Comparative analysis of phenotypic and genotypic antibiotic susceptibility patterns in Mycobacterium avium complex
Objective: Phenotypic (Sensititre Myco, pDST) and genotypic drug susceptibility testing (GenoType NTM DR, gDST) in M. avium complex (MAC) have become available as standardized assays, but comparable data is needed. This study aimed to investigate the phenotypic and genotypic drug susceptibility patt...
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Format: | Article |
Language: | English |
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Elsevier
2020-04-01
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Series: | International Journal of Infectious Diseases |
Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971220301181 |
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doaj-6b5f11a90f954c65a5582ec8235eaf46 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nils Wetzstein Thomas A. Kohl Sönke Andres Tilman G. Schultze Ari Geil Eunhee Kim Teodora Biciusca Christian Hügel Michael Hogardt Annette Lehn Maria J.G.T. Vehreschild Timo Wolf Stefan Niemann Florian P. Maurer Thomas A. Wichelhaus |
spellingShingle |
Nils Wetzstein Thomas A. Kohl Sönke Andres Tilman G. Schultze Ari Geil Eunhee Kim Teodora Biciusca Christian Hügel Michael Hogardt Annette Lehn Maria J.G.T. Vehreschild Timo Wolf Stefan Niemann Florian P. Maurer Thomas A. Wichelhaus Comparative analysis of phenotypic and genotypic antibiotic susceptibility patterns in Mycobacterium avium complex International Journal of Infectious Diseases |
author_facet |
Nils Wetzstein Thomas A. Kohl Sönke Andres Tilman G. Schultze Ari Geil Eunhee Kim Teodora Biciusca Christian Hügel Michael Hogardt Annette Lehn Maria J.G.T. Vehreschild Timo Wolf Stefan Niemann Florian P. Maurer Thomas A. Wichelhaus |
author_sort |
Nils Wetzstein |
title |
Comparative analysis of phenotypic and genotypic antibiotic susceptibility patterns in Mycobacterium avium complex |
title_short |
Comparative analysis of phenotypic and genotypic antibiotic susceptibility patterns in Mycobacterium avium complex |
title_full |
Comparative analysis of phenotypic and genotypic antibiotic susceptibility patterns in Mycobacterium avium complex |
title_fullStr |
Comparative analysis of phenotypic and genotypic antibiotic susceptibility patterns in Mycobacterium avium complex |
title_full_unstemmed |
Comparative analysis of phenotypic and genotypic antibiotic susceptibility patterns in Mycobacterium avium complex |
title_sort |
comparative analysis of phenotypic and genotypic antibiotic susceptibility patterns in mycobacterium avium complex |
publisher |
Elsevier |
series |
International Journal of Infectious Diseases |
issn |
1201-9712 |
publishDate |
2020-04-01 |
description |
Objective: Phenotypic (Sensititre Myco, pDST) and genotypic drug susceptibility testing (GenoType NTM DR, gDST) in M. avium complex (MAC) have become available as standardized assays, but comparable data is needed. This study aimed to investigate the phenotypic and genotypic drug susceptibility patterns in MAC clinical isolates. Methods: Overall, 98 isolates from 85 patients were included. pDST and gDST were performed on all isolates and results compared regarding specificity and sensitivity using pDST as a reference method. The impact of drug instability on pDST results was studied using a biological assay over 14 days. In addition, the evolution of antimicrobial resistance was investigated in sequential isolates of 13 patients. Results: Macrolide resistance was rare, 1.2% (95% CI 0.7–7.3) of isolates in the base cohort. No aminoglycoside resistances were found, but 14.1% of the studied isolates (95% CI 7.8–23.8) showed intermediate susceptibility. The GenoType NTM DR identified two out of four macrolide-resistant isolates. Antibiotic stability was demonstrated to be poor in rifampicin, rifabutin, and doxycycylin. Conclusions: pDST results in NTM for unstable antibiotics must be interpreted with care. A combination of pDST and gDST will be useful for the guidance of antimicrobial therapy in MAC-disease. Keywords: NTM, Non-tuberculous mycobacteria, M. avium complex, M. avium, M. chimaera, M. Intracellulare, Drug susceptibility testing, DST |
url |
http://www.sciencedirect.com/science/article/pii/S1201971220301181 |
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doaj-6b5f11a90f954c65a5582ec8235eaf462020-11-25T03:31:15ZengElsevierInternational Journal of Infectious Diseases1201-97122020-04-0193320328Comparative analysis of phenotypic and genotypic antibiotic susceptibility patterns in Mycobacterium avium complexNils Wetzstein0Thomas A. Kohl1Sönke Andres2Tilman G. Schultze3Ari Geil4Eunhee Kim5Teodora Biciusca6Christian Hügel7Michael Hogardt8Annette Lehn9Maria J.G.T. Vehreschild10Timo Wolf11Stefan Niemann12Florian P. Maurer13Thomas A. Wichelhaus14Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; Corresponding author at: Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.German Center for Infection Research, Research Center Borstel, Borstel, Germany; Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany; National and WHO Supranational Reference Center for Mycobacteria, Research Center Borstel, Borstel, GermanyNational and WHO Supranational Reference Center for Mycobacteria, Research Center Borstel, Borstel, GermanyInstitute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe University, Frankfurt am Main, GermanyDepartment of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, GermanyDepartment of Radiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, GermanyDepartment of Radiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, GermanyDepartment of Pneumology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, GermanyInstitute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany; German National Consiliary Laboratory on Cystic Fibrosis Bacteriology, GermanyInstitute of Biostatistics and Mathematical Modeling, Goethe University, Frankfurt am Main, GermanyDepartment of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, GermanyDepartment of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University, Frankfurt am Main, GermanyGerman Center for Infection Research, Research Center Borstel, Borstel, Germany; Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany; National and WHO Supranational Reference Center for Mycobacteria, Research Center Borstel, Borstel, GermanyNational and WHO Supranational Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany; Institute of Medical Microbiology, Virology and Hospital Hygiene, University Medical Center Hamburg- Eppendorf, Hamburg, GermanyInstitute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Goethe University, Frankfurt am Main, GermanyObjective: Phenotypic (Sensititre Myco, pDST) and genotypic drug susceptibility testing (GenoType NTM DR, gDST) in M. avium complex (MAC) have become available as standardized assays, but comparable data is needed. This study aimed to investigate the phenotypic and genotypic drug susceptibility patterns in MAC clinical isolates. Methods: Overall, 98 isolates from 85 patients were included. pDST and gDST were performed on all isolates and results compared regarding specificity and sensitivity using pDST as a reference method. The impact of drug instability on pDST results was studied using a biological assay over 14 days. In addition, the evolution of antimicrobial resistance was investigated in sequential isolates of 13 patients. Results: Macrolide resistance was rare, 1.2% (95% CI 0.7–7.3) of isolates in the base cohort. No aminoglycoside resistances were found, but 14.1% of the studied isolates (95% CI 7.8–23.8) showed intermediate susceptibility. The GenoType NTM DR identified two out of four macrolide-resistant isolates. Antibiotic stability was demonstrated to be poor in rifampicin, rifabutin, and doxycycylin. Conclusions: pDST results in NTM for unstable antibiotics must be interpreted with care. A combination of pDST and gDST will be useful for the guidance of antimicrobial therapy in MAC-disease. Keywords: NTM, Non-tuberculous mycobacteria, M. avium complex, M. avium, M. chimaera, M. Intracellulare, Drug susceptibility testing, DSThttp://www.sciencedirect.com/science/article/pii/S1201971220301181 |