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Abstract：
OBJECTIVE: This study investigated the differences in epidemiological and clinical data, and antimicrobial susceptibilities among different subspecies of Mycobacterium abscessus complex (MABSC) clinical isolates at a medical school in Thailand.
METHODS: A total of 143 MABSC clinical isolates recovered from 74 patients were genotypically analyzed for erm(41), rrl, and rrs mutations, and antimicrobial susceptibilities were determined using a broth microdilution method. Patient characteristics and clinical outcomes were reviewed from the medical records.
RESULTS: Seventy-four patients were infected with 28/74 (37.8%) M. abscessus subspecies abscessus (MAB), 43/74 (58.1%) M. abscessus subsp. massiliense (MMA), and 3/74 (4.1%) M. abscessus subsp. bolletii (MBO). The clinical findings and outcomes were generally indistinguishable between the three subspecies. All three subspecies of MABSC clinical isolates exhibited high resistance rates to ciprofloxacin, doxycycline, moxifloxacin, TMP/SMX, and tobramycin. MAB had the highest resistance rates to clarithromycin (27.8%, 20/72) and amikacin (6.9%, 5/72) compared to MBO and MMA, with p < 0.001 and p = 0.004, respectively. In addition, the rough morphotype was significantly associated with resistance to amikacin (8.9%, 5/56), clarithromycin (26.8%, 15/56), and imipenem (76.8%, 43/56) (p < 0.001), whereas the smooth morphotype was resistant to linezolid (57.1%, 48/84) (p = 0.002). In addition, T28 of erm(41), rrl (A2058C/G and A2059C/G), and rrs (A1408G) mutations were detected in 87.4% (125/143), 16.1% (23/143), and 9.1% (13/143) of MABSC isolates, respectively.
CONCLUSIONS: Three MABSC subspecies caused a variety of infections in patients with different underlying comorbidities. The drug susceptibility patterns of the recent circulating MABSC strains in Thailand were different among the three MABSC subspecies and two morphotypes.
METHODS: A total of 143 MABSC clinical isolates recovered from 74 patients were genotypically analyzed for erm(41), rrl, and rrs mutations, and antimicrobial susceptibilities were determined using a broth microdilution method. Patient characteristics and clinical outcomes were reviewed from the medical records.
RESULTS: Seventy-four patients were infected with 28/74 (37.8%) M. abscessus subspecies abscessus (MAB), 43/74 (58.1%) M. abscessus subsp. massiliense (MMA), and 3/74 (4.1%) M. abscessus subsp. bolletii (MBO). The clinical findings and outcomes were generally indistinguishable between the three subspecies. All three subspecies of MABSC clinical isolates exhibited high resistance rates to ciprofloxacin, doxycycline, moxifloxacin, TMP/SMX, and tobramycin. MAB had the highest resistance rates to clarithromycin (27.8%, 20/72) and amikacin (6.9%, 5/72) compared to MBO and MMA, with p < 0.001 and p = 0.004, respectively. In addition, the rough morphotype was significantly associated with resistance to amikacin (8.9%, 5/56), clarithromycin (26.8%, 15/56), and imipenem (76.8%, 43/56) (p < 0.001), whereas the smooth morphotype was resistant to linezolid (57.1%, 48/84) (p = 0.002). In addition, T28 of erm(41), rrl (A2058C/G and A2059C/G), and rrs (A1408G) mutations were detected in 87.4% (125/143), 16.1% (23/143), and 9.1% (13/143) of MABSC isolates, respectively.
CONCLUSIONS: Three MABSC subspecies caused a variety of infections in patients with different underlying comorbidities. The drug susceptibility patterns of the recent circulating MABSC strains in Thailand were different among the three MABSC subspecies and two morphotypes.
摘要：
目的：本研究调查了流行病学和临床数据的差异，以及泰国一所医学院的脓肿分枝杆菌复合体（MABSC）临床分离株的不同亚种之间的抗菌敏感性。
方法：对从74例患者中回收的143株MABSC临床分离株进行erm基因型分析（41株），rrl,和rrs突变，和抗菌敏感性是使用肉汤微量稀释法测定的。从病历中审查患者特征和临床结果。
结果：74例患者感染了28/74（37.8%）脓肿亚种脓肿（MAB），43/74（58.1%）M.脓肿亚种。马西利(MMA)，和3/74（4.1％）M.脓肿亚种。bolletii（MBO）。临床发现和结果通常在三个亚种之间没有区别。MABSC临床分离株的所有三个亚种对环丙沙星均表现出高耐药率，多西环素,莫西沙星,TMP/SMX,还有妥布霉素.MAB对克拉霉素的耐药率最高（27.8%，20/72）和阿米卡星（6.9%，5/72)与MBO和MMA相比，分别为p<0.001和p=0.004。此外,粗糙形态与阿米卡星耐药性显著相关(8.9%,5/56),克拉霉素（26.8%，15/56），和亚胺培南(76.8%，43/56）（p<0.001），而光滑形态对利奈唑胺具有抗性(57.1%，48/84)(p=0.002)。此外,ERM的T28（41），rrl（A2058C/G和A2059C/G），和rrs（A1408G）突变检测到87.4%（125/143），16.1%（23/143），和9.1%(13/143)的MABSC分离株，分别。
结论：三种MABSC亚种在具有不同潜在合并症的患者中引起多种感染。泰国最近流行的MABSC菌株的药物敏感性模式在三个MABSC亚种和两个形态型中有所不同。
方法：对从74例患者中回收的143株MABSC临床分离株进行erm基因型分析（41株），rrl,和rrs突变，和抗菌敏感性是使用肉汤微量稀释法测定的。从病历中审查患者特征和临床结果。
结果：74例患者感染了28/74（37.8%）脓肿亚种脓肿（MAB），43/74（58.1%）M.脓肿亚种。马西利(MMA)，和3/74（4.1％）M.脓肿亚种。bolletii（MBO）。临床发现和结果通常在三个亚种之间没有区别。MABSC临床分离株的所有三个亚种对环丙沙星均表现出高耐药率，多西环素,莫西沙星,TMP/SMX,还有妥布霉素.MAB对克拉霉素的耐药率最高（27.8%，20/72）和阿米卡星（6.9%，5/72)与MBO和MMA相比，分别为p<0.001和p=0.004。此外,粗糙形态与阿米卡星耐药性显著相关(8.9%,5/56),克拉霉素（26.8%，15/56），和亚胺培南(76.8%，43/56）（p<0.001），而光滑形态对利奈唑胺具有抗性(57.1%，48/84)(p=0.002)。此外,ERM的T28（41），rrl（A2058C/G和A2059C/G），和rrs（A1408G）突变检测到87.4%（125/143），16.1%（23/143），和9.1%(13/143)的MABSC分离株，分别。
结论：三种MABSC亚种在具有不同潜在合并症的患者中引起多种感染。泰国最近流行的MABSC菌株的药物敏感性模式在三个MABSC亚种和两个形态型中有所不同。
