Mycobacterium abscessus Pulmonary Disease: Important Pathogen as Microbial Substitution During the Treatment of Non- abscessus Mycobacterial Disease

Nontuberculous mycobacteria are human opportunistic pathogens whose source of infection is the environment. These include both slow-growing (eg,Mycobacterium kansasii and Mycobacterium avium) and rapid-growing (eg,Mycobacterium abscessusandMycobacterium fortuitum) species. Transmission is through ingestion or inhalation of water, particulate matter or aerosols, or through trauma. The historic presentation of pulmonary disease in older individuals with predisposing lung conditions and in children has been changing. Pulmonary disease in elderly individuals who lack the classic predisposing lung conditions is increasing. Pulmonary disease and hypersensitivity pneumonitis have been linked with occupational or home exposures to nontuberculous mycobacteria. There has been a shift fromMycobacterium scrofulaceumtoM aviumin children with cervical lymphadenitis. Further, individuals who are immunosuppressed due to therapy or HIV-infection are at a greatly increased risk for nontuberculous mycobacterial infection. The changing pattern of nontuberculous mycobacterial disease is due in part to the ability of these pathogens to survive and proliferate in habitats that they share with humans, such as drinking water. The advent of an aging population and an increase in the proportion of immunosuppressed individuals suggest that the prevalence of nontuberculous mycobacterial disease will increase.

Download Full-text

Faculty Opinions recommendation of Clinical and microbiologic outcomes in patients receiving treatment for Mycobacterium abscessus pulmonary disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.8471956.8940054 ◽

2011 ◽

Author(s):

Larry Bush

Keyword(s):

Pulmonary Disease ◽

Mycobacterium Abscessus

Download Full-text

Faculty Opinions recommendation of Clinical and microbiologic outcomes in patients receiving treatment for Mycobacterium abscessus pulmonary disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.8471956.793500784 ◽

2014 ◽

Author(s):

David Griffith

Keyword(s):

Pulmonary Disease ◽

Mycobacterium Abscessus

Download Full-text

Impact of susceptibility to injectable antibiotics on the treatment outcomes of Mycobacterium abscessus pulmonary disease

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab215 ◽

2021 ◽

Author(s):

Youngmok Park ◽

Yea Eun Park ◽

Byung Woo Jhun ◽

Jimyung Park ◽

Nakwon Kwak ◽

...

Keyword(s):

Treatment Outcomes ◽

Pulmonary Disease ◽

Drug Susceptibility ◽

Mycobacterium Abscessus ◽

Beta Lactams ◽

In Vitro Susceptibility ◽

Referral Hospitals ◽

Microbiological Cure ◽

Culture Conversion

Abstract Objectives Current guidelines recommend a susceptibility-based regimen for Mycobacterium abscessus subspecies abscessus pulmonary disease (MAB-PD), but the evidence is weak. We aimed to investigate the association between treatment outcomes and in vitro drug susceptibility to injectable antibiotics in MAB-PD patients. Methods We enrolled MAB-PD patients treated with intravenous amikacin and beta-lactams for ≥4 weeks at four referral hospitals in Seoul, South Korea. Culture conversion and microbiological cure at one year were evaluated based on susceptibility to injectable antibiotics among patients treated with those antibiotics for ≥ 2 weeks. Results A total of 82 patients were analysed. The mean age was 58.7 years, and 65.9% were women. Sputum culture conversion and microbiological cure were achieved in 52.4% and 41.5% of patients, respectively. Amikacin was the most common agent to which the M. abscessus subspecies abscessus isolates were susceptible (81.7%); 9.8% and 24.0% of the isolates were resistant to cefoxitin and imipenem, respectively. The clarithromycin-inducible resistance (IR) group (n = 65) had a lower microbiological cure rate than the clarithromycin-susceptible group (35.4% vs. 64.7%). The treatment outcomes appeared to be similar regardless of in vitro susceptibility results with regard to intravenous amikacin, cefoxitin, imipenem, and moxifloxacin. In the subgroup analysis of the clarithromycin-IR group, the treatment outcomes did not differ according to antibiotic susceptibility. Conclusions We did not find evidence supporting the use of susceptibility-based treatment with intravenous amikacin and beta-lactams in patients with MAB-PD. Further research would be required.

Download Full-text

Clinical and Radiographic Characteristics of 12 Patients with Mycobacterium abscessus Pulmonary Disease

Tuberculosis and Respiratory Diseases ◽

10.4046/trd.2003.54.1.45 ◽

2003 ◽

Vol 54 (1) ◽

pp. 45 ◽

Cited By ~ 4

Author(s):

Won Jung Koh ◽

O Jung Kwon ◽

Eun Hae Kang ◽

Ik Soo Jeon ◽

Yu Jang Pyun ◽

...

Keyword(s):

Pulmonary Disease ◽

Mycobacterium Abscessus

Download Full-text

Comparison of the Surgical Lung Histopathologic Features of Patients with Pulmonary Disease Due to Mycobacterium Avium Complex Versus Mycobacterium Abscessus Complex

10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a2532 ◽

2019 ◽

Author(s):

E.D. Chan ◽

K.J. Potts ◽

C. Cool ◽

M. Althoff ◽

S.D. Groshong ◽

...

Keyword(s):

Pulmonary Disease ◽

Mycobacterium Avium ◽

Mycobacterium Avium Complex ◽

Mycobacterium Abscessus ◽

Complex Versus ◽

Mycobacterium Abscessus Complex ◽

Histopathologic Features

Download Full-text

Treatment of Nontuberculous Mycobacterial Pulmonary Disease: An Official ATS/ERS/ESCMID/IDSA Clinical Practice Guideline

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1125 ◽

2020 ◽

Vol 71 (4) ◽

pp. 905-913 ◽

Cited By ~ 7

Author(s):

Charles L Daley ◽

Jonathan M Iaccarino ◽

Christoph Lange ◽

Emmanuelle Cambau ◽

Richard J Wallace ◽

...

Keyword(s):

Infectious Diseases ◽

Pulmonary Disease ◽

Healthcare Professionals ◽

Mycobacterium Abscessus ◽

Clinical Microbiology Laboratory ◽

Pulmonary Medicine ◽

Assessment Development ◽

Evaluation Approach ◽

Mycobacterium Xenopi ◽

Immunodeficiency Virus

Abstract Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. This guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as Mycobacterium avium complex, Mycobacterium kansasii, and Mycobacterium xenopi among the slowly growing NTM and Mycobacterium abscessus among the rapidly growing NTM. A panel of experts was carefully selected by leading international respiratory medicine and infectious diseases societies (ATS, ERS, ESCMID, IDSA) and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. Systematic reviews were conducted around each of 22 PICO (Population, Intervention, Comparator, Outcome) questions and the recommendations were formulated, written, and graded using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Thirty-one evidence-based recommendations about treatment of NTM pulmonary disease are provided. This guideline is intended for use by healthcare professionals who care for patients with NTM pulmonary disease, including specialists in infectious diseases and pulmonary diseases.

Download Full-text

Treatment of Nontuberculous Mycobacterial Pulmonary Disease: An Official ATS/ERS/ESCMID/IDSA Clinical Practice Guideline

Clinical Infectious Diseases ◽

10.1093/cid/ciaa241 ◽

2020 ◽

Vol 71 (4) ◽

pp. e1-e36 ◽

Cited By ~ 13

Author(s):

Charles L Daley ◽

Jonathan M Iaccarino ◽

Christoph Lange ◽

Emmanuelle Cambau ◽

Richard J Wallace ◽

...

Keyword(s):

Infectious Diseases ◽

Pulmonary Disease ◽

Healthcare Professionals ◽

Mycobacterium Abscessus ◽

Clinical Microbiology Laboratory ◽

Pulmonary Medicine ◽

Assessment Development ◽

Evaluation Approach ◽

Mycobacterium Xenopi ◽

Immunodeficiency Virus

Abstract Nontuberculous mycobacteria (NTM) represent over 190 species and subspecies, some of which can produce disease in humans of all ages and can affect both pulmonary and extrapulmonary sites. This guideline focuses on pulmonary disease in adults (without cystic fibrosis or human immunodeficiency virus infection) caused by the most common NTM pathogens such as Mycobacterium avium complex, Mycobacterium kansasii, and Mycobacterium xenopi among the slowly growing NTM and Mycobacterium abscessus among the rapidly growing NTM. A panel of experts was carefully selected by leading international respiratory medicine and infectious diseases societies (ATS, ERS, ESCMID, IDSA) and included specialists in pulmonary medicine, infectious diseases and clinical microbiology, laboratory medicine, and patient advocacy. Systematic reviews were conducted around each of 22 PICO (Population, Intervention, Comparator, Outcome) questions and the recommendations were formulated, written, and graded using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Thirty-one evidence-based recommendations about treatment of NTM pulmonary disease are provided. This guideline is intended for use by healthcare professionals who care for patients with NTM pulmonary disease, including specialists in infectious diseases and pulmonary diseases.

Download Full-text