Department of Clinical Laboratory, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, People's Republic of China; Department of Molecular Biology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, People's Republic of China.
Department of Clinical Laboratory, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, People's Republic of China.
J Glob Antimicrob Resist. 2021 Jun;25:72-76. doi: 10.1016/j.jgar.2021.02.024. Epub 2021 Mar 6.
The aim of this study was to compare the antibiotic susceptibility profiles of Mycobacterium abscessus complex (MABC) isolates and to investigate the relationship between susceptibility profiles and genetic mechanisms of macrolide resistance.
More than 200 isolates collected from respiratory specimens between 2014 and 2018 were randomly analysed in this study. Minimum inhibitory concentrations (Mics) of ten potential antimicrobial agents were determined by the microplate alamarBlue assay.
We identified 43 MABC isolates, including 32 M. abscessus subsp. abscessus (M. abscessus) (6 from immunocompromised patients) and 11 M. abscessus subsp. massiliense (M. massiliense). The majority of MABC isolates were susceptible to amikacin (96.9% and 100.0% for M. abscessus and M. massiliense, respectively), linezolid (96.9% and 100.0%, respectively), cefoxitin (100.0% and 100.0%, respectively), imipenem (90.6% and 72.7%, respectively) and tobramycin (90.6% and 72.7%, respectively). The resistance rates to clarithromycin and doxycycline in isolates of M. abscessus (68.8% and 100.0%) were significantly higher than those in isolates of M. massiliense (18.2% and 63.6%) (P < 0.05), whereas the percentage of tobramycin-resistant isolates among M. abscessus (9.4%) was significantly lower than among M. massiliense (27.3%) (P = 0.007). Sequencing analyses showed significant differences between erm(41) of M. abscessus and M. massiliense.
Mycobacterium abscessus is the dominant pathogen of pulmonary MABC infections in our hospital. Aminoglycosides (amikacin and tobramycin), β-lactams (cefoxitin and imipenem) and linezolid exhibited potent inhibitory activity against MABC in vitro. The erm(41) gene may be a promising marker to predict macrolide susceptibility for M. abscessus.
本研究旨在比较脓肿分枝杆菌复合体（MABC）分离株的抗生素敏感性谱，并探讨敏感性谱与大环内酯类耐药的遗传机制之间的关系。
本研究随机分析了 2014 年至 2018 年间从呼吸道标本中收集的 200 多个分离株。采用微量棋盘琼脂稀释法测定十种潜在抗菌药物的最小抑菌浓度（MIC）。
我们鉴定了 43 株 MABC 分离株，包括 32 株脓肿分枝杆菌亚种脓肿（M. abscessus）（免疫功能低下患者 6 例）和 11 株脓肿分枝杆菌亚种马萨利恩（M. massiliense）。大多数 MABC 分离株对阿米卡星（M. abscessus 和 M. massiliense 的分别为 96.9%和 100.0%）、利奈唑胺（M. abscessus 和 M. massiliense 的分别为 96.9%和 100.0%）、头孢西丁（100.0%和 100.0%）、亚胺培南（M. abscessus 和 M. massiliense 的分别为 90.6%和 72.7%）和妥布霉素（M. abscessus 和 M. massiliense 的分别为 90.6%和 72.7%）敏感。M. abscessus 分离株对克拉霉素和强力霉素的耐药率（分别为 68.8%和 100.0%）明显高于 M. massiliense 分离株（分别为 18.2%和 63.6%）（P<0.05），而 M. abscessus 分离株中妥布霉素耐药株的比例（9.4%）明显低于 M. massiliense 分离株（27.3%）（P=0.007）。序列分析显示，M. abscessus 和 M. massiliense 之间 erm(41) 存在显著差异。
脓肿分枝杆菌是我院肺部 MABC 感染的主要病原体。氨基糖苷类（阿米卡星和妥布霉素）、β-内酰胺类（头孢西丁和亚胺培南）和利奈唑胺对 MABC 具有体外抑制活性。erm(41) 基因可能是预测 M. abscessus 大环内酯类药物敏感性的有前途的标记物。
