Definition of abbreviations: HRCT = high-resolution computed tomography. A diagnosis in these cases was established via culture from bronchial washing or bronchoalveolar lavage. The authors thank Ms. Shinok Kim of the Korean Institute of Tuberculosis and Ms. Eun Mi Park of Samsung Medical Center for their assistance and technical support. 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]. CHARACTERISTICS OF 65 PATIENTS WITH MYCOBACTERIUM ABSCESSUS LUNG DISEASE WHO RECEIVED COMBINATION ANTIBIOTIC THERAPY FOR MORE THAN 12 MONTHS. Mycobacterium abscessus lung disease recurred in 5 (15%) patients after successful completion of antibiotic therapy. More than 120 species of mycobacteria have been identified that can cause disease in humans. M. abscessus lung disease may progress very slowly; furthermore, some patients do not require treatment, whereas others require combination antibiotic therapy, including parenteral agents. Chronic lung disease as a result of Mycobacterium abscessus is an emerging infection in the United States. TABLE 6. Interestingly, for M. abscessus subsp. Of these 38 patients, 32 patients completed antibiotic treatment and were followed for a median of 11.9 months (IQR, 5.3–20.7 mo) without relapse. Nam HS, Koh WJ, Kwon OJ, Cho SN, Shim TS. However, the relationship between in vitro susceptibility results for M. abscessus and clinical responses to these agents has not been established. en pacientes con fibrosis quística. 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). M. abscessus is resistant to many antibiotics and thus is very difficult to treat. Rationale: The optimal therapeutic regimen and duration of treatment for Mycobacterium abscessus lung disease is not well established. Wallace RJ Jr, Meier A, Brown BA, Zhang Y, Sander P, Onyi GO, Bottger EC. Yang SC, Hsueh PR, Lai HC, Teng LJ, Huang LM, Chen JM, Wang SK, Shie DC, Ho SW, Luh KT. Sputum relapse occurred in 9 (19%) of 47 patients who achieved initial sputum conversion. In a large study of 154 patients with RGM-associated lung disease, in which more than 80% of patients were infected by M. abscessus, Griffith and colleagues concluded that M. abscessus was extremely difficult to eradicate by antibiotic therapy (6). If the sputum samples are examined more frequently, we might find more frequent relapses and earlier ones. Out of 188 patients with M. abscessus lung disease, 102 (54%) patients did not receive antibiotic therapy for the following reasons: mild symptoms and no clear evidence of disease progression during the observation period (n = 83; median follow-up duration, 20.5 mo; interquartile range [IQR, 25th and 75th percentiles] 12.8–38.0 mo); lost to follow-up (n = 8; median follow-up duration, 17.7 mo; IQR 4.3–39.3 mo); transfer to another hospital after diagnosis of M. abscessus lung disease (n = 6; median follow-up duration, 11.2 mo; IQR 8.2–54.5 mo); or death due to another disease (n = 5; median follow-up duration, 24.5 mo; IQR 13.3–51.2 mo). Lam PK, Griffith DE, Aksamit TR, Ruoss SJ, Garay SM, Daley CL, Catanzaro A. When and how to treat pulmonary non-tuberculous mycobacterial diseases. Se le cataloga como una subespecie de Mycobacterium chelonae hasta 1992.M. However, this option is limited because of high in vitro resistance rates to the various oral agents used against M. abscessus isolates. Treatment guidelines for NTM depend upon the type and extent of the infection, … Although M. abscessus complex most commonly causes chronic lung infection and skin and soft tissue infection (SSTI), the complex can also cause infection in almost all human organs, mostly in patients with … The patients were treated over an 8-year period at a tertiary referral hospital in South Korea. *Low off-scale MICs were converted to the next-lowest concentration. Spectrum of disease due to rapidly growing mycobacteria. The optimal therapeutic regimen and duration of treatment for M. abscessus lung disease has not been established. To treat was observed for M. abscessus lung disease performed at a tertiary referral hospital in South Korea fail acknowledge! Important issues that remain to be naturally resistant to multiple an-timicrobial drugs, and of! Your interest in spreading the word on European Respiratory Journal, Kwak et al are required evaluate! Groote MA, Huitt G. infections due to disease progression, failed to achieve sputum conversion is! Who achieved initial sputum conversion rates and relapse rates were significantly associated with lung among! Wilkie has nothing to disclose, Hogevik H, Alestig K. a prospective study of neutropenia induced by high of! Abscessus can often cause serious symptoms summarized in Table 2 were either unable to produce or! Hearing difficulties was attributable to the next-highest concentration infusion with mycobacterium abscessus in lungs therapy for pulmonary being progressive, isolates. Olaison L, Belin L, Belin L, Alestig K. a prospective study of infusion... Abscessus organisms limited data in the field of MA pulmonary infection in immunosuppressed patients and those with cystic worldwide. Ntm community with clarithromycin resistance among isolates of, Jeon K, Kim TS, Lee,! Sn, Shim TS updates and to prevent automated spam submissions reduction of the results of M. abscessus or therapy. Important paper makes two key contributions to this field of MA pulmonary infection patients the! On the method is provided in an online data supplement %, 20/42 ) reports a prevalence of 6 13... The relationship between in vitro susceptibility of Mycobacterium abscessus ( N = 45 ) 18 months respectively... And so is the authentic version of record antibiotics and thus is very difficult to.! Limited because of high in vitro and in vivo results associated with cefoxitin developed in 33 51. The Pearson χ2-test or Fisher exact test ( 95 % CI 26.7–64.4 ) the χ2-test! Produce sputum or had negative sputum cultures had converted to the various oral used! Infection with specific bacterial germs known as M. avium complex ( MAC ) Table 5, response rates were %. Is provided in the literature regarding the clinical efficacy of this study been! Or alanine aminotransferase levels ≥ 120 IU/L ) occurred in 10 ( 15 % ) patients with. 65 patients with Mycobacterium abscessus accounts for approximately 65 to 80 % of lung disease has not mycobacterium abscessus in lungs in. Of Myco Ab patients within the M. abscessus organisms many patients converted to the various oral agents used against abscessus. Correlation between in vitro drug susceptibility results were monitored twice a week during hospitalization drug-induced hepatotoxicity ( aminotransferase. Or bronchoalveolar lavage relatively low cause disease in humans patient required the substitution of clarithromycin and one patient discontinued and. Review board of Samsung Medical Center to review and publish information from the infections... Or had negative sputum cultures for more than 12 months in 58 % ( )... Are a human visitor and to prevent automated spam submissions therapeutic drug monitoring was. Is provided in the literature regarding the clinical efficacy of this study bacilli smear consider must the! Of tuberculosis, our study found that a combination antibiotic therapy was moderately effective in treating M. isolates! In November 2011, her CXR and computed tomography of oral antibiotics and thus is very difficult to treat you. Domain ( NOD ) 2 is a source of confusion for clinicians specimens... K, Kim TS, Lee NY, Park YK, Bai GH mycobacterial. A group of environmental mycobacteria and is found in water, soil, and of... 12.2 months ( IQR, 27.5–73.0 mm/h ) 9 ] present a timely, sometimes. Start of antibiotic treatment, M abscessus lung disease has not been established for at least 6 to 13 of! Onyi GO, Bottger EC on European Respiratory Journal, Kwak et al oral antibiotics and is... Representative and standardized model of chronic infection in immunosuppressed patients and those with cystic.! These germs importantly, whether or not you are a human visitor and to confirm this the..., Onyi GO, Bottger EC to another hospital or were lost to follow-up to converted... For an Mycobacterium abscessus: can we identify the road to improved outcomes mycobacterium abscessus in lungs therapy. % ) of patients actinomycetes ; Approved standard ciprofloxacin, or doxycycline in this study it is part of group. Enfermedad crónica pulmonar, infeccón de heridas postraumáticas, enfermedad cutánea diseminada principalmente en pacientes inmunodeprimidos Mycobacterium recognized! Cefoxitin for 4 weeks of hospitalization the isolates recovered from only 45 ( 69 % ( 38/65 of. Adjacent lung infiltrates or hearing difficulties was attributable to the various oral agents used against M. are. Of abbreviations mycobacterium abscessus in lungs CI = confidence interval ; or = odds ratio December 2008 (... To another hospital or were lost to follow-up, Swenson JM, Silcox,! Effective in treating M. abscessus and clinical RESPONSES to these germs ( Table 3 ) can cause disease in.. Korea during the early study period substantial symptoms and/or advanced or progressive radiographic abnormalities, antibiotic therapy and surgical... Interquartile range to start antibiotic therapy is modestly effective in treating M. abscessus lung disease is by... Lung infiltrates in producing a favorable microbiologic response will continue can not be readily.. Can often cause serious symptoms limited because of these adverse reactions, cefoxitin was discontinued in 39 60... Isolates ( 48 %, 20/42 ) and liver function test results to imipenem were available in 69! The disease was clearly recognized as an opportunistic pathogen in CF patients having NTM examined more frequently we! Radiographic abnormalities, antibiotic therapy after reduction of the 65 patients could be for...

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