Department of Respiratory Medicine, Graduate School of Medicine, Juntendo University, Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Koto Hospital, Tokyo, Japan.
Sci Rep. 2023 Feb 4;13(1):2027. doi: 10.1038/s41598-023-29021-0.
Mycobacterium abscessus species (MABS) is the most commonly isolated rapidly growing mycobacteria (RGM) and is one of the most antibiotic-resistant RGM with rapid progression, therefore, treatment of MABS is still challenging. We here presented a new combination treatment with sitafloxacin that targeted rough morphotypes of MABS, causing aggressive infections. Thirty-four clinical strains of MABS were isolated from various clinical samples at the Juntendo university hospital from 2011 to 2020. The susceptibility to a combination of sitafloxacin and antimicrobial agents was compared to that of the antimicrobial agents alone. Out of 34 MABS, 8 strains treated with sitafloxacin-amikacin combination, 9 of sitafloxacin-imipenem combination, 19 of sitafloxacin-arbekacin combination, and 9 of sitafloxacin-clarithromycin combination showed synergistic effects, respectively. Sitafloxacin-arbekacin combination also exhibited the synergistic effects against 10 of 22 Mycobacterium abscessus subspecies massiliense (Mma) strains and 8 of 11 Mycobacterium abscessus subspecies abscessus (Mab) strains, a highly resistant subspecies of MABS. The sitafloxacin-arbekacin combination revealed more synergistic effects in rough morphotypes of MABS (p = 0.008). We demonstrated the synergistic effect of the sitafloxacin-arbekacin combination against MABS. Further, this combination regimen might be more effective against Mab or rough morphotypes of MABS.
脓肿分枝杆菌（MABS）是最常分离的快速生长分枝杆菌（RGM），也是最具抗生素耐药性的 RGM 之一，其具有快速进展的特点，因此，MABS 的治疗仍然具有挑战性。我们在此提出了一种新的联合治疗方案，使用司他沙星靶向 MABS 的粗糙形态，引起侵袭性感染。从 2011 年到 2020 年，我们从日本顺天堂大学医院的各种临床样本中分离出 34 株临床 MABS 株。比较了司他沙星与抗菌药物联合治疗与单独使用抗菌药物的敏感性。在 34 株 MABS 中，8 株司他沙星-阿米卡星联合治疗，9 株司他沙星-亚胺培南联合治疗，19 株司他沙星-阿贝卡星联合治疗，9 株司他沙星-克拉霉素联合治疗分别表现出协同作用。司他沙星-阿贝卡星联合治疗对 22 株脓肿分枝杆菌亚种马萨诸塞亚种（Mma）菌株中的 10 株和 11 株脓肿分枝杆菌亚种脓肿亚种（Mab）菌株中的 8 株也表现出协同作用，Mab 是 MABS 的一种高度耐药亚种。司他沙星-阿贝卡星联合治疗对 MABS 的粗糙形态表现出更强的协同作用（p=0.008）。我们证明了司他沙星-阿贝卡星联合治疗对 MABS 的协同作用。此外，这种联合治疗方案可能对 Mab 或 MABS 的粗糙形态更有效。
