title: Drug susceptibility testing of nontuberculous mycobacteria.
abstract: Diseases caused by nontuberculous mycobacteria are emerging in many settings. With an increased number of patients needing treatment, the role of drug susceptibility testing is again in the spotlight. This articles covers the history and methodology of drug susceptibility tests for nontuberculous mycobacteria, but focuses on the correlations between in vitro drug susceptibility, pharmacokinetics and in vivo outcomes of treatment. Among slow-growing nontuberculous mycobacteria, clear correlations have been established for macrolides and amikacin (Mycobacterium avium complex) and for rifampicin (Mycobacterium kansasii). Among rapid-growing mycobacteria, correlations have been established in extrapulmonary disease for aminoglycosides, cefoxitin and co-trimoxazole. In pulmonary disease, correlations are less clear and outcomes of treatment are generally poor, especially for Mycobacterium abscessus. The clinical significance of inducible resistance to macrolides among rapid growers is an important topic. The true role of drug susceptibility testing for nontuberculous mycobacteria still needs to be addressed, preferably within clinical trials.
authors.affiliation: Department of Medical Microbiology, Radboud University Medical Center, PO Box 9101, 6500HB Nijmegen, The Netherlands.
authors.forename: Jakko
authors.initials: J
authors.lastname: van Ingen
authors.forename: Ed J
authors.initials: EJ
authors.lastname: Kuijper
mesh_terms: D000583:Amikacin / Q000493:pharmacokinetics / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D004195:Disease Models, Animal; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy / Q000382:microbiology; D018942:Macrolides / Q000493:pharmacokinetics / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D015269:Mycobacterium avium Complex / Q000187:drug effects / Q000302:isolation & purification; D019909:Mycobacterium kansasii / Q000187:drug effects / Q000302:isolation & purification; D009170:Nontuberculous Mycobacteria / Q000187:drug effects* / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides; D000583:Amikacin
keywords: Mycobacterium abscessus; Mycobacterium avium complex; Mycobacterium kansasii; amikacin; clarithromycin; drug susceptibility testing; nontuberculous mycobacteria; rifampicin; treatment