Clinical features of patients with bacteraemia caused by Mycobacterium avium complex species and antimicrobial susceptibility of the isolates at a medical centre in Taiwan, 2008–2014
Journal
International Journal of Antimicrobial Agents
Journal Volume
50
Journal Issue
1
Pages
35-40
Date Issued
2017
Author(s)
Abstract
Advanced molecular typing methods have greatly expanded the taxonomy of Mycobacterium avium complex (MAC) species; however, little is known about the epidemiology and clinical features of bacteraemia caused by different MAC species. In this study, the clinical characteristics of patients treated for MAC bacteraemia in a tertiary-care centre in northern Taiwan during 2008–2014 were investigated. Isolates were identified to species level by rpoB gene and 16S–23S rRNA internal transcribed spacer region sequencing. Among 30 patients with bacteraemia due to MAC, the majority (n = 26) had concomitant human immunodeficiency virus (HIV) infection. Of the 30 blood isolates obtained from patients, 24 were M. avium subsp. hominissuis, 4 were Mycobacterium colombiense and 2 were Mycobacterium intracellulare. All four M. colombiense isolates were from HIV-infected patients. Bacteraemia due to M. colombiense was associated with higher 30-day mortality than bacteraemia due to M. avium subsp. hominissuis [2/4 (50%) vs. 1/24 (4%); P = 0.045, Fisher's exact test]. All four M. colombiense isolates were susceptible to clarithromycin, moxifloxacin and linezolid. Among the five patients who received ethambutol treatment and four patients who received fluoroquinolone treatment for various durations between positive MAC cultures, two and three patients, respectively, had isolates with significantly increased (?4-fold) ethambutol and fluoroquinolone minimum inhibitory concentrations. M. colombiense was the second leading causative pathogen of MAC bacteraemia, comprising 15% of all MAC isolates obtained from HIV-positive patients. Monitoring the susceptibility of MAC isolates to ethambutol and fluoroquinolones is warranted in patients with persistent MAC bacteraemia. ? 2017 Elsevier B.V. and International Society of Chemotherapy
SDGs
Other Subjects
amikacin; azithromycin; clarithromycin; ethambutol; ethionamide; internal transcribed spacer; isoniazid; levofloxacin; linezolid; moxifloxacin; quinolone derivative; rifabutin; rifamycin; RNA 16S; RNA 23S; tigecycline; antiinfective agent; bacterial DNA; DNA directed RNA polymerase; ribosomal spacer DNA; RNA polymerase beta subunit; adult; aged; amino acid sequence; antibiotic sensitivity; Article; bacteremia; bacterial gene; bacterium culture; bacterium identification; bacterium isolate; clinical article; clinical feature; controlled study; disease course; female; human; Human immunodeficiency virus infection; inhibitory concentration; male; middle aged; mortality; Mycobacterium avium complex; Mycobacterium colombiense; Mycobacterium hominissuis; Mycobacterium intracellulare; nonhuman; priority journal; rpoB gene; Taiwan; tertiary care center; treatment duration; antibiotic resistance; atypical mycobacteriosis; bacteremia; chemistry; DNA sequence; drug effects; genetics; isolation and purification; microbial sensitivity test; microbiology; Mycobacterium avium complex; pathology; phylogeny; survival analysis; very elderly; young adult; Adult; Aged; Aged, 80 and over; Anti-Infective Agents; Bacteremia; DNA, Bacterial; DNA, Ribosomal Spacer; DNA-Directed RNA Polymerases; Drug Resistance, Bacterial; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Phylogeny; Sequence Analysis, DNA; Survival Analysis; Taiwan; Tertiary Care Centers; Young Adult
Type
journal article