Different clinical features of patients with pulmonary disease caused by various Mycobacterium avium–intracellulare complex subspecies and antimicrobial susceptibility
Journal
International Journal of Infectious Diseases
Journal Volume
98
Pages
33-40
Date Issued
2020
Abstract
Objectives: Characteristics of the Mycobacterium avium–intracellulare complex pulmonary disease (MAC-PD) caused by distinct subspecies remain uncertain. Methods: This study was conducted from 2013–2015 in three hospitals in Taiwan. Results: Among the 144 patients with MAC-PD, 57 (39.6%), 37 (25.7%), 37 (25.7%), and 13 (9.0%) were infected with Mycobacterium intracellulare subspecies intracellulare (MIsI), Mycobacterium avium subspecies hominissuis (MAsH), Mycobacterium intracellulare subspecies chimaera (MIsC), and others, respectively. Patients with MAsH-PD were younger (p = 0.010) with higher human immunodeficiency virus infection rates (27.0%, 0.0%, 0.0%, and 7.7% for MAsH-PD, MIsC-PD, MIsI-PD, and others, respectively; p < 0.001). Twenty-two (15.3%) patients reported spontaneous culture-negative conversion, but 15 (10.4%) and 33 (22.9%) patients developed radiographic progression and unfavorable outcomes, especially MAsH-PD. The susceptibility rates to clarithromycin and inhaled amikacin were both 98.6%. MAsH demonstrated the lowest rate of resistance to moxifloxacin (66.7%, 97.3%, 89.1%, and 92.3% for MAsH-PD, MIsC-PD, MIsI-PD, and others, respectively; p = 0.001) and MIsI isolates had the highest rate of resistance to intravenous amikacin (25%, 13.5%, 38.2%, and 15.4% for MAsH-PD, MIsC-PD, MIsI-PD, and others, respectively; p = 0.024). Conclusions: Pulmonary disease caused by distinct MAC subspecies had different outcomes and drug susceptibility. The local prevalence of species needs to be monitored. ? 2020 The Author(s)
SDGs
Other Subjects
amikacin; ciprofloxacin; clarithromycin; cotrimoxazole; doxycycline; ethambutol; ethionamide; isoniazid; linezolid; moxifloxacin; rifabutin; rifampicin; streptomycin; amikacin; antiinfective agent; clarithromycin; moxifloxacin; adult; age; aged; antibiotic resistance; antibiotic sensitivity; Article; atypical mycobacteriosis; clinical feature; clinical outcome; cohort analysis; female; human; Human immunodeficiency virus infection; infection rate; lung infection; major clinical study; male; Mycobacterium avium complex; Mycobacterium avium subsp. chimaera; Mycobacterium avium subsp. hominissuis; Mycobacterium avium subsp. intracellulare; retrospective study; Taiwan; thorax radiography; atypical mycobacteriosis; drug effect; genetics; immunology; isolation and purification; lung disease; microbial sensitivity test; microbiology; middle aged; Mycobacterium avium; very elderly; young adult; Adult; Aged; Aged, 80 and over; Amikacin; Anti-Bacterial Agents; Clarithromycin; Drug Resistance, Bacterial; Female; Humans; Lung Diseases; Male; Microbial Sensitivity Tests; Middle Aged; Moxifloxacin; Mycobacterium avium; Mycobacterium avium-intracellulare Infection; Taiwan; Young Adult
Publisher
Elsevier B.V.
Type
journal article