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Mazzarelli A, Nisii C, Cannas A, Vulcano A, Bartolini B, Turchi F, Butera O, Rossi A, De Giuli C, Massimino C, Stellitano C, Antonelli V, Petriccione I, Girardi E, Gualano G, Palmieri F, Fontana C. The Drug Susceptibility of Non-Tuberculous Mycobacteria (NTM) in a Referral Hospital in Rome from 2018 to 2023. Microorganisms 2024; 12:1615. [PMID: 39203457 PMCID: PMC11356625 DOI: 10.3390/microorganisms12081615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/02/2024] [Accepted: 08/06/2024] [Indexed: 09/03/2024] Open
Abstract
Background: The treatment of non-tuberculous mycobacterial (NTM) infections is challenging because of the difficulty in obtaining phenotypic (pDST) and/or molecular (mDST) drug susceptibility testing and the need of a multi-drug regimen. Objectives: The objective was to describe the in vitro susceptibility patterns of various NTM species through an analysis of susceptibility results obtained on isolates collected between 2018 and 2023. Methods: Species identification and mutations in rrs or rrl genes (mDST) were identified by a line probe assay, while the pDST was performed by broth microdilution and interpreted according to CLSI criteria. Results: We analysed 337 isolates of NTM belonging to 15 species/subspecies. The Mycobacterium avium complex (MAC) was the most common (62%); other species identified included M. gordonae (11%), M. kansasii (5%), the M. abscessus complex (8%), M. chelonae (6%), and M. fortuitum (2%). The results of pDST (claritromycin and amikacin) and mDST (rrl and rrs genes) on 66 NTM strains showed that while wild-type rrl and rrs occurred in 86.3% and 94% strains, respectively, the pDST showed 88% sensitivity for clarithromycin and 57.5% for amikacin. The main incongruity was observed for macrolides. Conclusions: Most NTM are likely to be susceptible to macrolides and aminoglycosides. The molecular identification of resistant genotypes is accurate and strongly recommended for optimal patient management.
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Affiliation(s)
- Antonio Mazzarelli
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Carla Nisii
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Angela Cannas
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Antonella Vulcano
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Barbara Bartolini
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Federica Turchi
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Ornella Butera
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Alberto Rossi
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Chiara De Giuli
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Chiara Massimino
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Chiara Stellitano
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Valentina Antonelli
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Ivano Petriccione
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
| | - Enrico Girardi
- Scientific Direction, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, 00149 Rome, Italy;
| | - Gina Gualano
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, 00149 Rome, Italy; (G.G.); (F.P.)
| | - Fabrizio Palmieri
- Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, 00149 Rome, Italy; (G.G.); (F.P.)
| | - Carla Fontana
- Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI “Lazzaro Spallanzani”, IRCCS, Via Portuense 292, 00149 Rome, Italy; (A.M.); (A.C.); (A.V.); (B.B.); (F.T.); (O.B.); (A.R.); (C.D.G.); (C.M.) (C.S.); (V.A.); (I.P.); (C.F.)
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