Activities of ciprofloxacin and ofloxacin against rapidly growing mycobacteria with demonstration of acquired resistance following single-drug therapy

Wallace, Richard J.; Bedsole, Glenn; Sumter, G; Sanders, Charles V.; Steele, Lorraine C.; Brown, Barbara A.; Smith, Jennifer L.; Graham, Donald R.

doi:10.1128/aac.34.1.65

Cited by 125 publications

(68 citation statements)

References 18 publications

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“…Our strains showed a more resistant antimicrobial susceptibility pattern than those reported previously (8)(9)(10). It is recognized that erratic results are achieved with clarithromycin (11).…”

Section: Discussioncontrasting

confidence: 53%

Cardiac Device Infections due toMycobacterium fortuitum

Hemmersbach‐Miller

Cárdenes-Santana

Conde-Martel

et al. 2005

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Two cases of cardiac device infection due to Mycobacterium fortuitum are reported along with a discussion of their clinical management. Long-term therapy and removal of the infected device is needed. The slow progression and absence of systemic signs and symptoms suggest a low pathogenicity of M fortuitum. M ycobacterium fortuitum is a rapidly growing mycobacteria that is ubiquitous in soil and water. It is an opportunistic pathogen, and usually causes skin, skeletal or catheter-related infections (1,2). To date, no cases of M fortuitum infection of pacemakers or implantable cardioverter defibrillators have been reported. CASE PRESENTATIONS Case 1A 72-year-old man with a history of diabetes mellitus type 2 and hypertension had a pacemaker implanted in December 2000 for sinus node disease. Two weeks later, a surgical site infection with abscess formation at the site of pacemaker implantation was observed. The abscess fluid grew a coagulasenegative staphylococcus, which was treated with ciprofloxacin over four weeks. M fortuitum was also isolated, but was interpreted as a possible contamination. One year later, the patient was hospitalized for 11 days for exploration of the pacemaker site due to subcutaneous nodules and chronic drainage. He developed a postoperative fever, but blood cultures were negative. Parenteral teicoplanin and ceftriaxone were administered for three weeks. Two months later, treatment with ciprofloxacin, trimethoprim-sulfamethoxazole and clarithromycin was started and then changed to amikacin and ciprofloxacin once the antimicrobial susceptibility pattern for the isolated M fortuitum was available. Susceptibility testing was performed in the clinical microbiology laboratory with the agar disk elution method for amikacin, tobramycin, ciprofloxacin, doxycycline, cefoxitin, imipenem and trimethoprim-sulfamethoxazole, and by a disk diffusion method for clarithromycin, azithromycin, erythromycin and tetracycline. The isolate was susceptible only to amikacin and ciprofloxacin. Ceftriaxone was not tested. All subsequent cultures remained sterile, but the patient was again hospitalized for 23 days for pacemaker removal. Further postoperative fever delayed the implantation of a new pacemaker by 14 days. An echocardiography showed no vegetations. Ciprofloxacin was continued for six months after pacemaker replacement, and amikacin was discontinued after 15 days due to injection site problems and the development of hearing impairment. At three years follow-up, the patient was well with no evidence of recurrence. Case 2A 61-year-old man had an implantable cardioverter defibrillator in July 2000 for severe coronary artery disease and multiple episodes of ventricular tachycardia. At routine follow-up in December 2001, he presented with evidence of a cutaneous infection overlying the generator. M fortuitum was isolated from culture. Treatment with ciprofloxacin was initiated but

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Section: Discussioncontrasting

confidence: 53%

Cardiac Device Infections due toMycobacterium fortuitum

Hemmersbach‐Miller

Cárdenes-Santana

Conde-Martel

et al. 2005

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…These isolates had also been identified as rapidly growing mycobacteria or as members of Mycobacterium species before their submission to our laboratory by the referring laboratory. Isolates were identified as presumptive members of the Mycobacterium fortuitum group on the basis of the absence of pigmentation and typical drug susceptibility patterns that included disk diffusion susceptibility to polymyxin B and amikacin (51), susceptible MICs to amikacin (38), ciprofloxacin (43), and sulfamethoxazole, and intermediate or susceptible MICs to cefoxitin (38,44) and imipenem (see the next section for methods and breakpoints) (39,44).…”

Section: Methodsmentioning

confidence: 99%

Polyphasic Characterization Reveals that the Human Pathogen Mycobacterium peregrinum Type II Belongs to the Bovine Pathogen Species Mycobacterium senegalense

et al. 2005

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Mycobacterium peregrinum consists of two taxa: types I and II. We evaluated 43 clinical type II strains from throughout the United States. They were responsible for soft-tissue and bone infections, catheter-related infections, and possible pneumonitis. By carbohydrate utilization, they were indistinguishable from type I strains, being D-mannitol and trehalose positive. However, they had a distinct susceptibility pattern that included intermediate ciprofloxacin MICs but low clarithromycin and doxycycline MICs of <1 g/ml. These features were also shared by reference isolates of Mycobacterium senegalense from African bovine cases of "farcy." By 16S rRNA gene sequencing, the type II isolates shared 100% sequence identity with M. senegalense. Partial sequencing of the type II hsp65 gene (441 bp) revealed four sequevars showing >98.4% identity with each other and >98.6% identity with the sequence of five bovine strains of M. senegalense. There was <97.1% identity with M. peregrinum type I isolates and other Mycobacterium fortuitum group species. Sequencing of additional gene targets including the 16S-23S rDNA internal transcribed spacer region and the rpoB gene (partial sequence) revealed a similar phylogenetic grouping. DNA-DNA hybridization showed 76 to 99% relatedness between the bovine and human strains. These studies demonstrate that type II isolates are not isolates of M. peregrinum but represent human strains of M. senegalense. This study is the first to demonstrate this species as a human pathogen. Representative human M. senegalense strains include ATCC 35755 and newly submitted strains ATCC BAA-849, ATCC BAA-850, and ATCC BAA-851.

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“…A major problem associated with quinolone monotherapy, however, was the development of mutational resistance with treatment failure or relapse (187,192). Therefore, if a quinolone is used for therapy, an additional antimicrobial agent is usually necessary.…”

Section: Antimicrobial Treatmentmentioning

confidence: 99%

Clinical and Taxonomic Status of Pathogenic Nonpigmented or Late-Pigmenting Rapidly Growing Mycobacteria

2002

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The history, taxonomy, geographic distribution, clinical disease, and therapy of the pathogenic nonpigmented or late-pigmenting rapidly growing mycobacteria (RGM) are reviewed. Community-acquired disease and health care-associated disease are highlighted for each species. The latter grouping includes health care-associated outbreaks and pseudo-outbreaks as well as sporadic disease cases. Treatment recommendations for each species and type of disease are also described. Special emphasis is on the Mycobacterium fortuitum group, including M. fortuitum, M. peregrinum, and the unnamed third biovariant complex with its recent taxonomic changes and newly recognized species (including M. septicum, M. mageritense, and proposed species M. houstonense and M. bonickei). The clinical and taxonomic status of M. chelonae, M. abscessus, and M. mucogenicum is also detailed, along with that of the closely related new species, M. immunogenum. Additionally, newly recognized species, M. wolinskyi and M. goodii, as well as M. smegmatis sensu stricto, are included in a discussion of the M. smegmatis group. Laboratory diagnosis of RGM using phenotypic methods such as biochemical testing and high-performance liquid chromatography and molecular methods of diagnosis are also discussed. The latter includes PCR-restriction fragment length polymorphism analysis, hybridization, ribotyping, and sequence analysis. Susceptibility testing and antibiotic susceptibility patterns of the RGM are also annotated, along with the current recommendations from the National Committee for Clinical Laboratory Standards (NCCLS) for mycobacterial susceptibility testing

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Activities of ciprofloxacin and ofloxacin against rapidly growing mycobacteria with demonstration of acquired resistance following single-drug therapy

Cited by 125 publications

References 18 publications

Cardiac Device Infections due toMycobacterium fortuitum

Cardiac Device Infections due toMycobacterium fortuitum

Polyphasic Characterization Reveals that the Human Pathogen Mycobacterium peregrinum Type II Belongs to the Bovine Pathogen Species Mycobacterium senegalense

Clinical and Taxonomic Status of Pathogenic Nonpigmented or Late-Pigmenting Rapidly Growing Mycobacteria

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