Treatment response rates to combination antibiotic therapy including clarithromycin were much higher in patients with M. massiliense lung disease than in those with M. abscessus lung disease. The inducible resistance to clarithromycin could explain the lack of efficacy of clarithromycin-containing antibiotic therapy against M. abscessus lung disease.
Standardized combination antibiotic therapy was moderately effective in treating M. abscessus lung disease. However, frequent adverse reactions and the potential for long-duration hospitalization are important problems that remain to be solved.
In Korea, the prevalence of nontuberculous mycobacterial (NTM) pulmonary disease has risen, observed primarily in immunocompetent patients with or without preexisting lung disease. The purpose of this study was to determine the frequency of various species of NTM isolates from respiratory specimens in a single institution over a 14-year period in Korea. All samples referred to our reference laboratory over a 14-year period in Korea were analyzed. From 1993 to 2000 our laboratory used conventional NTM identification methods, and from 2001 we adapted PCR-restriction fragment length polymorphism analysis(PRA). A total of 17,915 isolates were collected from 1993 to 2006. The most frequently isolated organisms were M. avium complex (n=11,705, 65%), M. abscessus (n=2,076, 11.59%), M. fortuitum complex (n=1,279, 7.14%). M. chelonae complex (n=1,134, 6.33%), M. kansasii (n=762, 4.25%), M. szulgai (n=139, 0.78%), M. celatum (n=87, 0.49%), M. scrofulaceum (n=18, 0.10%) and M. marium (n=11, 0.06%).
BackgroundNotified tuberculosis (TB) cases in Korea have not decreased over the last decade (2001-2010).MethodsTo clarify the reasons, we analyzed an annual report on notified tuberculosis patients and age-specific population drift in Korea.ResultsCompared to the age-specific notified TB cases between 2001 and 2010, distinctive features in notified TB cases and new cases increased markedly in people aged 45-54 years and in patients over 65 years old, whereas those between 15-34 years in 2010 decreased drastically. In particular, notified TB individuals over 65 years old occupied 29.6% of the cases in 2010, which was 1.5 times higher than that in 2001. The main reason not to decrease in notified TB patients for the last decade (2001-2010) was due to the increasing elderly population as well as the aging of baby boomers, which have a higher risk of TB development.ConclusionKorea needs to pay attention to the older population in order to successfully decrease the burden of TB in the future.
BackgroundBacteria of the Mycobacterium abscessus group are the second most common pathogens responsible for lung disease caused by nontuberculous mycobacteria in Korea. There is still a lack of studies investigating the genetic mechanisms involved in M. abscessus resistance to antibiotics other than clarithromycin. This study investigated the characteristics of drug resistance exhibited by M. abscessus clinical isolates from Korea.MethodsWe performed drug susceptibility testing for a total of 404 M. abscessus clinical strains. Subspecies were differentiated by molecular biological methods and examined for mutations in drug resistance-related genes.ResultsOf the 404 strains examined, 202 (50.00%), 199 (49.26%), and 3 (0.74%) strains were identified as M. abscessus, M. massiliense, and M. bolletii, respectively. Of the 152 clarithromycin-resistant strains, 6 possessed rrl mutations, while 4 of the 30 amikacin-resistant strains contained rrs mutations, and 5 of the 114 quinolone-resistant strains had gyr mutations. All mutant strains had high minimal inhibitory concentration values for the antibiotics.ConclusionsOur results showed the distribution of the strains with mutations in drug resistance-related genes was low in the M. abscessus group. Furthermore, we performed drug susceptibility testing and sequence analyses to determine the characteristics of these genes in the M. abscessus group.
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