Abstract
Background. Treatment outcomes of patients with Mycobacterium abscessus subspecies abscessus lung disease are poor, and the microbial characteristics associated with treatment outcomes have not been studied systematically. The purpose of this study was to identify associations between microbial characteristics and treatment outcomes in patients with M. abscessus lung disease. Methods. Sixty-seven consecutive patients with M. abscessus lung disease undergoing antibiotic treatment for ≥12 months between January 2002 and December 2012 were included. Morphotypic and genetic analyses were performed on isolates from 44 patients. Results. Final sputum conversion to culture negative occurred in 34 (51%) patients. Compared to isolates from 24 patients with persistently positive cultures, pretreatment isolates from 20 patients with final negative conversion were more likely to exhibit smooth colonies (9/20, 45% vs 2/24, 8%; P = .020), susceptibility to clarithromycin (7/20, 35% vs 1/24, 4%; P = .015), and be of the C28 sequevar with regard to the erm(41) gene (6/20, 30% vs 1/24, 4%; P = .035). Mycobacterium abscessus lung disease recurred in 5 (15%) patients after successful completion of antibiotic therapy. Genotypic analysis revealed that most episodes (22/24, 92%) of persistently positive cultures during antibiotic treatment and all cases of microbiologic recurrence after treatment completion were caused by different M. abscessus genotypes within a patient. Conclusions. Precise identification to the subspecies level and analysis of mycobacterial characteristics could help predict treatment outcomes in patients with M. abscessus lung disease. Treatment failures and recurrences are frequently associated with multiple genotypes, suggesting reinfection. Clinical Trials Registration. NCT00970801.
| Original language | English |
|---|---|
| Pages (from-to) | 309-316 |
| Number of pages | 8 |
| Journal | Clinical Infectious Diseases |
| Volume | 64 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2017 Jan 1 |
| Externally published | Yes |
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Keywords
- Lung disease
- Macrolides
- Mycobacterium abscessus
- Nontuberculous mycobacteria
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases
Cite this
Mycobacterial characteristics and treatment outcomes in mycobacterium abscessus lung disease. / Koh, Won Jung; Jeong, Byeong Ho; Kim, Su Young; Jeon, Kyeongman; Park, Kyoung Un; Jhun, Byung Woo; Lee, Hyun; Park, Hye Yun; Kim, Dae Hun; Huh, Hee Jae; Ki, Chang Seok; Lee, Nam Yong; Kim, Hong Kwan; Choi, Yong Soo; Kim, Jhingook; Lee, Seung Heon; Kim, Chang Ki; Shin, Sung Jae; Daley, Charles L.; Kim, Hojoong; Kwon, O. Jung.
In: Clinical Infectious Diseases, Vol. 64, No. 3, 01.01.2017, p. 309-316.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Mycobacterial characteristics and treatment outcomes in mycobacterium abscessus lung disease
AU - Koh, Won Jung
AU - Jeong, Byeong Ho
AU - Kim, Su Young
AU - Jeon, Kyeongman
AU - Park, Kyoung Un
AU - Jhun, Byung Woo
AU - Lee, Hyun
AU - Park, Hye Yun
AU - Kim, Dae Hun
AU - Huh, Hee Jae
AU - Ki, Chang Seok
AU - Lee, Nam Yong
AU - Kim, Hong Kwan
AU - Choi, Yong Soo
AU - Kim, Jhingook
AU - Lee, Seung Heon
AU - Kim, Chang Ki
AU - Shin, Sung Jae
AU - Daley, Charles L.
AU - Kim, Hojoong
AU - Kwon, O. Jung
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background. Treatment outcomes of patients with Mycobacterium abscessus subspecies abscessus lung disease are poor, and the microbial characteristics associated with treatment outcomes have not been studied systematically. The purpose of this study was to identify associations between microbial characteristics and treatment outcomes in patients with M. abscessus lung disease. Methods. Sixty-seven consecutive patients with M. abscessus lung disease undergoing antibiotic treatment for ≥12 months between January 2002 and December 2012 were included. Morphotypic and genetic analyses were performed on isolates from 44 patients. Results. Final sputum conversion to culture negative occurred in 34 (51%) patients. Compared to isolates from 24 patients with persistently positive cultures, pretreatment isolates from 20 patients with final negative conversion were more likely to exhibit smooth colonies (9/20, 45% vs 2/24, 8%; P = .020), susceptibility to clarithromycin (7/20, 35% vs 1/24, 4%; P = .015), and be of the C28 sequevar with regard to the erm(41) gene (6/20, 30% vs 1/24, 4%; P = .035). Mycobacterium abscessus lung disease recurred in 5 (15%) patients after successful completion of antibiotic therapy. Genotypic analysis revealed that most episodes (22/24, 92%) of persistently positive cultures during antibiotic treatment and all cases of microbiologic recurrence after treatment completion were caused by different M. abscessus genotypes within a patient. Conclusions. Precise identification to the subspecies level and analysis of mycobacterial characteristics could help predict treatment outcomes in patients with M. abscessus lung disease. Treatment failures and recurrences are frequently associated with multiple genotypes, suggesting reinfection. Clinical Trials Registration. NCT00970801.
AB - Background. Treatment outcomes of patients with Mycobacterium abscessus subspecies abscessus lung disease are poor, and the microbial characteristics associated with treatment outcomes have not been studied systematically. The purpose of this study was to identify associations between microbial characteristics and treatment outcomes in patients with M. abscessus lung disease. Methods. Sixty-seven consecutive patients with M. abscessus lung disease undergoing antibiotic treatment for ≥12 months between January 2002 and December 2012 were included. Morphotypic and genetic analyses were performed on isolates from 44 patients. Results. Final sputum conversion to culture negative occurred in 34 (51%) patients. Compared to isolates from 24 patients with persistently positive cultures, pretreatment isolates from 20 patients with final negative conversion were more likely to exhibit smooth colonies (9/20, 45% vs 2/24, 8%; P = .020), susceptibility to clarithromycin (7/20, 35% vs 1/24, 4%; P = .015), and be of the C28 sequevar with regard to the erm(41) gene (6/20, 30% vs 1/24, 4%; P = .035). Mycobacterium abscessus lung disease recurred in 5 (15%) patients after successful completion of antibiotic therapy. Genotypic analysis revealed that most episodes (22/24, 92%) of persistently positive cultures during antibiotic treatment and all cases of microbiologic recurrence after treatment completion were caused by different M. abscessus genotypes within a patient. Conclusions. Precise identification to the subspecies level and analysis of mycobacterial characteristics could help predict treatment outcomes in patients with M. abscessus lung disease. Treatment failures and recurrences are frequently associated with multiple genotypes, suggesting reinfection. Clinical Trials Registration. NCT00970801.
KW - Lung disease
KW - Macrolides
KW - Mycobacterium abscessus
KW - Nontuberculous mycobacteria
UR - http://www.scopus.com/inward/record.url?scp=85019678204&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019678204&partnerID=8YFLogxK
U2 - 10.1093/cid/ciw724
DO - 10.1093/cid/ciw724
M3 - Article
C2 - 28011608
AN - SCOPUS:85019678204
VL - 64
SP - 309
EP - 316
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 3
ER -