Mycobacterium kansasii: antibiotic susceptibility and PCR-restriction analysis of clinical isolates.
Mycobacterium kansasii is the second most common cause of non-tuberculosis mycobacterial diseases in Sao Paulo, Brazil. An important component of the management of infections caused by this organism is antibiotic susceptibility testing. The objective of this study was to determine the drug susceptibility profiles and genotypes of clinical isolates of M. kansasii obtained from patients with or without an infection that met the American Thoracic Society's case definition criteria of M. kansasii disease. One hundred and sixty-nine clinical isolates of M. kansasii collected between 1993 and 1998 in Sao Paulo, Brazil, were tested consecutively. The isolates were genotyped by PCR restriction-enzyme pattern analysis (PRA). Most of the M. kansasii strains were susceptible to isoniazid, streptomycin, rifabutin, rifampicin, clarithromycin, ethionamide, amikacin, clofazimine and cycloserine, and resistant to ethambutol, ciprofloxacin and doxycycline. Of 169 isolates, 167 belonged to the type I PRA genotype and one each belonged to type II and III genotypes. There was no correlation between PRA subtype and M. kansasii disease according to the American Thoracic Society case definition. Clinical trials may be needed to better correlate MIC values with treatment outcomes to identify appropriate parameters for drug-resistance testing of M. kansasii.
da Silva Telles
Maria Alice
MA
Instituto Adolfo Lutz, Sao Paulo, Av. Dr. Arnaldo, 355, Sao Paulo, SP 01246-902, Brazil 2School of Public Health, University of California, Berkeley, CA, USA.
Chimara
Erica
E
Instituto Adolfo Lutz, Sao Paulo, Av. Dr. Arnaldo, 355, Sao Paulo, SP 01246-902, Brazil 2School of Public Health, University of California, Berkeley, CA, USA.
Ferrazoli
Lucilaine
L
Instituto Adolfo Lutz, Sao Paulo, Av. Dr. Arnaldo, 355, Sao Paulo, SP 01246-902, Brazil 2School of Public Health, University of California, Berkeley, CA, USA.
Riley
Lee W
LW
Instituto Adolfo Lutz, Sao Paulo, Av. Dr. Arnaldo, 355, Sao Paulo, SP 01246-902, Brazil 2School of Public Health, University of California, Berkeley, CA, USA.
D000583:Amikacin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001938:Brazil; D002939:Ciprofloxacin / Q000494:pharmacology; D017291:Clarithromycin / Q000494:pharmacology; D002991:Clofazimine / Q000494:pharmacology; D003523:Cycloserine / Q000494:pharmacology; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D004318:Doxycycline / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D004977:Ethambutol / Q000494:pharmacology; D005000:Ethionamide / Q000494:pharmacology; D005838:Genotype; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D009165:Mycobacterium Infections, Nontuberculous / Q000382:microbiology*; D019909:Mycobacterium kansasii / Q000145:classification / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D017828:Rifabutin / Q000494:pharmacology; D012293:Rifampin / Q000494:pharmacology; D013307:Streptomycin / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D017828:Rifabutin; D002939:Ciprofloxacin; D000583:Amikacin; D004977:Ethambutol; D003523:Cycloserine; D002991:Clofazimine; D017291:Clarithromycin; D004318:Doxycycline; D005000:Ethionamide; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin