Clinical significance of differentiation of Mycobacterium massiliense from Mycobacterium abscessus

Won Jung Koh, Kyeongman Jeon, Nam Yong Lee, Bum Joon Kim, Yoon Hoh Kook, Seung Heon Lee, Young Kil Park, Chang Ki Kim, Sung Jae Shin, Gwen A. Huitt, Charles L. Daley, O. Jung Kwon

Research output: Contribution to journalArticle

286 Citations (Scopus)

Abstract

Rationale: Mycobacterium massiliense has been recognized as a separate species from Mycobacterium abscessus; however, little is known regarding the clinical impact of this differentiation. Objectives: To compare clinical features and treatment outcomes between patients with M. abscessus lung disease and those with M. massiliense lung disease. Methods: We performed molecular identification of stored clinical isolates of M. abscessus complex and compared clinical characteristics and treatment outcomes between 64 patients with M. abscessus lung disease and 81 patients with M. massiliense lung disease. Measurements and Main Results: The clinical and radiographic manifestations of disease causedb yeach species were similar. Standardized combination antibiotic therapy, including a clarithromycin-containing regimen in combination with an initial 4-week course of cefoxitin and amikacin, was given to 57 patients (24 with M. abscessus and 33 with M. massiliense) for more than 12 months. The proportion of patients with sputum conversion and maintenance of negative sputum cultures was higher in patients with M. massiliense infection (88%) than in those with M. abscessus infection (25%; P< 0.001). Inducible resistance to clarithromycin (minimal inhibitory concentrations ≥32 μg/ml) was found in all tested M. abscessus isolates (n = 19), but in none of the M. massiliense isolates (n = 28). Conclusions: Treatment response rates to combination antibiotic therapy including clarithromycin were much higher in patients with M.massiliense lung disease than inthose with M. abscessus lung disease. The inducible resistance to clarithromycin could explain the lack of efficacy of clarithromycin-containing antibiotic therapy against M. abscessus lung disease.

Original languageEnglish
Pages (from-to)405-410
Number of pages6
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume183
Issue number3
DOIs
Publication statusPublished - 2011 Feb 1
Externally publishedYes

Fingerprint

Mycobacterium
Lung Diseases
Clarithromycin
Anti-Bacterial Agents
Sputum
Cefoxitin
Amikacin
Therapeutics
Infection
Maintenance

Keywords

  • Clarithromycin
  • Mycobacterium abscessus
  • Mycobacterium massiliense
  • Nontuberculous mycobacteria
  • Treatment outcome

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Clinical significance of differentiation of Mycobacterium massiliense from Mycobacterium abscessus. / Koh, Won Jung; Jeon, Kyeongman; Lee, Nam Yong; Kim, Bum Joon; Kook, Yoon Hoh; Lee, Seung Heon; Park, Young Kil; Kim, Chang Ki; Shin, Sung Jae; Huitt, Gwen A.; Daley, Charles L.; Kwon, O. Jung.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 183, No. 3, 01.02.2011, p. 405-410.

Research output: Contribution to journalArticle

Koh, WJ, Jeon, K, Lee, NY, Kim, BJ, Kook, YH, Lee, SH, Park, YK, Kim, CK, Shin, SJ, Huitt, GA, Daley, CL & Kwon, OJ 2011, 'Clinical significance of differentiation of Mycobacterium massiliense from Mycobacterium abscessus', American Journal of Respiratory and Critical Care Medicine, vol. 183, no. 3, pp. 405-410. https://doi.org/10.1164/rccm.201003-0395OC
Koh, Won Jung ; Jeon, Kyeongman ; Lee, Nam Yong ; Kim, Bum Joon ; Kook, Yoon Hoh ; Lee, Seung Heon ; Park, Young Kil ; Kim, Chang Ki ; Shin, Sung Jae ; Huitt, Gwen A. ; Daley, Charles L. ; Kwon, O. Jung. / Clinical significance of differentiation of Mycobacterium massiliense from Mycobacterium abscessus. In: American Journal of Respiratory and Critical Care Medicine. 2011 ; Vol. 183, No. 3. pp. 405-410.
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abstract = "Rationale: Mycobacterium massiliense has been recognized as a separate species from Mycobacterium abscessus; however, little is known regarding the clinical impact of this differentiation. Objectives: To compare clinical features and treatment outcomes between patients with M. abscessus lung disease and those with M. massiliense lung disease. Methods: We performed molecular identification of stored clinical isolates of M. abscessus complex and compared clinical characteristics and treatment outcomes between 64 patients with M. abscessus lung disease and 81 patients with M. massiliense lung disease. Measurements and Main Results: The clinical and radiographic manifestations of disease causedb yeach species were similar. Standardized combination antibiotic therapy, including a clarithromycin-containing regimen in combination with an initial 4-week course of cefoxitin and amikacin, was given to 57 patients (24 with M. abscessus and 33 with M. massiliense) for more than 12 months. The proportion of patients with sputum conversion and maintenance of negative sputum cultures was higher in patients with M. massiliense infection (88{\%}) than in those with M. abscessus infection (25{\%}; P< 0.001). Inducible resistance to clarithromycin (minimal inhibitory concentrations ≥32 μg/ml) was found in all tested M. abscessus isolates (n = 19), but in none of the M. massiliense isolates (n = 28). Conclusions: Treatment response rates to combination antibiotic therapy including clarithromycin were much higher in patients with M.massiliense lung disease than inthose with M. abscessus lung disease. The inducible resistance to clarithromycin could explain the lack of efficacy of clarithromycin-containing antibiotic therapy against M. abscessus lung disease.",
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AU - Park, Young Kil

AU - Kim, Chang Ki

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AU - Daley, Charles L.

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KW - Nontuberculous mycobacteria

KW - Treatment outcome

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