Identification and Antimicrobial Susceptibilities for Patients with Non-tuberculous Mycobacteria Infection in Jeju Island: Single-Center Retrospective Study
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Background The distribution of species and characteristics of non-tuberculous mycobacteria (NTM) differ, and surveillance data for changes in antimicrobial susceptibilities of NTM is insufficient. This study analyzed the changes in antimicrobial susceptibility trends across NTM species and assessed the appropriateness of empirical antimicrobial drugs for NTM. Materials and Methods We retrospectively analyzed the clinical characteristics, including demographics, distribution of NTM species, antimicrobial drug susceptibilities, and outcomes, at a teaching hospital in Jeju Island from 2009 - 2022. Results Overall, 342 patients were included in the analysis; 93.0% were classified into the pulmonary group (PG) and 7.0% into the extrapulmonary group (EPG). The isolation rate of Mycobacterium avium was significantly higher in PG (36.8% vs. 0%, P = 0.001), while that of Mycobacterium fortuitum was significantly higher in EPG (4.5% vs. 31.3%, P = 0.001). The antimicrobial susceptibility rate is higher against clarithromycin (89.9%) and amikacin (83.3%) and lower against rifampin (54.7%) and ethambutol (28.1%). The susceptibility rate to clarithromycin was over 80%, but those to rifampin and ethambutol showed decreasing annual trends. Of the 162 patients who received empirical antimicrobial therapy, actual antimicrobial susceptibility rates were high (90.1%) using empirical macrolide, and relatively low using ethambutol and rifampin (28.0% and 58.8%, respectively). Conclusion This is the first study of analysis of the distribution, baseline characteristics, and antimicrobial susceptibility of isolated NTM species in pulmonary and extrapulmonary patients in Jeju Island over 10 years. Policies that continuously monitor changes in susceptibility rate are required to ensure effective treatment strategies.
Abstract
Background The distribution of species and characteristics of non-tuberculous mycobacteria (NTM) differ, and surveillance data for changes in antimicrobial susceptibilities of NTM is insufficient. This study analyzed the changes in antimicrobial susceptibility trends across NTM species and assessed the appropriateness of empirical antimicrobial drugs for NTM. Materials and Methods We retrospectively analyzed the clinical characteristics, including demographics, distribution of NTM species, antimicrobial drug susceptibilities, and outcomes, at a teaching hospital in Jeju Island from 2009 - 2022. Results Overall, 342 patients were included in the analysis; 93.0% were classified into the pulmonary group (PG) and 7.0% into the extrapulmonary group (EPG). The isolation rate of Mycobacterium avium was significantly higher in PG (36.8% vs. 0%, P = 0.001), while that of Mycobacterium fortuitum was significantly higher in EPG (4.5% vs. 31.3%, P = 0.001). The antimicrobial susceptibility rate is higher against clarithromycin (89.9%) and amikacin (83.3%) and lower against rifampin (54.7%) and ethambutol (28.1%). The susceptibility rate to clarithromycin was over 80%, but those to rifampin and ethambutol showed decreasing annual trends. Of the 162 patients who received empirical antimicrobial therapy, actual antimicrobial susceptibility rates were high (90.1%) using empirical macrolide, and relatively low using ethambutol and rifampin (28.0% and 58.8%, respectively). Conclusion This is the first study of analysis of the distribution, baseline characteristics, and antimicrobial susceptibility of isolated NTM species in pulmonary and extrapulmonary patients in Jeju Island over 10 years. Policies that continuously monitor changes in susceptibility rate are required to ensure effective treatment strategies.
