Clinical and microbiological differences between Mycobacterium abscessus and Mycobacterium massiliense lung diseases.
In recent years, many novel nontuberculous mycobacterial species have been discovered through genetic analysis. Mycobacterium massiliense and M. bolletii have recently been identified as species separate from M. abscessus. However, little is known regarding their clinical and microbiological differences in Japan. We performed a molecular identification of stored M. abscessus clinical isolates for further identification. We compared clinical characteristics, radiological findings, microbiological findings, and treatment outcomes among patients with M. abscessus and M. massiliense lung diseases. An analysis of 102 previous isolates of M. abscessus identified 72 (71%) M. abscessus, 27 (26%) M. massiliense, and 3 (3%) M. bolletii isolates. Clinical and radiological findings were indistinguishable between the M. abscessus and M. massiliense groups. Forty-two (58%) patients with M. abscessus and 20 (74%) patients with M. massiliense infections received antimicrobial treatment. Both the M. abscessus and M. massiliense groups showed a high level of resistance to all antimicrobials, except for clarithromycin, kanamycin, and amikacin. However, resistance to clarithromycin was more frequently observed in the M. abscessus than in the M. massiliense group (16% and 4%, respectively; P = 0.145). Moreover, the level of resistance to imipenem was significantly lower in M. abscessus isolates than in M. massiliense isolates (19% and 48%, respectively; P = 0.007). The proportions of radiological improvement, sputum smear conversion to negativity, and negative culture conversion during the follow-up period were higher in patients with M. massiliense infections than in those with M. abscessus infections. Patients with M. massiliense infections responded more favorably to antimicrobial therapy than those with M. abscessus infections.
Center for Respiratory Diseases, Hokkaido Social Insurance Hospital, Sapporo, Japan. t-harada@hok-shaho-hsp.jp
Toshiyuki
T
Harada
Yasushi
Y
Akiyama
Atsuyuki
A
Kurashima
Hideaki
H
Nagai
Kazunari
K
Tsuyuguchi
Takashi
T
Fujii
Syuichi
S
Yano
Eriko
E
Shigeto
Toshihiko
T
Kuraoka
Akira
A
Kajiki
Yoshihiro
Y
Kobashi
Fumio
F
Kokubu
Atsuo
A
Sato
Shiomi
S
Yoshida
Tomotada
T
Iwamoto
Hajime
H
Saito
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D006801:Humans; D007564:Japan; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009161:Mycobacterium / Q000145:classification / Q000302:isolation & purification* / Q000472:pathogenicity*; D009164:Mycobacterium Infections / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D011859:Radiography; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents