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Narimisa N, Goodarzi F, Bostanghadiri N, Masjedian Jazi F. Prevalence of antibiotic resistance in clinical isolates of Mycobacterium kansasii: a systematic review and meta-analysis. Expert Rev Anti Infect Ther 2024:1-11. [PMID: 38294514 DOI: 10.1080/14787210.2024.2313051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/30/2023] [Indexed: 02/01/2024]
Abstract
INTRODUCTION The prevalence of diseases caused by non-tuberculous mycobacteria (NTM), including M. kansasii, is increasing, necessitating further information to guide prevention, control, and treatment strategies. AREAS COVERED A comprehensive analysis of articles published until February 2023 was conducted on PubMed, Web of Science, and Scopus databases to investigate antibiotic resistance in M. kansasii species. Stata software version 17 was employed for all analyses. EXPERT OPINION A total of 1647 articles were obtained through database search. After removing duplicates and unrelated studies, 17 cross-sectional studies that examined the breakpoints proposed by CLSI were included. The rates of resistance of M. kansasii to various antibiotics were as follows: clarithromycin (0%), rifampin (1%), amikacin (0%), ciprofloxacin (14%), linezolid (0%), moxifloxacin (0%), rifabutin (1%), doxycycline (96%), and SXT (49%). Our findings underscore the importance of managing and monitoring the use of these antibiotics, as well as the need for further studies to elucidate the exact mechanism of M. kansasii resistance to these antibiotics.
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Affiliation(s)
- Negar Narimisa
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Forough Goodarzi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Narjess Bostanghadiri
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Faramarz Masjedian Jazi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Guo Y, Li X, Xiao Q, Yang J, Tao R, Xu L, Zhu B. Mycobacterium colombiense Pneumonia in HIV-Infected Patients: Three Case Reports and a Literature Review. Infect Drug Resist 2023; 16:7767-7773. [PMID: 38148773 PMCID: PMC10750772 DOI: 10.2147/idr.s441083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/19/2023] [Indexed: 12/28/2023] Open
Abstract
Background Mycobacterium colombiense pneumonia in HIV-infected patients is relatively unusual but is associated with a high mortality rate, as well as high rates of misdiagnosis and delayed diagnosis. Clinical metagenome next-generation sequencing (mNGS) may have potential for its accurate and timely diagnosis. Case Presentation We retrospectively reviewed the medical records of three HIV-infected patients who presented with M. colombiense pneumonia in Zhejiang Province between January 2019 and December 2020. No specific clinical presentations or radiological manifestations were found in any of the patients. The detection of M. colombiense is 28-55 days earlier using mNGS on bronchoalveolar lavage fluid (BALF) compared to traditional culture methods. A combined treatment of rifabutin, clarithromycin, or azithromycin, and ethambutol did not provide timely relief of symptoms in these three patients. In the early stage of treatment, moxifloxacin and linezolid were used for several weeks. The average course of treatment for all three patients was close to 17 months. Conclusion We recommend early BALF mNGS for fast and accurate diagnosis of M. colombiense pneumonia in HIV-infected patients with low CD4 counts and long duration of symptoms. Further, moxifloxacin and linezolid may be beneficial in the early stage of treatment.
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Affiliation(s)
- Yongzheng Guo
- The Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Xiaofeng Li
- The Department of Infectious Diseases, Huzhou Central Hospital, Huzhou, Zhejiang, People’s Republic of China
| | - Qianggu Xiao
- The Department of Infectious Diseases, Xiaoshan First People’s Hospital, Hangzhou, Zhejiang, People’s Republic of China
| | - Jie Yang
- The Department of Infectious Diseases, Lishui Municipal Central Hospital, Lishui, Zhejiang, People’s Republic of China
| | - Ran Tao
- The Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Lijun Xu
- The Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
| | - Biao Zhu
- The Department of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China
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Wang XY, Jia QN, Li J. Treatment of non-tuberculosis mycobacteria skin infections. Front Pharmacol 2023; 14:1242156. [PMID: 37731736 PMCID: PMC10508292 DOI: 10.3389/fphar.2023.1242156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/25/2023] [Indexed: 09/22/2023] Open
Abstract
Non-tuberculosis mycobacteria (NTM) skin infections have become increasingly prevalent in recent years, presenting a unique challenge in clinical management. This review explored the complexities of NTM infections localized to the superficial tissues and provided valuable insights into the optimal therapeutic strategies. The antibiotic selection should base on NTM species and their susceptibility profiles. It is recommended to adopt a comprehensive approach that considers the unique characteristics of superficial tissues to improve treatment effectiveness and reduce the incidence of adverse reactions, infection recurrence, and treatment failure. Infection control measures, patient education, and close monitoring should complement the treatment strategies to achieve favorable outcomes in managing NTM skin infections. Further efforts are warranted to elucidate factors and mechanisms contributing to treatment resistance and relapse. Future research should focus on exploring novel treatment options, innovative drug development/delivery platforms, and precise methodologies for determining therapeutic duration. Longitudinal studies are also needed to assess the long-term safety profiles of the integrated approaches.
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Affiliation(s)
| | | | - Jun Li
- Department of Dermatology and Venereology, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China
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Fernandez-Pittol M, Batista-Arnau S, Román A, San Nicolás L, Oliver L, González-Moreno O, Martínez JA, Amaro-Rodríguez R, Soler N, Gené A, González-Cuevas A, Tudó G, Gonzalez-Martin J. Differences in Drug-Susceptibility Patterns between Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium chimaera Clinical Isolates: Prospective 8.5-Year Analysis by Three Laboratories. Antibiotics (Basel) 2022; 12:antibiotics12010064. [PMID: 36671265 PMCID: PMC9854862 DOI: 10.3390/antibiotics12010064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
Background: It has been suggested that Mycobacterium avium, Mycobacterium intracellulare, and M. chimaera have differential drug susceptibility patterns. We prospectively analyzed and compared the drug susceptibility patterns among these species over an 8.5-year period. Methods: A microdilution method (Slomyco®) was performed for drug susceptibility testing of 402 M. avium, 273 M. intracellulare, and 139 M. chimaera clinical isolates. Results: M. avium showed significantly higher resistance to moxifloxacin, ciprofloxacin, rifampicin, ethambutol, streptomycin, linezolid, cotrimoxazole, and clarithromycin. M. avium also showed higher minimum inhibitory concentrations (MIC) than M. intracellulare and M. chimaera against all drugs except ethionamide, to which M. intracellulare and M. chimaera showed greater resistance. Conclusions: Our series demonstrated differential drug resistance patterns among the most frequent M. avium complex species. M. avium was more resistant than M. intracellulare and M. chimaera versus eight antibiotics and showed greater MIC values to most of the antibiotics studied. These data suggest that knowledge of the local distribution and susceptibility profiles of these pathogens is essential for adequate clinical management.
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Affiliation(s)
- Mariana Fernandez-Pittol
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain
- ISGLOBAL, Institute for Global Health, c/Rosselló 132, 08036 Barcelona, Spain
| | - Sara Batista-Arnau
- ISGLOBAL, Institute for Global Health, c/Rosselló 132, 08036 Barcelona, Spain
- Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, c/Casanova 143, 080036 Barcelona, Spain
| | - Angely Román
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain
| | - Lorena San Nicolás
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain
| | - Laura Oliver
- SYNLAB Diagnósticos Globales, Departamento de Microbiología y Parasitología, 08950 Esplugues de Llobregat, Spain
| | - Olga González-Moreno
- SYNLAB Diagnósticos Globales, Departamento de Microbiología y Parasitología, 08950 Esplugues de Llobregat, Spain
| | - José Antonio Martínez
- Servei de Malalties Infeccioses, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
- CIBER of Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Rosanel Amaro-Rodríguez
- Department of Pneumonology, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
| | - Néstor Soler
- Department of Pneumonology, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
| | - Amadeu Gené
- Laboratori, Hospital Sant Joan de Deu, 08950 Esplugues de Llobregat, Spain
| | | | - Griselda Tudó
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain
- ISGLOBAL, Institute for Global Health, c/Rosselló 132, 08036 Barcelona, Spain
- Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, c/Casanova 143, 080036 Barcelona, Spain
- Correspondence: (G.T.); (J.G.-M.)
| | - Julian Gonzalez-Martin
- Servei de Microbiologia, CDB, Hospital Clínic de Barcelona, c/Villarroel 170, 08036 Barcelona, Spain
- ISGLOBAL, Institute for Global Health, c/Rosselló 132, 08036 Barcelona, Spain
- Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, c/Casanova 143, 080036 Barcelona, Spain
- CIBER of Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (G.T.); (J.G.-M.)
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Mason M, Gregory E, Foster K, Klatt M, Zoubek S, Eid A. Pharmacologic management of Mycobacterium chimaera Infections: A Primer for Clinicians. Open Forum Infect Dis 2022; 9:ofac287. [PMID: 35866101 PMCID: PMC9297092 DOI: 10.1093/ofid/ofac287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/13/2022] [Indexed: 11/28/2022] Open
Abstract
Mycobacterium chimaera, a member of the Mycobacterium avium complex, can cause infections in individuals after open heart surgery due to contaminated heater-cooler units. The diagnosis can be challenging, as the incubation period can be quite variable, and symptoms are nonspecific. In addition to aggressive surgical management, combination pharmacologic therapy is the cornerstone of therapy, which should consist of a macrolide, a rifamycin, ethambutol, and amikacin. Multiple second-line agents may be utilized in the setting of intolerances or toxicities. In vitro susceptibility of these agents is similar to activity against other species in the Mycobacterium avium complex. Drug–drug interactions are frequently encountered, as many individuals have chronic medical comorbidities and are prescribed medications that interact with the first-line agents used to treat M. chimaera. Recognition of these drug–drug interactions and appropriate management are essential for optimizing treatment outcomes.
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Affiliation(s)
- Matt Mason
- The University of Kansas Health System, Department of Pharmacy , Kansas City, KS , USA
| | - Eric Gregory
- The University of Kansas Health System, Department of Pharmacy , Kansas City, KS , USA
| | - Keith Foster
- The University of Kansas Health System, Department of Pharmacy , Kansas City, KS , USA
| | - Megan Klatt
- The University of Kansas Health System, Department of Pharmacy , Kansas City, KS , USA
| | - Sara Zoubek
- The University of Kansas Health System, Department of Pharmacy , Kansas City, KS , USA
| | - Albert Eid
- Kansas University Medical Center, Department of Infectious Diseases , Kansas City, KS , USA
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Cantillon D, Goff A, Taylor S, Salehi E, Fidler K, Stoneham S, Waddell SJ. Searching for new therapeutic options for the uncommon pathogen Mycobacterium chimaera: an open drug discovery approach. THE LANCET. MICROBE 2022; 3:e382-e391. [PMID: 35544099 PMCID: PMC9042791 DOI: 10.1016/s2666-5247(21)00326-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/05/2021] [Accepted: 11/19/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Mycobacterium chimaera is a slowly growing non-tuberculous mycobacterium associated with outbreaks of fatal infections in patients after cardiac surgery, and it is increasingly being detected in patients with chronic lung conditions. M chimaera can cause disseminated disease, osteomyelitis, and chronic skin or soft-tissue infections. We aimed to find new inhibitory compounds and drug repurposing opportunities for M chimaera, as current therapeutic options often result in poor outcomes. METHODS In an open drug discovery approach, we screened the Medicines for Malaria Venture (MMV) Pathogen Box to assess the in-vitro antimicrobial drug susceptibility of M chimaera compared with the antimicrobial drug susceptibility of the slowly growing, major human pathogen Mycobacterium tuberculosis, and the rapidly growing Mycobacterium abscessus reference strains. Compounds identified from an initial resazurin microtitre cell viability assay screen were further characterised by determining the minimum inhibitory concentration (MIC) of MMV Pathogen Box compounds against M chimaera; and the MICs of a panel of 20 drugs commonly used to treat mycobacterial infections against M tuberculosis, M abscessus, and M chimaera. We also assessed the time-kill kinetics of doxycycline, clarithromycin, ethambutol, and rifabutin against M chimaera. FINDINGS M chimaera was inhibited by 21 (5%) of 400 compounds in the Pathogen Box. Ten compounds were active against all three mycobacteria. MMV675968, with activity against slowly growing mycobacteria that probably targets folate metabolism, had a mean MIC of 2·22 μM (0·80 μg/mL) against M chimaera. Antimicrobial susceptibility testing showed that oxazolidinones such as linezolid (mean MIC 3·13 μg/mL) were active against M chimaera and that bedaquiline was the most potent compound (mean MIC 0·02 μg/mL). Doxycycline, a broad-spectrum antimicrobial drug with excellent tissue penetration properties, also inhibited M chimaera with a mean MIC of 6·25 μg/mL. INTERPRETATION Molecular diagnostics present an opportunity for more effective, targeted drug therapies-treating bacterial infections at the species level. Using an open drug discovery platform, we identified compounds that inhibit the newly recognised pathogen M chimaera. The existing evidence base is poor and the option for expensive drug discovery is improbable; therefore, we have also found options for drug repurposing. Future in-vivo efficacy studies will reveal whether these findings result in new, targeted treatment regimens for M chimaera. FUNDING Wellcome Trust, National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs), and the University of Sussex Junior Research Associate scheme.
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Affiliation(s)
- Daire Cantillon
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Falmer, UK
| | - Aaron Goff
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Falmer, UK
| | - Stuart Taylor
- Department of Microbiology and Infection, Royal Sussex County Hospital, Brighton, UK
| | - Emad Salehi
- School of Pharmacy, University of Sussex, Falmer, UK
| | - Katy Fidler
- Clinical and Experimental Medicine, Brighton and Sussex Medical School, University of Sussex, Falmer, UK; Academic Department of Paediatrics, Royal Alexandra Children's Hospital, Brighton, UK
| | - Simon Stoneham
- Department of Microbiology and Infection, Royal Sussex County Hospital, Brighton, UK
| | - Simon J Waddell
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Falmer, UK.
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Pidot SJ, Porter JL, Lister T, Stinear TP. In vitro activity of SPR719 against Mycobacterium ulcerans, Mycobacterium marinum and Mycobacterium chimaera. PLoS Negl Trop Dis 2021; 15:e0009636. [PMID: 34310615 PMCID: PMC8341698 DOI: 10.1371/journal.pntd.0009636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 08/05/2021] [Accepted: 07/07/2021] [Indexed: 11/18/2022] Open
Abstract
Nontuberculosis mycobacterial (NTM) infections are increasing in prevalence across the world. In many cases, treatment options for these infections are limited. However, there has been progress in recent years in the development of new antimycobacterial drugs. Here, we investigate the in vitro activity of SPR719, a novel aminobenzimidazole antibiotic and the active form of the clinical-stage compound, SPR720, against several isolates of Mycobacterium ulcerans, Mycobacterium marinum and Mycobacterium chimaera. We show that SPR719 is active against these NTM species with a MIC range of 0.125–4 μg/ml and that this compares favorably with the commonly utilized antimycobacterial antibiotics, rifampicin and clarithromycin. Our findings suggest that SPR720 should be further evaluated for the treatment of NTM infections. Nontuberculosis mycobacteria represent a large group of diverse bacteria that live across a range of environments. Human contact with the habitats in which these organisms live can result in opportunistic infections. Among the NTM, Mycobacterium ulcerans causes necrotic skin ulcers that can lead to significant long term physical impairment; Mycobacterium marinum causes granulomatous skin lesions; and Mycobacterium chimaera has been linked to contaminated heater-cooler units used during cardiac surgery, resulting in prosthetic heart valve infections that are particularly difficult to treat. We performed laboratory experiments to test the susceptibility of these NTM species (M. ulcerans, M. marinum and M. chimaera) to a recently developed antibiotic, SPR719. We found that SPR719 inhibits the growth of these mycobacteria at concentration ranges similar to or better than commonly used anti-mycobacterial antibiotics. As SPR720, the oral prodrug of SPR719, has recently completed a Phase I safety, tolerability and PK study in healthy human volunteers, the potential exists for this product to be explored for the treatment of NTM infections, where new treatment options are urgently needed.
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Affiliation(s)
- Sacha J. Pidot
- Department of Microbiology and Immunology at the Doherty Institute, University of Melbourne, Melbourne, Australia
- * E-mail:
| | - Jessica L. Porter
- Department of Microbiology and Immunology at the Doherty Institute, University of Melbourne, Melbourne, Australia
| | - Troy Lister
- Spero Therapeutics, Cambridge, Massachusetts, United States of America
| | - Timothy P. Stinear
- Department of Microbiology and Immunology at the Doherty Institute, University of Melbourne, Melbourne, Australia
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