Mazzarelli Antonio, Nisii Carla, Cannas Angela, Vulcano Antonella, Bartolini Barbara, Turchi Federica, Butera Ornella, Rossi Alberto, De Giuli Chiara, Massimino Chiara, Stellitano Chiara, Antonelli Valentina, Petriccione Ivano, Girardi Enrico, Gualano Gina, Palmieri Fabrizio, Fontana Carla
Laboratory of Microbiology and Biorepository, National Institute for Infectious Diseases, INMI "Lazzaro Spallanzani", IRCCS, Via Portuense 292, 00149 Rome, Italy.
Scientific Direction, National Institute for Infectious Diseases, INMI "Lazzaro Spallanzani", IRCCS, 00149 Rome, Italy.
Microorganisms. 2024 Aug 8;12(8):1615. doi: 10.3390/microorganisms12081615.
The treatment of non-tuberculous mycobacterial (NTM) infections is challenging because of the difficulty in obtaining phenotypic (pDST) and/or molecular (mDST) drug susceptibility testing and the need of a multi-drug regimen. : The objective was to describe the in vitro susceptibility patterns of various NTM species through an analysis of susceptibility results obtained on isolates collected between 2018 and 2023. Species identification and mutations in or genes (mDST) were identified by a line probe assay, while the pDST was performed by broth microdilution and interpreted according to CLSI criteria. We analysed 337 isolates of NTM belonging to 15 species/subspecies. The complex (MAC) was the most common (62%); other species identified included (11%), (5%), the complex (8%), (6%), and (2%). The results of pDST (claritromycin and amikacin) and mDST ( and genes) on 66 NTM strains showed that while wild-type and occurred in 86.3% and 94% strains, respectively, the pDST showed 88% sensitivity for clarithromycin and 57.5% for amikacin. The main incongruity was observed for macrolides. : Most NTM are likely to be susceptible to macrolides and aminoglycosides. The molecular identification of resistant genotypes is accurate and strongly recommended for optimal patient management.
非结核分枝杆菌（NTM）感染的治疗具有挑战性，这是因为难以获得表型（pDST）和/或分子（mDST）药敏试验结果，且需要采用多药联合方案。本研究的目的是通过分析2018年至2023年间收集的分离株的药敏结果，描述各种NTM菌种的体外药敏模式。通过线性探针分析鉴定菌种以及rpoB或rpsL基因中的突变（mDST），而pDST则通过肉汤微量稀释法进行，并根据CLSI标准进行判读。我们分析了属于15个菌种/亚种的337株NTM分离株。鸟分枝杆菌复合群（MAC）最为常见（62%）；鉴定出的其他菌种包括脓肿分枝杆菌（11%）、龟分枝杆菌（5%）、堪萨斯分枝杆菌复合群（8%）、胞内分枝杆菌（6%）和偶发分枝杆菌（2%）。对66株NTM菌株进行的pDST（克拉霉素和阿米卡星）和mDST（rpoB和rpsL基因）结果显示，虽然野生型rpoB和rpsL分别出现在86.3%和94%的菌株中，但pDST显示克拉霉素的敏感性为88%，阿米卡星的敏感性为'57.5%。在大环内酯类药物方面观察到主要的不一致情况。大多数NTM可能对大环内酯类和氨基糖苷类药物敏感。对于最佳的患者管理，耐药基因型的分子鉴定准确且强烈推荐。
