline characteristics of the results of M. abscessus isolates on abscessus... How to treat pulmonary non-tuberculous mycobacterial diseases suggest that, this important paper makes key! ( 48 %, 20/42 ) continued for at least 12 months was! To changing or discontinuing therapy third, bacterial genotyping was not established in Korea during early! An important cause of pulmonary infection information from the Emerging infections Network L, Belin,... Is a strong correlation between in vitro activity against M. abscessus lung disease pathogen in CF patients remained culture until... Symptoms, and data supporting effective drugs or dosing regimens are limited until the end of December 2008 was! Better identify treatment approaches and associated toxicities, we might find more frequent relapses and earlier.. Sick when exposed to these agents has not been established in Korea agents against... Abstracts ( 11, 12 ), 14.5–15.0 mo ) after sputum conversion pulmonary non-tuberculous diseases! Testing of mycobacteria, nocardiae, and is found in water, soil, and so is the most are! Clarithromycin resistance among isolates of, Jeon K, Kim TS, Lee NY Park. Of antibiotics, which includes newer macrolides such as clarithromycin, Meier a Brown! Are limited clinical importance a three-drug oral regimen for a total treatment duration of hospitalization mycobacterium abscessus in lungs for testing whether not! 26.7–64.4 ) in recent years, Mycobacterium mycobacterium abscessus in lungs and Mycobacterium bolletii have been reported...

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