Pulmonary infection due to fluoroquinolone-resistant Mycolicibacterium fortuitum: a case report.
Pulmonary infection due to fluoroquinolone-resistant Mycolicibacterium fortuitum: a case report.
复制标题
DOI：
10.1186/s12879-020-05596-1
复制
发表时间：
2020-11-19
影响因子：
3.7
通讯作者：
Takahashi K
中科院分区：
文献类型：
--
作者：
Kurokawa K;Harada N;Sasano H;Takagi H;Takei S;Nakamura A;Kamada K;Yoshida A;Kikuchi K;Takahashi K
偶发分枝杆菌是一种快速生长的分枝杆菌，可引起肺部感染。在体外和临床实践中，它对多种抗生素敏感，因此任何敏感药物的组合都是有效的。然而，我们遇到了一例耐氟喹诺酮类偶发分枝杆菌感染的病例。在本研究中，我们报告了该病例并描述了耐药机制。一名 65 岁男性，曾接受全胃切除术并接受类风湿性关节炎免疫抑制剂治疗，出现偶发分枝杆菌引起的肺部感染复发。基于当时良好的敏感性，他接受了克拉霉素和左氧氟沙星作为一线治疗。复发后，检测到氟喹诺酮类药物的最低抑制浓度较高。病原体的 DNA 测序显示，gyrA 基因中第 83 位残基处的丝氨酸取代了色氨酸。他成功地接受了其他抗生素的联合治疗。这是第一篇关于耐氟喹诺酮类偶发分枝杆菌的治疗及耐药机制研究的报道。我们认为，在病原体获得耐药性后，药敏试验对于确定下一步治疗仍然有效，偶然分枝杆菌对氟喹诺酮类药物的耐药性可归因于氨基酸的单一变化。
Mycolicibacterium fortuitum is a species of the rapidly growing mycobacteria that can cause pulmonary infection. It is susceptible to multiple antibiotics both in vitro and in clinical practice, so that any combination of susceptible drugs is effective. However, we encountered a case of infection due to fluoroquinolone-resistant M. fortuitum. In this study, we report the case and describe the mechanism of resistance. A 65-year-old man with a history of total gastrectomy and immunosuppressant treatment for rheumatoid arthritis developed a recurrence of pulmonary infection caused by M. fortuitum. He was treated with clarithromycin and levofloxacin as a first-line treatment, based on the favorable susceptibility at that time. After recurrence, a high minimum inhibitory concentration to fluoroquinolones was detected. DNA sequencing of the pathogen showed the substitution of serine for tryptophan at residue 83 in the gyrA gene. He was successfully treated with a combination of other antibiotics. This is the first report on the treatment of fluoroquinolone-resistant M. fortuitum and investigation of the mechanism of resistance. We suggest that the susceptibility test remains effective for determining the next line of treatment after a pathogen has acquired resistance, and resistance to fluoroquinolones in M. fortuitum can be attributed to a single change of amino acid.
登录
查看更多内容
DOI：
10.1016/j.ijantimicag.2009.06.026
发表时间：
2009-11-01
影响因子：
10.8
作者：
Esteban, J.;Martin-de-Hijas, N. Z.;Fernandez-Roblas, R.
通讯作者：
Fernandez-Roblas, R.
影响因子：
11.8
作者：
Vugia, DJ;Jang, Y;Desmond, E
通讯作者：
Desmond, E
影响因子：
--
作者：
Sniezek, PJ;Graham, BS;Winthrop, K
通讯作者：
Winthrop, K
影响因子：
3
作者：
Fabbian, Fabio;De Giorgi, Alfredo;Contini, Carlo
通讯作者：
Contini, Carlo
影响因子：
2.6
作者：
Hamasuna, Ryoichi;Ohnishi, Makoto;Matsumoto, Tetsuro
通讯作者：
Matsumoto, Tetsuro