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  • Title: Different clinical features of patients with pulmonary disease caused by various Mycobacterium avium-intracellulare complex subspecies and antimicrobial susceptibility.
    Author: Chang CL, Chen LC, Yu CJ, Hsueh PR, Chien JY.
    Journal: Int J Infect Dis; 2020 Sep; 98():33-40. PubMed ID: 32534139.
    Abstract:
    OBJECTIVES: Characteristics of the Mycobacterium avium-intracellulare complex pulmonary disease (MAC-PD) caused by distinct subspecies remain uncertain. METHODS: This study was conducted from 2013-2015 in three hospitals in Taiwan. RESULTS: Among the 144 patients with MAC-PD, 57 (39.6%), 37 (25.7%), 37 (25.7%), and 13 (9.0%) were infected with Mycobacterium intracellulare subspecies intracellulare (MIsI), Mycobacterium avium subspecies hominissuis (MAsH), Mycobacterium intracellulare subspecies chimaera (MIsC), and others, respectively. Patients with MAsH-PD were younger (p = 0.010) with higher human immunodeficiency virus infection rates (27.0%, 0.0%, 0.0%, and 7.7% for MAsH-PD, MIsC-PD, MIsI-PD, and others, respectively; p < 0.001). Twenty-two (15.3%) patients reported spontaneous culture-negative conversion, but 15 (10.4%) and 33 (22.9%) patients developed radiographic progression and unfavorable outcomes, especially MAsH-PD. The susceptibility rates to clarithromycin and inhaled amikacin were both 98.6%. MAsH demonstrated the lowest rate of resistance to moxifloxacin (66.7%, 97.3%, 89.1%, and 92.3% for MAsH-PD, MIsC-PD, MIsI-PD, and others, respectively; p = 0.001) and MIsI isolates had the highest rate of resistance to intravenous amikacin (25%, 13.5%, 38.2%, and 15.4% for MAsH-PD, MIsC-PD, MIsI-PD, and others, respectively; p = 0.024). CONCLUSIONS: Pulmonary disease caused by distinct MAC subspecies had different outcomes and drug susceptibility. The local prevalence of species needs to be monitored.
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