Article ; Online: Cumulative antimicrobial susceptibilities for respiratory clinical isolates of
International journal of mycobacteriology
2023 Volume 12, Issue 3, Page(s) 310–315
Abstract: Background: Nontuberculous mycobacteria (NTM) are increasingly identified as causes of protracted pulmonary infections. Antibiotic susceptibility testing requires microdilution methods, which are often unavailable in laboratories in resource-poor ... ...
Abstract | Background: Nontuberculous mycobacteria (NTM) are increasingly identified as causes of protracted pulmonary infections. Antibiotic susceptibility testing requires microdilution methods, which are often unavailable in laboratories in resource-poor settings. We report cumulative antibiograms for the most frequently isolated clinical pulmonary NTM from Pakistan to inform empiric antibiotic management of initial NTM infections. Methods: We analyzed data from 2018 to 2022 for the most frequently isolated and clinically relevant NTM isolated from respiratory specimens, i.e., Mycobacterium avium complex (MAC), Mycobacterium abscessus group (MAG), and Mycobacterium kansasii (MK). Antibiograms were developed using the Clinical Laboratory Standards Institute's M39ED5 standard. Percentage susceptibilities and 95% confidence intervals (CI) were calculated. Results: Over 4 years, 529 NTM, comprising 209 MAC, 249 MAG, and 71 MK were analyzed. For MAC and MAG, where clarithromycin (CLR)-based regimens are recommended, CLR was active for 94.8% (95% CI 91.3-96.9), and 77.5% (95% CI 71.4-82.7) isolates, respectively. Combination regimens comprising 3 active drugs CLR + linezolid (LZD) + moxifloxacin for MAC and CLR + LZD + Amikacin for MAG had 98.4% (95% CI 95.9-99.4) and 68.9% (95% CI 62.3-74.8) coverage for pulmonary disease, respectively. For MK, 91.5% (95% CI 82.8-96.1) isolates were susceptible to rifampin (RIF), with a combination of RIF + CLR covering 88.7% (95% CI 79.3-94.2) of MK pulmonary infections, respectively. Conclusions: These data can inform empiric treatment guidance for the most common NTM pulmonary infections, i.e., for MAC, MAG, and MK disease in Pakistan. |
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MeSH term(s) | Humans ; Mycobacterium avium Complex ; Mycobacterium abscessus ; Mycobacterium kansasii ; Pakistan ; Mycobacterium avium-intracellulare Infection/drug therapy ; Mycobacterium Infections, Nontuberculous/drug therapy ; Mycobacterium Infections, Nontuberculous/microbiology ; Nontuberculous Mycobacteria ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Clarithromycin ; Linezolid ; Rifampin/therapeutic use ; Microbial Sensitivity Tests |
Chemical Substances | Anti-Bacterial Agents ; Clarithromycin (H1250JIK0A) ; Linezolid (ISQ9I6J12J) ; Rifampin (VJT6J7R4TR) |
Language | English |
Publishing date | 2023-09-18 |
Publishing country | India |
Document type | Journal Article |
ZDB-ID | 2696590-2 |
ISSN | 2212-554X ; 2212-554X |
ISSN (online) | 2212-554X |
ISSN | 2212-554X |
DOI | 10.4103/ijmy.ijmy_136_23 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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