scholarly journals 1274. Evaluating the Activity of SPR719, a Novel Aminobenzimidazole, against Nontuberculous Mycobacteria

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S653-S654
Author(s):  
Beverly Murray ◽  
Danielle Hall ◽  
Nicole S Cotroneo ◽  
Ian Critchley ◽  
Michael Pucci ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Mycobacterium Avium Complex ◽  
Nontuberculous Mycobacteria ◽  
Treatment Options ◽  
Pulmonary Infections ◽  
Disease Treatment ◽  
Summary Table ◽  
New Agents ◽  
Mortality And Morbidity ◽  
Slow Growing

Abstract Background Pulmonary infections caused by Nontuberculous Mycobacteria (NTM) are increasing in prevalence and are associated with high mortality and morbidity. Members of the Mycobacterium avium complex (MAC; primarily M. avium and M. intracellulare) and M. abscessus are most commonly associated with NTM pulmonary disease. Treatment options are limited and new agents with potent activity are needed. In this study, the activity of SPR719, a novel aminobenzimidazole, against NTM is reported. MIC range and MIC50/90 summary table Methods The susceptibility of 58 non-consecutive, non-duplicate clinical NTM isolates was determined in accordance with the Clinical and Laboratory Standards Institute (CLSI) standard M24. Isolates included 20 rapidly-growing mycobacteria (10 M. abscessus/chelonae Group, 6 M. fortuitum Group, and 4 M. mucogenicum Group) and 38 slow-growing mycobacteria (28 MAC and 10 M. kansasii). SPR719 and comparators clarithromycin (CLA), amikacin (AMK), moxifloxacin (MXF), rifabutin (RFB), minocycline (MIN), and imipenem (IPM) were evaluated. Minimum bactericidal concentrations (MBC) for SPR719, CLA, and AMK were determined in accordance with CLSI M26. Results The activity of SPR719 and comparators by MIC range and MIC50/90 (µg/mL) is summarized in the accompanying table. SPR719 activity was not affected by resistance to CLA, AMK, or MXF. MBC:MIC ratios for SPR719 and CLA were typically >8 which indicates a bacteriostatic mode of action; AMK MBC:MIC ratios were typically ≤ 4 indicative of bactericidal activity. Conclusion SPR719 had potent activity by both MIC50/90 and MIC range across the evaluated NTM species. The SPR719 activity against clinically relevant MAC and M. abcessus/chelonae Group isolates was comparable or superior to the evaluated comparators, and SPR719 was active against isolates resistant to currently utilized agents. These results highlight the potential of SPR719 in the treatment of NTM pulmonary disease. Disclosures Nicole S. Cotroneo, BS, Spero Therapeutics (Employee, Shareholder) Ian Critchley, PhD, Spero Therapeutics (Employee, Shareholder) Michael Pucci, PhD, Spero Therapeutics (Employee, Shareholder) Suzanne Stokes, PhD, Spero Therapeutics (Employee, Shareholder)

Current Perspectives in the Diagnosis and Treatment of Nontuberculous Mycobacterial Pulmonary Disease

2016 ◽  
Vol 02 (02) ◽  
pp. 54 ◽  
Author(s):  
Michael R Loebinger ◽  
Tobias Welte ◽  
◽  
Keyword(s):  
Natural History ◽  
Pulmonary Disease ◽  
Mycobacterium Avium Complex ◽  
Nontuberculous Mycobacteria ◽  
Wide Spectrum ◽  
Treatment Options ◽  
Diverse Group ◽  
Sputum Production ◽  
Drug Regimens ◽  
Slow Growing

Nontuberculous mycobacteria (NTM), an extremely diverse group with a wide spectrum of virulence, appear to be rising in prevalence. This may be due to both increased awareness and improved diagnosis, among other factors. Most NTM-pulmonary disease (NTM-PD) infections are caused by the slow growingMycobacterium avium complex(MAC) however, other species can also cause pulmonary disease includingM. abscessus, M. xenopi, M. malmoenseandM. kansasii.Symptoms of NTM-PD vary considerably and may include chronic cough, with or without sputum production or haemoptysis. Treatment options are limited at present and associated with significant intolerance, treatment failures and drug–drug interactions. Further prospective studies are needed to define suitable drug regimens for different NTM species and to improve knowledge of the natural history and epidemiology of NTM-PD.

Nontuberculous Mycobacteria

2021 ◽  
Vol 42 (04) ◽  
pp. 567-586
Author(s):  
Shera Tan ◽  
Shannon Kasperbauer
Keyword(s):  
Risk Factor ◽  
Pulmonary Disease ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Nontuberculous Mycobacteria ◽  
Mycobacterium Abscessus ◽  
Pulmonary Infections ◽  
Human Pathogens ◽  
Common Manifestation

AbstractNontuberculous mycobacteria (NTM) are ubiquitous in the environment and 193 species of NTM have been discovered thus far. NTM species vary in virulence from benign environmental organisms to difficult-to-treat human pathogens. Pulmonary infections remain the most common manifestation of NTM disease in humans and bronchiectasis continues to be a major risk factor for NTM pulmonary disease (NTM PD). This article will provide a useful introduction and framework for clinicians involved in the management of bronchiectasis and NTM. It includes an overview of the epidemiology, pathogenesis, diagnosis, and management of NTM PD. We will address the challenges faced in the diagnosis of NTM PD and the importance of subspeciation in guiding treatment and follow-up, especially in Mycobacterium abscessus infections. The treatment of both Mycobacterium avium complex and M. abscessus, the two most common NTM species known to cause disease, will be discussed in detail. Elements of the recent ATS/ERS/ESCMID/IDSA NTM guidelines published in 2020 will also be reviewed.

scholarly journals Mycobacterium avium Complex: Addressing Gaps in Diagnosis and Management

2020 ◽  
Vol 222 (Supplement_4) ◽  
pp. S199-S211
Author(s):  
Charles L Daley ◽  
Kevin L Winthrop
Keyword(s):  
Pulmonary Disease ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Treatment Options ◽  
Research Priorities ◽  
Drug Regimen ◽  
Common Species ◽  
New Drugs ◽  
Routes Of Administration

Abstract Nontuberculous mycobacteria (NTM) are ubiquitous in the environment and an important cause of disease. The most common species causing pulmonary disease are members of Mycobacterium avium complex (MAC). MAC pulmonary disease (MAC-PD) can be chronic, debilitating, costly, and associated with a high mortality. However, MAC diagnoses are often delayed due to the nonspecific presentation of MAC-PD and radiological findings that overlap with other pulmonary diseases. Patients with risk factors and who meet the diagnostic criteria—which include clinical, radiological, and microbiologic criteria—should be considered for treatment. Diagnosis requires 2 or more positive sputum cultures or 1 bronchoscopic specimen culture. The recommendation for those who are treated is a 3-drug regimen including macrolide, rifamycin, and ethambutol that is continued for 12 months beyond sputum culture conversion to negative. MAC-PD is difficult to treat, with frequent drug-related side effects and suboptimal treatment outcomes. Refractory and recurrent disease is common, leading to lifelong follow-up of patients. There are limited treatment options for patients with macrolide-resistant or refractory disease. Amikacin liposome inhalation suspension is recommended for treatment-refractory patients whose cultures remain positive after 6 months of guideline-based therapy. Among the research priorities to improve patient outcomes and quality of life are developing new, more rapid diagnostic tests, investigating biomarkers associated with disease progression, and identifying new drugs and routes of administration as well as new, shorter, and better-tolerated regimens.

scholarly journals ­­­­­­­­­Surgical Resection Compared to Medical Management in localized Mycobacteria Avium Complex­­­ Pulmonary Infection­­­­s-A Case Control Study

2020 ◽  
Author(s):  
Gabriel Fregoso ◽  
Rakesh Dhiman ◽  
Michael Lanuti ◽  
John Wain ◽  
Rocio Hurtado ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Surgical Resection ◽  
Mycobacterium Avium ◽  
Medical Management ◽  
Odds Ratio ◽  
Mycobacterium Avium Complex ◽  
Lung Resection ◽  
Case Series ◽  
Case Control ◽  
Pulmonary Infections

Abstract Background Pulmonary infections associated with Mycobacterium avium complex can be challenging to treat medically and the role of surgical lung resection is not well established. We aim to assess safety and microbiologic response in patient with localized Mycobacterium avium complex pulmonary infections managed with surgical lung resection compared to medical management alone. Methods We present a multi-institutional case series of 16 patients with localized Mycobacterium avium complex pulmonary infections managed with surgical lung resection. We highlight the case of a 30 to 40-year-old patient with localized pulmonary disease amenable to surgical resection for illustrative purposes and report on outcomes compared with medically treated patients at the same institution in case-control design. Results Of 745 patients meeting microbiologic diagnostic criteria for Mycobacterium avium complex pulmonary infections, 98 had localized pulmonary disease and of these 16 underwent surgical resection. Univariate and multivariate analysis results indicated no difference in surgical resection group compared with medical treatment: microbiologic response rate (odds ratio 0.49, 0.1–2.41), 2-year all-cause mortality (odds ratio 0.87, 0.18–4.32), and composite outcome of 2-year mortality and lack of microbiological response (multivariate logistic regression OR = 0.45, 0.09–1.57). Conclusions This case series describes patients with localized pulmonary Mycobacterium avium complex for whom surgical resection was pursued and shows examples of patients that may benefit from surgery. Though surgery for pulmonary Mycobacterium avium complex disease is rarely performed, it appears as safe and at least as effective as medical-therapy alone.

scholarly journals Lower Recovery of Nontuberculous Mycobacteria from Outdoor Hawai’i Environmental Water Biofilms Compared to Indoor Samples

2021 ◽  
Vol 9 (2) ◽  
pp. 224
Author(s):  
Ravleen Virdi ◽  
Melissa E. Lowe ◽  
Grant J. Norton ◽  
Stephanie N. Dawrs ◽  
Nabeeh A. Hasan ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Environmental Samples ◽  
Nontuberculous Mycobacteria ◽  
Phylogenetic Analyses ◽  
Environmental Water ◽  
Rpob Gene ◽  
The United States ◽  
Indoor Environments ◽  
Respiratory Specimens ◽  
Rpob Sequence

Nontuberculous mycobacteria (NTM) are environmental organisms that can cause opportunistic pulmonary disease with species diversity showing significant regional variation. In the United States, Hawai’i shows the highest rate of NTM pulmonary disease. The need for improved understanding of NTM reservoirs led us to identify NTM from patient respiratory specimens and compare NTM diversity between outdoor and indoor locations in Hawai’i. A total of 545 water biofilm samples were collected from 357 unique locations across Kaua’i (n = 51), O’ahu (n = 202), Maui (n = 159), and Hawai’i Island (n = 133) and divided into outdoor (n = 179) or indoor (n = 366) categories. rpoB sequence analysis was used to determine NTM species and predictive modeling applied to develop NTM risk maps based on geographic characteristics between environments. M. chimaera was frequently identified from respiratory and environmental samples followed by M. chelonae and M. abscessus; yet significantly less NTM were consistently recovered from outdoor compared to indoor biofilms, as exemplified by showerhead biofilm samples. While the frequency of M. chimaera recovery was comparable between outdoor and indoor showerhead biofilms, phylogenetic analyses demonstrate similar rpoB gene sequences between all showerhead and respiratory M. chimaera isolates, supporting outdoor and indoor environments as possible sources for pulmonary M. chimaera infections.

Preferences of Nephrologists among End-Stage Renal Disease Treatment Options

1985 ◽  
Vol 5 (6) ◽  
pp. 470-475 ◽  
Author(s):  
Cindy Dunham ◽  
William D. Mattern ◽  
William C. McGaghie
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Treatment Options ◽  
Disease Treatment ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Gastric Schwannoma: A Rare but Important Differential Diagnosis of a Gastric Submucosal Mass

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
William Yoon ◽  
Kari Paulson ◽  
Paul Mazzara ◽  
Sweety Nagori ◽  
Mohammed Barawi ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Surgical Resection ◽  
Treatment Options ◽  
Partial Gastrectomy ◽  
Preoperative Imaging ◽  
Mesenchymal Tumors ◽  
Gastric Schwannoma ◽  
Gastric Mass ◽  
Submucosal Mass ◽  
Slow Growing

Schwannomas are generally slow growing asymptomatic neoplasms that rarely occur in the GI tract. However, if found, the most common site is the stomach. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and 60–70% of them occur in the stomach. Owing to their typical presentation as submucosal neoplasms, gastric schwannomas and GISTs appear grossly similar. Accordingly, the differential diagnosis for a gastric submucosal mass should include gastric schwannomas. Furthermore, GI schwannomas are benign neoplasms with excellent prognosis after surgical resection, whereas 10–30% of GISTs have malignant behavior. Hence, it is important to distinguish gastric schwannomas from GISTs to make an accurate diagnosis to optimally guide treatment options. Nevertheless, owing to the paucity of gastric schwannomas, the index of suspicion for this diagnosis is low. We report a rare case of gastric schwannoma in 53-year-old woman who underwent laparoscopic partial gastrectomy under the suspicion of a GIST preoperatively but confirmed to have a gastric schwannoma postoperatively. This case underscores the importance of including gastric schwannomas in the differential diagnosis when preoperative imaging studies reveal a submucosal, exophytic gastric mass. For a gastric schwannoma, complete margin negative surgical resection is the curative treatment of choice.

Sign in / Sign up

Export Citation Format

Share Document