참고문헌 (31)
- Falkinham JO 3rd, "Nontuberculous mycobacteria in the environment", Clin Chest Med, 23, pp.529~551 (2002)
- Tortoli E, "Microbiological features and clinical relevance of new species of the genus Mycobacterium", Clin Microbiol Rev, 27, pp.727~752 (2014)
- Griffith DE, "An official ATS", IDSA statement : diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases, 2007, pp.175, 367~416
- Johansen MD, "Non-tuberculous mycobacteria and the rise of Mycobacterium abscessus", Nat Rev Microbiol, 18, pp.392~407 (2020)
- Wi YM, "Treatment of extrapulmonary nontuberculous mycobacterial diseases", Infect Chemother, 51, pp.245~255 (2019)
- Hermansen TS, "Nontuberculous mycobacteria in Denmark, incidence and clinical importance during the last quarter-century", Sci Rep, 7, pp.6696~ (2017)
- Smith GS, "Epidemiology of nontuberculous mycobacteria isolations among central North Carolina residents, 2006-2010", J Infect, 72, pp.678~686 (2016)
- Simons S, "Nontuberculous mycobacteria in respiratory tract infections, eastern Asia", Emerg Infect Dis, 17, pp.343~349 (2011)
- Ahn K, "Continued upward trend in non-tuberculous mycobacteria isolation over 13 years in a tertiary care hospital in Korea", Yonsei Med J, 62, pp.903~910 (2021)
- Ricotta EE, "Extrapulmonary nontuberculous mycobacteria infections in hospitalized patients, United States, 2009-2014", Emerg Infect Dis, 27, pp.845~852 (2021)
- Hoefsloot W, "The geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples : an NTM-NET collaborative study", Eur Respir J, 42, pp.1604~1613 (2013)
- Blanc P, "Nontuberculous mycobacterial infections in a French hospital : a 12-year retrospective study", PLoS One, 11, pp.e0168290~ (2016)
- Thangavelu K, "Prevalence and speciation of non-tuberculous mycobacteria among pulmonary and extrapulmonary tuberculosis suspects in South India", J Infect Public Health, 14, pp.320~323 (2021)
- Kim N, "Recovery rates of non-tuberculous mycobacteria from clinical specimens are increasing in Korean tertiary-care hospitals", J Korean Med Sci, 32, pp.1263~1267 (2017)
- Kim JH, "Profiles of extrapulmonary nontuberculous mycobacteria infections and predictors for species : a multicenter retrospective study", Pathogens, 9, pp.949~ (2020)
- Musaddaq B, "Diagnosis of non-tuberculous mycobacterial pulmonary disease(NTM-PD) : modern challenges", Br J Radiol, 93, pp.20190768~ (2020)
- Park SC, "Prevalence, incidence, and mortality of nontuberculous mycobacterial infection in Korea : a nationwide population-based study", BMC Pulm Med, 19, pp.140~ (2019)
- Mun SK, "Changes in respiratory diseases in South Korea during the COVID-19 pandemic : an interrupted time series study", BMJ Glob Health, 6, pp.e006912~ (2021)
- Kim J, "Distribution and Antimicrobial Resistance of Non-Tuberculous Mycobacteria during 2015~2020 : A Single-Center Study in Incheon, South Korea", Korean Journal of Clinical Laboratory Science, 53, pp.225~232 (2021)
- Marras TK, "Nontuberculous mycobacterial lung infections in Ontario, Canada : clinical and microbiological characteristics", Lung, 188, pp.289~299 (2010)
- Wani SR, "Epidemiology and risk factors associated with NTM pulmonary and extrapulmonary infections in a high tuberculosis endemic Region", Indian J Med Microbiol, 38, pp.169~175 (2020)
- Kang JY, "Severity of underweight affects the development of nontuberculous mycobacterial pulmonary disease; a nationwide longitudinal study", Sci Rep, 12, pp.17180~ (2022)
- Kham-Ngam I, "Epidemiology of and risk factors for extrapulmonary nontuberculous mycobacterial infections in Northeast Thailand", PeerJ, 6, pp.e5479~ (2018)
- Lee YM, "Increasing trend of nontuberculous mycobacteria isolation in a referral clinical laboratory in South Korea", Medicina(Kaunas), 57, pp.720~ (2021)
- Hoefsloot W, "The geographic diversity of nontuberculous mycobacteria isolated from pulmonary samples : an NTM-NET collaborative study", Eur Respir J, 42, pp.1604~1613 (2013)
- Goslee S, "Water as a source of potentially pathogenic mycobacteria", Am Rev Respir Dis, 113, pp.287~292 (1976)
- Kirschner RA Jr, "Epidemiology of infection by nontuberculous mycobacteria. Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum in acid, brown-water swamps of the southeastern United States and their association with environmental variables", Am Rev Respir Dis, 145, pp.271~275 (1992)
- Daley CL, "Treatment of nontuberculous mycobacterial pulmonary disease : an official ATS", ERS, IDSA clinical practice guideline, pp.Eur Respir J, 2020[DOI]
- Brown-Elliott BA, "Antimicrobial susceptibility testing, drug resistance mechanisms, and therapy of infections with nontuberculous mycobacteria", Clin Microbiol Rev, 25, pp.545~582 (2012)
- Daley CL, "Treatment of nontuberculous mycobacterial pulmonary disease : an official ATS", ERS, IDSA clinical practice guideline, pp.Clin Infect Dis, 2020[DOI]
- Hong SK, "Distribution and antibiotic susceptibility patterns of genus Mycobacterium at a private hospital, Korea", Biomed Sci Lett, 19, pp.132~141 (2013)