title: Rapid development of resistance to clarithromycin following monotherapy for disseminated Mycobacterium chelonae infection in a heart transplant patient.
abstract: Mycobacterium chelonae (formerly known as M. chelonae subspecies chelonae) is a rapidly growing mycobacterium that can cause disseminated infections, especially in immunocompromised hosts. The bacterium is typically resistant to antimicrobial agents; less than 20% of M. chelonae isolates are susceptible to trimethoprim-sulfamethoxazole, doxycycline, erythromycin, or ciprofloxacin. Findings in a recent study suggested that clarithromycin may be the drug of choice for the treatment of cutaneous (disseminated) disease due to M. chelonae. We describe a 60-year-old heart transplant patient with disseminated M. chelonae infection for whom monotherapy with clarithromycin failed because of the rapid development of resistance to the drug.
authors.affiliation: Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: P
authors.initials: P
authors.lastname: Tebas
authors.forename: F
authors.initials: F
authors.lastname: Sultan
authors.forename: R J
authors.initials: RJ
authors.lastname: Wallace
authors.forename: V
authors.initials: V
authors.lastname: Fraser
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D017291:Clarithromycin / Q000494:pharmacology / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy* / Q000382:microbiology; D016926:Mycobacterium chelonae / Q000187:drug effects* / Q000302:isolation & purification; D017202:Myocardial Ischemia / Q000601:surgery; D017192:Skin Diseases, Bacterial / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin