Current treatment of nontuberculous mycobacteriosis: an update

Esteban, Jaime; García-Pedrazuela, María; Muñoz-Egea, María-Carmen; Alcaide, Fernando

doi:10.1517/14656566.2012.677824

Cited by 57 publications

(32 citation statements)

References 146 publications

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“…While the most well-known infections are tuberculosis and leprosy, infections with nontuberculous mycobacteria are an increasing problem in soft tissues after surgical or cosmetic procedures (1) or in the lungs of cystic fibrosis and immunosuppressed patients (2). Killing mycobacteria in health care settings is important because Mycobacterium tuberculosis strains in clinical specimens or cultures may contain drug-resistant organisms that are difficult or impossible to eradicate (3), and environmental mycobacteria must be thoroughly eliminated from surgical implements and respiratory equipment.…”

Section: Observationmentioning

confidence: 99%

Acetic Acid, the Active Component of Vinegar, Is an Effective Tuberculocidal Disinfectant

Cortesia

Vilchèze

Bernut

et al. 2014

mBio

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Effective and economical mycobactericidal disinfectants are needed to kill both Mycobacterium tuberculosis and non-M. tuberculosis mycobacteria. We found that acetic acid (vinegar) efficiently kills M. tuberculosis after 30 min of exposure to a 6% acetic acid solution. The activity is not due to pH alone, and propionic acid also appears to be bactericidal. M. bolletii and M. massiliense nontuberculous mycobacteria were more resistant, although a 30-min exposure to 10% acetic acid resulted in at least a 6-log10 reduction of viable bacteria. Acetic acid (vinegar) is an effective mycobactericidal disinfectant that should also be active against most other bacteria. These findings are consistent with and extend the results of studies performed in the early and mid-20th century on the disinfectant capacity of organic acids.IMPORTANCE Mycobacteria are best known for causing tuberculosis and leprosy, but infections with nontuberculous mycobacteria are an increasing problem after surgical or cosmetic procedures or in the lungs of cystic fibrosis and immunosuppressed patients. Killing mycobacteria is important because Mycobacterium tuberculosis strains can be multidrug resistant and therefore potentially fatal biohazards, and environmental mycobacteria must be thoroughly eliminated from surgical implements and respiratory equipment. Currently used mycobactericidal disinfectants can be toxic, unstable, and expensive. We fortuitously found that acetic acid kills mycobacteria and then showed that it is an effective mycobactericidal agent, even against the very resistant, clinically important Mycobacterium abscessus complex. Vinegar has been used for thousands of years as a common disinfectant, and if it can kill mycobacteria, the most disinfectant-resistant bacteria, it may prove to be a broadly effective, economical biocide with potential usefulness in health care settings and laboratories, especially in resource-poor countries.

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Section: Observationmentioning

confidence: 99%

Acetic Acid, the Active Component of Vinegar, Is an Effective Tuberculocidal Disinfectant

Cortesia

Vilchèze

Bernut

et al. 2014

mBio

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“…NTM are environmental opportunistic pathogens in some cases [1, 2] and nonpathogenic in others [1, 3]. To date, more than 160 NTM species have been recognized, while many others await classification [4]; approximately one-third have been associated with diseases in humans [4].…”

Section: Introductionmentioning

confidence: 99%

Identification of Species of Nontuberculous Mycobacteria Clinical Isolates from 8 Provinces of China

Liu

Lian

Jiang

et al. 2016

BioMed Research International

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Pulmonary diseases caused by nontuberculous mycobacteria (NTM) are increasing in incidence and prevalence worldwide. In this study, we identified NTM species of the clinical isolates from 8 provinces in China, in order to preliminarily provide some basic scientific data in the different species and distribution of NTM related to pulmonary disease in China. A total of 523 clinical isolates from patients with tuberculosis (TB) diagnosed clinically from 2005 to 2012 were identified to the species using conventional and molecular methods, including multilocus PCR, rpoB and hsp65 PCR-PRA, hsp65, rpoB, and 16S-23S internal transcribed spacer region sequencing. The isolates were identified into 3 bacterium genera, including NTM, Gordonia bronchialis, and Nocardia farcinica, and, for the 488 NTM isolates, 27 species were identified. For all the 27 species of NTM which were found to cause pulmonary infections in humans, the most prevalent species was M. intracellulare, followed by M. avium and M. abscessus. And seven other species were for the first time identified in patients with TB in China. NTM species identification is very important for distinguishing between tuberculosis and NTM pulmonary diseases, and the species diversity drives the creation of diverse and integrated identification methods with higher accuracy and efficacy.

