title: [MYCOBACTERIUM ABSCESSUS PULMONARY DISEASE: IMPORTANT PATHOGEN INVOLVED IN MICROBIAL SUBSTITUTION DURING THE TREATMENT OF NON-ABSCESSUS MYCOBACTERIAL DISEASE].
abstract: BACKGROUND
  Mycobacterium abscessus pulmonary disease is common in patients with bronchiectasis. However, the underlying disease that is more likely to be present in patients with M. abscessus pulmonary disease remains poorly understood.
  
  
  METHODS
  From 2001 through 2010, all patients, whose sputum or bronchoscopic lavage cultures yielded M. abscessus, were included in the study.
  
  
  RESULTS
  Among the 11 patients included (male/female: 4/7), 4 male patients had a history of smoking. All 11 patients presented with bronchiectasis on computed tomography before the detection of M. abscessus, and most patients demonstrated nodular bronchiectasis on chest computed tomography. Six patients (54.5%) developed M. abscessus pulmonary disease during treatment for non-abscessus non-tuberculous mycobacterial disease: M. avium complex pulmonary disease in 5 and M. kansasii infection in 1. Although laboratory examination yielded negative findings for non-abscessus mycobacterium when M. abscessus was detected, radiographic deterioration was observed in 4 of 6 patients. Five patients received drug therapy, 3 of whom were treated with multi-drug therapy including clarithromycin, ethambutol, and rifampicin, and the remaining 2 patients received low-dose macrolide therapy. However, M. abscessus was detected consistently in all patients, and deteriorated chest CT findings were observed in 4. Among the remaining 6 patients untreated with drugs, sputum cultures yielded. M. abscessus with radiographic deterioration in 4 patients.
  
  
  CONCLUSIONS
  Our results indicated that M. abscessus infection developed during the treatment for non-abscessus mycobacterial disease, which was mainly due to M. avium complex pulmonary disease in most patients. M. abscessus infection thus occurred via microbial substitution. This phenomenon should be considered an important issue during the treatment for non-abscessus mycobacterial disease, which requires long-term medication.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Tsunoda
authors.forename: Akimasa
authors.initials: A
authors.lastname: Sekine
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sumazaki
authors.forename: Toru
authors.initials: T
authors.lastname: Tanaka
authors.forename: Shih-Yuan
authors.initials: SY
authors.lastname: Lin
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takoi
authors.forename: Kenji
authors.initials: K
authors.lastname: Hayashihara
authors.forename: Ataru
authors.initials: A
authors.lastname: Moriya
authors.forename: Takefumi
authors.initials: T
authors.lastname: Saito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents