Objective Macrolide susceptibility and drug resistance mechanisms of clinical non-tuberculous mycobacteria（NTM） isolates were preliminarily investigated for more accurate diagnosis and treatment of the infection in ...Objective Macrolide susceptibility and drug resistance mechanisms of clinical non-tuberculous mycobacteria（NTM） isolates were preliminarily investigated for more accurate diagnosis and treatment of the infection in China. Methods Four macrolides, including clarithromycin（CLAR）, azithromycin（AZM）, roxithromycin（ROX）, and erythromycin（ERY）, were used to test the drug susceptibility of 310 clinical NTM isolates from six provinces of China with the broth microdilution method. Two resistance mechanisms, 23 S r RNA and erm, were analyzed with nucleotide sequence analysis. Results Varied effectiveness of macrolides and species-specific resistance patterns were observed. Most Mycobacterium abscessus subsp. massiliense were susceptible and all M. fortuitum were highly resistant to macrolides. All the drugs, except for erythromycin, exhibited excellent activities against slow-growing mycobacteria, and drug resistance rates were below 22.2%. Only four highly resistant strains harbored 2,058/2,059 substitutions on rrl and none of other mutations were related to macrolide resistance. G2191 A and T2221 C on rrl were specific for the M. abscessus complex（MABC）. Seven sites, G2140 A, G2210 C, C2217 G, T2238 C, T2322 C, T2404 C, and A2406 G, were specifically carried by M. avium and M. intracellulare. Three sites, A2192 G, T2358 G, and A2636 G, were observed only in M. fortuitum and one site G2152 A was specific for M. gordonae. The genes erm（39） and erm（41） were detected in M. fortuitum and M. abscessus and inducible resistance was observed in relevant sequevar. Conclusion The susceptibility profile of macrolides against NTM was demonstrated. The well-known macrolide resistance mechanisms, 23 S r RNA and erm, failed to account for all resistant NTM isolates, and further studies are warranted to investigate macrolide resistance mechanisms in various NTM species.展开更多
<b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">To under...<b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">To understand the distribution of drug susceptibility test results of opportunistic infections of tuberculosis and non-tuberculous bacilli in AIDS patients. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">The AIDS patients who were hospitalized in our hospital from January 2016 to June 2019 were collected as the research objects, and patients with opportunistic tuberculosis and non-tuberculous bacilli from AIDS patients were screened for drug susceptibility tests, and the distribution characteristics of drug susceptibility were analyzed. </span><b><span style="font-family:Verdana;">Results: </span></b><span><span style="font-family:Verdana;">179 strains of tuberculosis and non-tuberculous mycobacteria were isolated from the specimens of AIDS patients, including 135 cases of tuberculosis mycobacteria and 44 cases of non-tuberculous mycobacteria. In the results of the drug susceptibility test, most strains of </span><i></i></span><i><i><span style="font-family:Verdana;">Mycobacterium tuberculosis</span></i><span></span></i><span style="font-family:Verdana;"> showed sensitivity to commonly used drugs, and a few strains showed resistance;most strains </span></span><span style="font-family:Verdana;">of non-tuberculous mycobacteria showed resistance, and a few strains showed</span><span style="font-family:Verdana;"> sensitivity. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span><span style="font-family:Verdana;">AIDS opportunistic infection of </span><i></i></span><i><i><span style="font-family:Verdana;">Mycobacterium tuberculosis</span></i><span></span></i><span style="font-family:Verdana;"> and non-tuberculous mycobacteria have significant differences in drug sensitivity test results. Timely detection and analysis are of great significance to the diagnosis and treatment of the disease.</span>展开更多
基金supported by the Key Project of the State Key Laboratory for Infectious Disease Prevention and Control[2014SKLID104]the National Key Programs of Mega Infectious Diseases[2013ZX10003002-001]
文摘Objective Macrolide susceptibility and drug resistance mechanisms of clinical non-tuberculous mycobacteria（NTM） isolates were preliminarily investigated for more accurate diagnosis and treatment of the infection in China. Methods Four macrolides, including clarithromycin（CLAR）, azithromycin（AZM）, roxithromycin（ROX）, and erythromycin（ERY）, were used to test the drug susceptibility of 310 clinical NTM isolates from six provinces of China with the broth microdilution method. Two resistance mechanisms, 23 S r RNA and erm, were analyzed with nucleotide sequence analysis. Results Varied effectiveness of macrolides and species-specific resistance patterns were observed. Most Mycobacterium abscessus subsp. massiliense were susceptible and all M. fortuitum were highly resistant to macrolides. All the drugs, except for erythromycin, exhibited excellent activities against slow-growing mycobacteria, and drug resistance rates were below 22.2%. Only four highly resistant strains harbored 2,058/2,059 substitutions on rrl and none of other mutations were related to macrolide resistance. G2191 A and T2221 C on rrl were specific for the M. abscessus complex（MABC）. Seven sites, G2140 A, G2210 C, C2217 G, T2238 C, T2322 C, T2404 C, and A2406 G, were specifically carried by M. avium and M. intracellulare. Three sites, A2192 G, T2358 G, and A2636 G, were observed only in M. fortuitum and one site G2152 A was specific for M. gordonae. The genes erm（39） and erm（41） were detected in M. fortuitum and M. abscessus and inducible resistance was observed in relevant sequevar. Conclusion The susceptibility profile of macrolides against NTM was demonstrated. The well-known macrolide resistance mechanisms, 23 S r RNA and erm, failed to account for all resistant NTM isolates, and further studies are warranted to investigate macrolide resistance mechanisms in various NTM species.
文摘<b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">To understand the distribution of drug susceptibility test results of opportunistic infections of tuberculosis and non-tuberculous bacilli in AIDS patients. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">The AIDS patients who were hospitalized in our hospital from January 2016 to June 2019 were collected as the research objects, and patients with opportunistic tuberculosis and non-tuberculous bacilli from AIDS patients were screened for drug susceptibility tests, and the distribution characteristics of drug susceptibility were analyzed. </span><b><span style="font-family:Verdana;">Results: </span></b><span><span style="font-family:Verdana;">179 strains of tuberculosis and non-tuberculous mycobacteria were isolated from the specimens of AIDS patients, including 135 cases of tuberculosis mycobacteria and 44 cases of non-tuberculous mycobacteria. In the results of the drug susceptibility test, most strains of </span><i></i></span><i><i><span style="font-family:Verdana;">Mycobacterium tuberculosis</span></i><span></span></i><span style="font-family:Verdana;"> showed sensitivity to commonly used drugs, and a few strains showed resistance;most strains </span></span><span style="font-family:Verdana;">of non-tuberculous mycobacteria showed resistance, and a few strains showed</span><span style="font-family:Verdana;"> sensitivity. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span><span style="font-family:Verdana;">AIDS opportunistic infection of </span><i></i></span><i><i><span style="font-family:Verdana;">Mycobacterium tuberculosis</span></i><span></span></i><span style="font-family:Verdana;"> and non-tuberculous mycobacteria have significant differences in drug sensitivity test results. Timely detection and analysis are of great significance to the diagnosis and treatment of the disease.</span>