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“…ycobacterium avium and M. intracellulare are referred as the M. avium complex (MAC) (1) and are known as causative agents of opportunistic infections in humans (1)(2)(3). The first-line recommended treatment consists of a combination of either clarithromycin or azithromycin with rifampin and ethambutol, the two latter drugs being considered companion drugs to prevent the emergence of macrolide resistance (4,5).…”

mentioning

confidence: 99%

Significant Difference in Drug Susceptibility Distribution between Mycobacterium avium and Mycobacterium intracellulare

et al. 2014

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c M ycobacterium avium and M. intracellulare are referred as the M. avium complex (MAC) (1) and are known as causative agents of opportunistic infections in humans (1-3). The first-line recommended treatment consists of a combination of either clarithromycin or azithromycin with rifampin and ethambutol, the two latter drugs being considered companion drugs to prevent the emergence of macrolide resistance (4, 5). Amikacin is an alternative to macrolides for the treatment of MAC lung cavitary disease or in case of macrolide resistance (6). To date, the treatment guidelines have referred to MAC as a complex (4), but there are no clear data regarding the antibiotic susceptibility of each species separately. Therefore, we sought to delineate the clarithromycin and amikacin susceptibility profiles of both species (4, 5).All of the clinically relevant MAC isolates sent to the French National Reference Center for Mycobacteria between 2009 and 2011 were routinely identified by using GenoType Mycobacterium CM/AS line probe assays (Hain, Lifescience) as recommended by the manufacturer, leading to the identification of M. avium or M. intracellulare (7). After the exclusion of duplicates, only isolates from patients with no history of previous antibiotic treatment were selected to be representative of a wild population. MICs were determined by the broth microdilution method with Sensititre SLOMYCO (Biocentric) (8). The Kruskal-Wallis test was used for statistical comparisons. Epidemiological cutoff (ECOFF) values were determined as values larger than the modal MIC plus one 2-fold dilution (variability of the test) and including at least 95% of the isolates tested.One hundred eighty-six M. avium and 154 M. intracellulare isolates were studied. The distributions of clarithromycin and amikacin MICs were unimodal for both species (Fig. 1). Clarithromycin MICs were lower for M. intracellulare than for M. avium isolates (MIC 50 , 2 versus 8 mg/liter, respectively; P Ͻ 0.001) ( Table 1). The same observation was made for amikacin MICs, although the difference was not as drastic (MIC 50 , 8 versus 16 mg/liter, respectively; P Ͻ 0.001). Consequently, the tentative ECOFFs were slightly lower for M. intracellulare than for M. avium (Table 1).Many studies report MAC as a single entity. Our results demonstrate that M. avium and M. intracellulare have different patterns of clarithromycin and amikacin susceptibility. Such a difference has been previously reported (9, 10), but recent data considering both clarithromycin and standardized methods (recommended by CLSI [8]) were lacking at the time of those publi- (7,12). In fine, our results need to be further confirmed by a definitive species identification method, such as sequencing. LETTER TO THE EDITORIn conclusion, there are differences in antibiotic susceptibility between MAC species in terms of MIC 50 s and ECOFFs. Whether these differences are clinically relevant remains to be determined; indeed, there are not a wide variety of drugs and dosage options for the treatment of MAC infect...

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Current treatment of nontuberculous mycobacteriosis: an update

Cited by 57 publications

References 146 publications

Acetic Acid, the Active Component of Vinegar, Is an Effective Tuberculocidal Disinfectant

Acetic Acid, the Active Component of Vinegar, Is an Effective Tuberculocidal Disinfectant

Identification of Species of Nontuberculous Mycobacteria Clinical Isolates from 8 Provinces of China

Significant Difference in Drug Susceptibility Distribution between Mycobacterium avium and Mycobacterium intracellulare

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