title: Advances in the management of pulmonary disease due to Mycobacterium abscessus complex.
abstract: Mycobacterium abscessus complex is a group of rapidly growing mycobacteria, and an emerging cause of non-tuberculous mycobacterial lung disease in patients with cystic fibrosis and chronic lung diseases, such as bronchiectasis. M. abscessus complex is the most drug-resistant of the mycobacterial pathogens, resulting in limited therapeutic options and a high treatment failure rate. M. abscessus complex is comprised of three closely related subspecies: M. abscessus (sensu stricto), M. massiliense and M. bolletii. M. abscessus encodes a functional erythromycin ribosomal methylase gene, erm(41), which modifies the binding site for macrolide antibiotics, causing inducible macrolide resistance. However, this inducible macrolide resistance is not seen in M. massiliense, as the erm(41) gene of this subspecies is non-functional. Accordingly, treatment success rates with macrolide-based antibiotic treatment are much higher in patients with M. massiliense infections than in those infected with M. abscessus. Precise speciation of M. abscessus complex is important for predicting antibiotic susceptibilities and patient outcome.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: W-J
authors.initials: WJ
authors.lastname: Koh
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Stout
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, SAR China.
authors.forename: W-W
authors.initials: WW
authors.lastname: Yew
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019468:Disease Management; D024881:Drug Resistance, Bacterial; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D018942:Macrolides / Q000627:therapeutic use; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000188:drug therapy*; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000187:drug effects* / Q000254:growth & development; D015995:Prevalence
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides