Abstract:
One of the most relevant and pathogenic groups among the rapidly growing mycobacteria (RGM) is Mycobacterium abscessus complex (MABC) that includes three subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. bolletii, and M. abscessus subsp. massiliense. The aim of this study was the analysis of prevalence of MABC among other non-tuberculous mycobacteria isolated from patients in the Malopolska Region of Poland, between 2018 and 2021, as well as determination of their subspecies and molecular mechanisms of resistance to macrolides and aminoglycosides. The incidence of MABC was 5,4% (12/223). Eight strains were classified as M. abscessus subsp. abscessus, three as M. abscessus subsp. massiliense and one M. abscessus subsp. bolletii. Molecular analysis showed resistance to macrolides for eight strains of M. abscessus subsp. abscessus associated with erm(41)T28 gene mutations. One strain of M. abscessus subsp. abscessus showed resistance to macrolides (two mutations simultaneously: in erm(41)T28 and rrl genes) and aminoglycosides (point mutation in rrs gene). One strain of M. abscessus subs. bolletii was resistant to macrolides (erm(41)T28 mutation), whereas presented no mutations for aminoglycosides. M. abscessus subsp. massiliense reveal no mutations. High clarithromycin resistance of M. abscessus, determines the urgent need for susceptibility-based treatment. Molecular determination of resistance mechanisms to aminoglycosides and macrolides enables fast and accurate targeted treatment implementation.
摘要:
在快速增长的分枝杆菌(RGM)中,最相关和最致病的群体之一是脓肿分枝杆菌复合体(MABC),其中包括三个亚种:脓肿分枝杆菌亚种。脓肿,M.脓肿亚科。bolletii,和M.脓肿亚科。Massiliense.这项研究的目的是分析从波兰Malopolska地区患者中分离出的其他非结核分枝杆菌中MABC的患病率,在2018年至2021年之间,以及确定其亚种和对大环内酯类和氨基糖苷类耐药的分子机制。MABC发生率为5.4%(12/223)。八个菌株被分类为脓肿分枝杆菌亚种。脓肿,三个作为M.脓肿亚科。massiliense和一个M.脓肿亚种。bolletii.分子分析表明,八株脓肿分枝杆菌亚种对大环内酯类抗生素具有抗性。与erm(41)T28基因突变相关的脓肿。脓肿分枝杆菌亚种一株。脓肿对大环内酯类(同时有两个突变:erm(41)T28和rrl基因)和氨基糖苷类(rrs基因的点突变)具有抗性。一株脓肿分枝杆菌。bolletii对大环内酯类抗生素具有抗性(erm(41)T28突变),而氨基糖苷类无突变。M.脓肿亚科。Massiliense没有发现突变.脓肿分枝杆菌对克拉霉素的高耐药性,决定了基于易感性的治疗的迫切需要。对氨基糖苷类和大环内酯类的抗性机制的分子测定能够实现快速和准确的靶向治疗实施。