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Drug resistance profile of Mycobacterium kansasii clinical isolates before and after 2-month empirical antimycobacterial treatment.
Zhang, Yangyi; Yu, Chenlei; Jiang, Yuan; Zheng, Xubin; Wang, Lili; Li, Jing; Shen, Xin; Xu, Biao.
Afiliación
  • Zhang Y; Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, People's Republic of China; Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China; Shanghai
  • Yu C; Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China; Shanghai Institutes of Preventive Medicine, Shanghai, People's Republic of China.
  • Jiang Y; Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China; Shanghai Institutes of Preventive Medicine, Shanghai, People's Republic of China.
  • Zheng X; Clinic and Research Center of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University, Shanghai, People's Republic of China.
  • Wang L; Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China; Shanghai Institutes of Preventive Medicine, Shanghai, People's Republic of China.
  • Li J; Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China; Shanghai Institutes of Preventive Medicine, Shanghai, People's Republic of China.
  • Shen X; Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China; Shanghai Institutes of Preventive Medicine, Shanghai, People's Republic of China. Electronic address: shenxin@scdc.sh.cn.
  • Xu B; Department of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai, People's Republic of China. Electronic address: bxu@shmu.edu.cn.
Clin Microbiol Infect ; 29(3): 353-359, 2023 Mar.
Article en En | MEDLINE | ID: mdl-36209990
OBJECTIVES: Mycobacterium kansasii pulmonary disease is frequently misdiagnosed and treated as tuberculosis, especially in countries with high tuberculosis burden. This study aimed to investigate the drug resistance profile of M.kansasii in patients with M.kansasii pulmonary disease in Shanghai and to determine the variations in drug resistance after 2 months of antimycobacterial treatment. METHODS: All patients with a diagnosis of M.kansasii pulmonary disease from 2017 to 2019 in Shanghai were retrospectively analysed. Whole-genome sequencing was performed, and the minimum inhibitory concentration (MIC) to antimycobacterial drugs was measured using the broth microdilution method. RESULTS: In total, 191 patients had a diagnosis of M.kansasii pulmonary disease. Of them, 24.1% (46/191) had persistent positive culture after 2 months of antimycobacterial treatment. Whole-genome sequencing revealed that the 46 paired isolates had a difference of <17 single nucleotide polymorphisms, thus excluding the possibility of exogenous reinfection. More than 90% of the baseline isolates were sensitive to rifampin, clarithromycin, moxifloxacin, or amikacin, whereas a high resistance to ethambutol (118/191, 61.8%) and 4 µg/mL of isoniazid (32/191, 16.8%) were observed. Two isolates presented high resistance to rifamycin (i.e. a rifampin MIC of >8 µg/mL and a rifabutin MIC of 8 µg/mL) both containing the rpoB mutation (S454L). The increase of MIC to rifampin, ethambutol, and/or isoniazid was identified in 50.0% (23/46) of the patients. DISCUSSION: A high prevalence of innate resistance to ethambutol and isoniazid was observed among circulating M.kansasii clinical strains in Shanghai. The increase in drug resistance under empirical antimycobacterial treatment highlighted the urgency of definitive species identification before initiating treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Mycobacterium kansasii / Enfermedades Pulmonares Tipo de estudio: Risk_factors_studies Límite: Humans País/Región como asunto: Asia Idioma: En Revista: Clin Microbiol Infect Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Mycobacterium kansasii / Enfermedades Pulmonares Tipo de estudio: Risk_factors_studies Límite: Humans País/Región como asunto: Asia Idioma: En Revista: Clin Microbiol Infect Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido