They demonstrated that overall treatment success for MAB-PD was 45.6% (95% CI 26.7–64.4). Mycobacterium abscessus is a prominent cause of pulmonary infection in immunosuppressed patients and those with cystic fibrosis. Pulmonary disease caused by Mycobacterium abscessus (MAB-PD) is of particular interest as, when coupled with underlying lung disease, it is associated with rapidly declining lung function, significant morbidity and mortality, and particularly poor treatment outcomes: cure, as generally defined by persistent culture conversion, is generally reported to be found in less than 50% of cases in published data [4, 5]. Wayne, PA: NCCLS. Although clinical presentations do not vary by subspecies, clinical outcomes appear to be re… Introduction. The indications for surgery included failure of sputum conversion (n = 6), sputum relapse after initial conversion (n = 2), and complications such as recurrent hemoptysis despite negative sputum conversion (n = 6). *At the time of antibiotic therapy initiation. American Thoracic Society. Moreover, a study showed that moxifloxacin has a good activity against M. abscessus and combinations of clarithromycin and moxifloxacin were effective against M. abscessus strains in in vitro models (25). The optimal therapeutic regimen and duration of treatment for Mycobacterium abscessus lung disease is not well established. Specifically, optimal therapeutic regimens and treatment durations are not well established. A diagnosis in these cases was established via culture from bronchial washing or bronchoalveolar lavage. Antibiotic treatment of, Jeon K, Kwon OJ, Lee NY, Park YK, Lew WJ, Koh WJ. Olaison L, Alestig K. A prospective study of neutropenia induced by high doses of β-lactam antibiotics. massiliense and M. abscessus subsp. Sputum relapse occurred in 9 (19%) of 47 patients who achieved initial sputum conversion. Having said that, this important paper makes two key contributions to this field of research. Common symptoms of NTM are chronic, dry cough, and shortness of breath. Recurrent respiratory infections result in a persistent productive cough and bronchiectasis, with the lungs becoming infected with a variety of organisms including Staph. If the sputum samples are examined more frequently, we might find more frequent relapses and earlier ones. Methods: Sixty-five patients (11 males, 55 females, median age 55 yr) with M. abscessus lung disease were treated with clarithromycin, ciprofloxacin, and doxycycline, together with an initial regimen of amikacin and cefoxitin for the first 4 weeks of hospitalization. abcessus puede causar enfermedad crónica pulmonar, infeccón de heridas postraumáticas, enfermedad cutánea diseminada principalmente en pacientes inmunodeprimidos. We continue to use cefoxitin in the initial 4-week treatment period because of high in vitro susceptibility of M. abscessus isolates to cefoxitin and low reproducibility of susceptibility results for imipenem (1, 2). When and how to treat pulmonary non-tuberculous mycobacterial diseases. In South Korea, M. abscessus is the second most common pathogen responsible for lung disease caused by nontuberculous mycobacteria (NTM), after Mycobacterium avium-intracellulare complex (9, 10). Isolates were considered resistant if the MIC of clarithromycin was 8 μg/ml or greater and susceptible if the MIC of clarithromycin was 2 μg/ml or less (14). The ATS guidelines (1997) and ATS/IDSA guidelines (2007) recommend treating patients with clarithromycin in combination with high-dose cefoxitin and low-dose amikacin (1, 2). Se le cataloga como una subespecie de Mycobacterium chelonae hasta 1992.M. However, there are very limited data in the literature regarding the clinical efficacy of this combination antibiotic therapy for M. abscessus lung disease. We retrospectively reviewed our prospectively collected institutional adult lung transplant database from 2001 to 2015 to identify patients with M. abscessus or Mycobacterium chelonae/abscessus infection before or after transplantation. For instance, M. abscessus has been labeled as Mycobacterium cheloneii subspecies abscessus, Mycobacterium chelonae subspecies abscessus, and finally, in 1992, as M. abscessus (34). The rate of infected patients is rapidly growing, and so is the proportion of Myco Ab patients within the NTM community. Mycobacterium abscessus complex (MABC) is one of the predominant pathogens capable of a wide spectrum of infections, with 50% of infections involving the lungs. Italic and bold type indicate susceptible and resistant categories of interpretive criteria to each antimicrobial agent, respectively. In addition, the broth microdilution MIC determination method had not yet been established in Korea during the early study period. 2003. Negative conversion of sputum was achieved and maintained for more than 12 months in 58% (38/65) of patients. The remaining 15 patients continued antibiotic therapy until the end of December 2008 (median duration of treatment, 21.0 mo; IQR, 17.9–35.2 mo). Thus, the nomenclature of M. abscessus in the present study was referred to the M. abscessus group, which is now divided into three species: M. abscessus, M. massiliense and M. bolletii. To evaluate our institutional experience with Mycobacterium abscessus infections occurring in lung transplant recipients (LTR).. Methods. Madrid. This regimen continued for at least 12 months after sputum culture conversion. Published by John Wiley & Sons Ltd. Rationale: The optimal therapeutic regimen and duration of treatment for Mycobacterium abscessus lung disease is not well established. TABLE 2. Wallace RJ Jr, Swenson JM, Silcox VA, Good RC, Tschen JA, Stone MS. A multiple logistic regression model revealed that resistance to clarithromycin was independently associated with failure to conversion or relapse (odds ratio, 0.03; 95% CI, 0.01–0.32; P = 0.004) (Table 6). For the treatment of M. abscessus lung disease, clarithromycin administration plus at least one other agent to which the organism is susceptible may follow initial therapy. Colle… The roles of combined activities of fluoroquinolones with clarithromycin against M. abscessus are controversial. Side effects were common and often led to changing or discontinuing therapy. In these 14 patients, 5 patients continued clarithromycin and ciprofloxacin after discontinuation of doxycycline. MYCOBACTERIUM TB: Acid -fast bacilli are slow growing aerobic, commonly found in the lungs. Definition of abbreviation: MICS = minimum inhibitory concentrations. When the disease was clearly recognized as being progressive, the patients received a standardized combination antibiotic therapy after hospitalization. Therefore, a total of 65 patients who received antibiotic therapy for more than 12 months were included in the study. This site uses cookies. Initial and follow-up HRCT scans were available for all patients, and these images were reviewed by two of the authors (K. Jeon and W-J. National Committee for Clinical Laboratory Standards. Conflict of interest: M. Wilkie has nothing to disclose. I have been diagnosed with Mycobacterium abcessus and Mycobacterium chelanae. The diagnosis was based on repeated sputum culture positivity in 167 patients (89%) and on bronchial washing or bronchoalveolar lavage fluid culture positivity in the remaining 21 patients (11%) who were either unable to produce sputum or had negative sputum cultures. These rates were significantly lower in patients whose isolates were resistant to clarithromycin (17%, 2/12) compared with those whose isolates were susceptible or intermediate to clarithromycin (64%, 21/33; P = 0.007). With this in mind, in this issue of the European Respiratory Journal, Kwak et al. None of the 65 patients tested positive for human immunodeficiency virus. However, linezolid was not used at our institution for the treatment of NTM lung disease because of high costs and side effects such as peripheral neuropathy and bone marrow suppression (30, 31). Mycobacterium abscessus in both adults and children has been associated with a wide variety of clinical manifestations including the following: pulmonary infections; chronic otitis media; lymphadenitis; central line-associated blood stream infections, especially in oncology and hematopoietic stem cell transplant patients; and skin and soft tissue infections in both immune compromised and normal host children [20, 21, 47–49]. This approach usually requires placement of a long-term indwelling intravenous access with the potential for morbidity. Sputum smear and culture examinations were performed monthly for the first 6 months and then at 2- to 3-month intervals until the end of treatment. 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