https://scholars.lib.ntu.edu.tw/handle/123456789/479929
標題: | CNS infections caused by Mycobacterium abscessus complex: clinical features and antimicrobial susceptibilities of isolates | 作者: | MENG-RUI LEE ARISTINE CHENG Lee Y.-C. CHING-YAO YANG Lai C.-C. YU-TSUNG HUANG CHAO-CHI HO HAO-CHIEN WANG CHONG-JEN YU PO-REN HSUEH |
公開日期: | 2012 | 卷: | 67 | 期: | 1 | 起(迄)頁: | 222-225 | 來源出版物: | Journal of Antimicrobial Chemotherapy | 摘要: | Objectives: CNS infections caused by non-tuberculous mycobacteria (NTM) are rare and only three cases of CNS infections due to Mycobacterium abscessus complex have been reported. Methods: We searched the Mycobacteriology Database of the National Taiwan University Hospital and identified patients with CNS infections due to NTM. Results: A total of 15 patients, namely 4 HIV-seropositive patients and 11 HIV-seronegative patients, with CNS infections caused by NTM were identified during 2000-10. All of the HIV-seropositive patients had disseminated Mycobacterium avium complex infections. Among the 11 HIV-seronegative patients, NTM CNS infections were due to M. abscessus complex in 8 patients, M. avium complexin 2 patients and Mycobacterium kansasii in 1 patient. All the six preserved M. abscessus complex isolates were confirmed to be Mycobacterium massiliense by erm(41) PCR and 23S rRNA gene sequence analysis. Among the eight patients with infections due to M. abscessus complex, three had otolaryngological diseases, four had received neurosurgery and one had disseminated disease. Five patients received surgical debridement or intracranial device removal and three patients died ofM. abscessus complex CNS infection. Among the five patients who survived, all received clarithromycin-based combination therapy with a median duration of 12 months and four received surgical intervention. All six isolates available for drugsusceptibility testing showed uniform susceptibility to clarithromycin and five were susceptible to amikacin. Conclusions: Our study revealed that M. abscessus complex isolates, particularly M. massiliense, should be considered potential pathogens causing CNS infections. Long-duration clarithromycin-based combination therapy plus surgical intervention may provide the best chance of cure. ? The Author 2011. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/479929 | ISSN: | 0305-7453 | DOI: | 10.1093/jac/dkr420 | SDG/關鍵字: | amikacin; antibiotic agent; cefoxitin; clarithromycin; cotrimoxazole; doxycycline; imipenem; levofloxacin; linezolid; meropenem; minocycline; moxifloxacin; RNA 23S; tigecycline; antiinfective agent; adult; aged; antibiotic sensitivity; article; atypical mycobacteriosis; atypical Mycobacterium; bacterial strain; bacterium isolate; central nervous system infection; clinical article; controlled study; debridement; device removal; female; gene expression; gene sequence; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; male; minimum inhibitory concentration; Mycobacterium abscessus; Mycobacterium avium; neurosurgery; nucleotide sequence; otorhinolaryngology; polymerase chain reaction; risk factor; survival rate; treatment duration; university hospital; atypical mycobacteriosis; atypical Mycobacterium; central nervous system infection; drug effect; isolation and purification; microbiological examination; microbiology; middle aged; mortality; mycobacteriosis; pathology; survival; Taiwan; Adult; Aged; Anti-Bacterial Agents; Central Nervous System Infections; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Survival Analysis; Taiwan; Young Adult |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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