Clinical manifestations, antibiotic susceptibility and molecular analysis of Mycobacterium kansasii isolates from a university hospital in Taiwan.
OBJECTIVE
Mycobacterium kansasii causes a variety of infections. Although previous reports on the prognosis of antimicrobial therapy have been mostly satisfactory, problems involving treatment failure or relapse have been encountered. The purpose of this study was to establish a relationship between the clinical treatment outcomes of M. kansasii infections and bacterial drug susceptibility, and their clonality.


METHODS
A total of 37 M. kansasii clinical isolates and clinical information on 34 patients were retrospectively collected in a tertiary medical centre in Taiwan. Bacterial drug susceptibility was determined by the microdilution method. The phylogenetic relationship was analysed by PFGE analysis.


RESULTS
Results of PFGE typing revealed a major cluster (cluster I) and eight other divergent patterns. Two/three strains leading to treatment failure were also multidrug resistant and belonged to cluster I.


CONCLUSIONS
A relationship between high drug resistance and genetic relatedness of some M. kansasii strains was established. This was associated with clinical treatment failure.
Wu
Ting-Shu
TS
Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Gueishan Shiang 33305, Taoyuan, Taiwan.
Leu
Hsieh-Shong
HS
Chiu
Cheng-Hsun
CH
Lee
Ming-Hsun
MH
Chiang
Ping-Cherng
PC
Wu
Tsu-Lan
TL
Chia
Ju-Hsin
JH
Su
Lin-Hui
LH
Kuo
An-Jing
AJ
Lai
Hsin-Chih
HC
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015373:Bacterial Typing Techniques; D016000:Cluster Analysis; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D019909:Mycobacterium kansasii / Q000145:classification* / Q000187:drug effects* / Q000302:isolation & purification; D012189:Retrospective Studies; D013624:Taiwan; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial