Serial CT Findings of<i>Mycobacterium massiliense</i>Pulmonary Disease Compared with<i>Mycobacterium abscessus</i>Disease after Treatment with Antibiotic Therapy

Kim, Hyun Su; Lee, Kyung Soo; Koh, Won‐Jung; Jeon, Kyeongman; Lee, Eun Ju; Kang, Hee Yoon; Ahn, Joonghyun

doi:10.1148/radiol.12111374

Cited by 69 publications

(64 citation statements)

References 17 publications

(33 reference statements)

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“…54 Separately, CT scan fi ndings before and aft er therapy showed that most patients with Mam had improvement compared with only one-third of patients with Maa . 55 As noted previously, differing response to macrolide-based regimens among subspecies of M abscessus relates to the presence or absence of a truncated erm gene. [42][43][44] Th is raises the question of whether diff erent macrolides equally aff ect erm induction.…”

Section: Choice Of Macrolidementioning

confidence: 84%

Pulmonary Disease Due to Nontuberculous Mycobacteria

McShane

Glassroth

2015

Chest

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Section: Choice Of Macrolidementioning

confidence: 84%

Pulmonary Disease Due to Nontuberculous Mycobacteria

McShane

Glassroth

2015

Chest

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“…The fibrocavitary form (previously called the upper lobe cavitary form) is defined by the presence of cavitary opacities, mainly in the upper lobes. The nodular bronchiectatic form is defined by the presence of bronchiectasis and multiple nodules upon chest HRCT, regardless of the presence of small cavities in the lungs (44,45).…”

Section: Methodsmentioning

confidence: 99%

Clofazimine-Containing Regimen for the Treatment of Mycobacterium abscessus Lung Disease

Yang

Jhun

Moon

et al. 2017

Antimicrob Agents Chemother

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Patients with lung disease caused by Mycobacterium abscessus subsp. abscessus (here M. abscessus) typically have poor treatment outcomes. Although clofazimine (CFZ) has been increasingly used in the treatment of M. abscessus lung disease in clinical practice, there are no reported data on its effectiveness for this disease. This study sought to evaluate the clinical efficacy of a CFZ-containing regimen for the treatment of M. abscessus lung disease. We performed a retrospective review of the medical records of 42 patients with M. abscessus lung disease who were treated with CFZ-containing regimens between November 2013 and January 2015. CFZ was administered in combination with other antibiotics as an initial antibiotic regimen in 15 (36%) patients (initial treatment group), and it was added to an existing antibiotic regimen for refractory M. abscessus lung disease in 27 (64%) patients (salvage treatment group). Overall, there was an 81% treatment response rate based on symptoms and a 31% response rate based on radiographic findings. Conversion to culture-negative sputum samples was achieved in 10 (24%) patients after CFZ-containing antibiotic treatment, and during treatment, there were significant decreases in the positivity of semiquantitative sputum cultures for acid-fast bacilli in both the initial (P ϭ 0.018) and salvage (P ϭ 0.001) treatment groups. Our study suggests that CFZ-containing regimens may improve treatment outcomes in patients with M. abscessus lung disease and that a prospective evaluation of CFZ in M. abscessus lung disease is warranted.

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“…The fibrocavitary form of the disease (previously called the upper lobe cavitary form) was defined by the presence of cavitary opacities, mainly in the upper lobes. The nodular bronchiectatic form was defined by the presence of bronchiectasis and multiple nodules on chest HRCT scans, irrespective of the presence of small cavities (diameters of Ͻ3 cm) in the lungs (33,34).…”

Section: Methodsmentioning

confidence: 99%

Clinical Characteristics and Treatment Outcomes of Patients with Macrolide-Resistant Mycobacterium massiliense Lung Disease

Choi

Kim

Lee

et al. 2017

Antimicrob Agents Chemother

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Macrolide antibiotics are cornerstones in the treatment of Mycobacterium massiliense lung disease. Despite the emergence of resistance, limited data on macrolide-resistant M. massiliense lung disease are available. This study evaluated the clinical features and treatment outcomes of patients and the molecular characteristics of macrolide-resistant M. massiliense isolates. We performed a retrospective review of medical records and genetic analyses of clinical isolates from 15 patients who had macrolide-resistant M. massiliense lung disease between September 2005 and February 2015. Nine patients (60%) had the nodular bronchiectatic form of the disease, and six (40%) had the fibrocavitary form. Before the detection of macrolide resistance, three patients (20%) were treated with macrolide monotherapy, four (27%) with therapy for presumed Mycobacterium avium complex infections, and eight (53%) with combination antibiotic therapy for M. massiliense lung disease. The median treatment duration after the detection of resistance was 18.7 months (interquartile range, 11.2 to 39.8 months). Treatment outcomes were poor, with a favorable outcome being achieved for only one patient (7%), who underwent surgery in addition to antibiotic therapy. The 1-, 3-, and 5-year mortality rates were 7, 13, and 33%, respectively. Of the 15 clinical isolates, 14 (93%) had point mutations at position 2058 (n ϭ 9) or 2059 (n ϭ 5) of the 23S rRNA gene, resulting in macrolide resistance. Our study indicates that treatment outcomes are poor and mortality rates are high after the development of macrolide resistance in patients with M. massiliense lung disease. Thus, preventing the development of macrolide resistance should be a key consideration during treatment.KEYWORDS nontuberculous mycobacteria, Mycobacterium massiliense, macrolides, drug resistance P ulmonary disease caused by nontuberculous mycobacteria (NTM) is increasing worldwide (1, 2); for patients with chronic lung diseases, such as bronchiectasis or cystic fibrosis, the Mycobacterium abscessus complex (MABC) is the most important cause of pulmonary infections due to rapidly growing mycobacteria (3, 4). Currently, the MABC can be divided into three subspecies, i.e., M. abscessus subsp. abscessus (hereafter M. abscessus), M. abscessus subsp. massiliense (hereafter M. massiliense), and M. abscessus subsp. bolletii (hereafter M. bolletii) (5, 6). Of the three subspecies, M.

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Serial CT Findings ofMycobacterium massiliensePulmonary Disease Compared withMycobacterium abscessusDisease after Treatment with Antibiotic Therapy

Abstract: Common CT findings of M massiliense diseases overlap with those of M abscessus disease. However, responses to antibiotic treatment are much different; in M massiliense disease, negative sputum conversion is accomplished in all patients and serial CT scans show improvement in most patients.

Cited by 69 publications

References 17 publications

Pulmonary Disease Due to Nontuberculous Mycobacteria

Pulmonary Disease Due to Nontuberculous Mycobacteria

Clofazimine-Containing Regimen for the Treatment of Mycobacterium abscessus Lung Disease

Clinical Characteristics and Treatment Outcomes of Patients with Macrolide-Resistant Mycobacterium massiliense Lung Disease

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