Abstract
Objectives. Several species of rapidly growing mycobacteria (RGM) are now recognized as human pathogens. However, limited data on effective drug treatments against these organisms exists. Here, we describe the species distribution and drug susceptibility profiles of RGM clinical isolates collected from four southern Chinese provinces from January 2005 to December 2012. Methods. Clinical isolates (73) were subjected to in vitro testing with 31 antimicrobial agents using the cation-adjusted Mueller-Hinton broth microdilution method. The isolates included 55 M. abscessus, 11 M. fortuitum, 3 M. chelonae, 2 M. neoaurum, and 2 M. septicum isolates. Results. M. abscessus (75.34%) and M. fortuitum (15.07%), the most common species, exhibited greater antibiotic resistance than the other three species. The isolates had low resistance to amikacin, linezolid, and tigecycline, and high resistance to first-line antituberculous agents, amoxicillin-clavulanic acid, rifapentine, dapsone, thioacetazone, and pasiniazid. M. abscessus and M. fortuitum were highly resistant to ofloxacin and rifabutin, respectively. The isolates showed moderate resistance to the other antimicrobial agents. Conclusions. Our results suggest that tigecycline, linezolid, clofazimine, and cefmetazole are appropriate choices for M. abscessus infections. Capreomycin, sulfamethoxazole, tigecycline, clofazimine, and cefmetazole are potentially good choices for M. fortuitum infections. Our drug susceptibility data should be useful to clinicians.
Highlights
Nontuberculous mycobacteria (NTM) form a large class within the Mycobacteriaceae family
International-standard rapidly growing mycobacteria (RGM) species were used as the corresponding quality control strains for the clinical isolates tested (i.e., M. abscessus ATCC19977, M. chelonae ATCC35752, M. fortuitum DSM44220, M. neoaurum ATCC25795, and M. septicum DSM44393)
We found that aminoglycoside antibiotics including amikacin, kanamycin, capreomycin, and tobramycin, were effective antimicrobials for the RGM species
Summary
Nontuberculous mycobacteria (NTM) form a large class within the Mycobacteriaceae family. More than 100 NTM species are found in soil, potable water, food, and animals [1]. In China, the proportion of NTM among all mycobacterial isolates has increased from 11.1% to 22.9% according to National surveys conducted in 1990 and 2010 [2]. The rising percentage of NTM in China is an important public health concern [1, 2]. More than 50 RGM species are able to produce mature colonies on agar plates within 7 days [3]. Many of these are important human pathogens that cause pulmonary and soft tissue infections and various other infections [4, 5]. Most studies have shown that M. abscessus accounts for 80% of the lung disease caused by RGM, and after M. fortuitum, M abscessus is the second most common RGM to cause extrapulmonary disease [3, 6]
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