Utility of Sequencing the erm(41) Gene in Isolates of Mycobacterium abscessus subsp abscessus with Low and Intermediate Clarithromycin MICs
Utility of Sequencing the erm(41) Gene in Isolates of Mycobacterium abscessus subsp abscessus with Low and Intermediate Clarithromycin MICs
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DOI：
10.1128/jcm.02950-14
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发表时间：
2015-04-01
影响因子：
9.4
通讯作者：
Wallace, Richard J., Jr.
中科院分区：
文献类型：
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作者：
Brown-Elliott, Barbara A.;Vasireddy, Sruthi;Wallace, Richard J., Jr.
Erm(41)基因赋予脓肿分枝杆菌大环内酯类抗生素诱导性耐药性。对大环内酯类抗生素治疗脓肿亚种的有效性提出了质疑。脓肿感染。延长培养时间(14天)后，根据目前的CLSI指南，MIC=8微克/毫升的分离株被认为对大环内酯类抗生素耐药。我们的目标是确定美国分离株中大环内酯类药物敏感性的发生率、目前被接受的MIC断裂点的有效性以及与敏感性相关的erm(41)序列。除23S rRNA基因突变株外，85株(24%)克拉霉素MIC=16mU g/ml，其中ATCC 19977(T)有10株。ATCC 19977(T)中的序列被命名为Sequevar(Type)1；大多数大环内酯类耐药菌株都属于这种类型。7个序列包含MIC值为16微克/毫升的分离物。以前与大环内酯类药物敏感性有关的ERM(41)中的T28C替换在62个分离物(18%)中被鉴定，其中3个序列的MIC值为
The erm(41) gene confers inducible macrolide resistance in Mycobacterium abscessus subsp. abscessus, calling into question the usefulness of macrolides for treating M. abscessus subsp. abscessus infections. With an extended incubation (14 days), isolates with MICs of >= 8 mu g/ml are considered macrolide resistant by current CLSI guidelines. Our goals were to determine the incidence of macrolide susceptibility in U.S. isolates, the validity of currently accepted MIC breakpoints, and the erm(41) sequences associated with susceptibility. Of 349 isolates (excluding those with 23S rRNA gene mutations), 85 (24%) had clarithromycin MICs of = 16 mu g/ml, including ATCC 19977(T), revealed 10 sequevars. The sequence in ATCC 19977(T) was designated sequevar (type) 1; most macrolide-resistant isolates were of this type. Seven sequevars contained isolates with MICs of >16 mu g/ml. The T28C substitution in erm(41), previously associated with macrolide susceptibility, was identified in 62 isolates (18%) comprising three sequevars, with MICs of