Ethambutol-Susceptibility of Clinical and Environmental Atypical Mycobacteria Isolated from Isfahan, Iran

Document Type : Original Article (s)

Authors

1 MSc Student, Department of Microbiology, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate professor Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Assistant Professor, Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Assistant Professor, Nosocomial Infection Research Center AND Department of Microbiology, Isfahan University of Medical Sciences, Isfahan, Iran

5 Assistant Professor, Infectious Diseases and Tropical Medicine Research Center AND Department of Microbiology, Isfahan University of Medical Sciences, Isfahan, Iran

6 Assistant Professor, Department of Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran

7 MSc Student, Department of Microbiology, Islamic Azad University, Fars Science and Research Branch, Shiraz, Iran

Abstract

Background: Due to increasing of AIDS and nontuberculous mycobacteria (NTM) pathogenesis in this group of patients, the role of NTM is becoming bold and more concerned. Furthermore, the treatment of NTM diseases is species related. Thus, information about the pattern of treatment to cure the related diseases is very important in any geographical area. In this study, environmental and clinical isolates of NTM and their sensitivity to ethambutol has been determined.Methods: 41 clinical and environmental isolates from Isfahan, Iran, were identified by conventional phenotypic methods. To determine sensitivity to ethambutol, the isolates were tested in 2, 5, and 10 μg/ml antibiotic concentrations by agar microdilution method.Findings: The identified isolates included M. fortuitum (27 cases), M. gordonae (10 cases) M. smegmatis (1 case), M. abscessus (2 cases), and M. conceptionense (1 case). All of the clinical and environmental isolates were resistant to ethambutol except M. conceptionense which was susceptible in 5 and 10 μg/ml ethambutol concentrations [minimum inhibitory concentration (MIC): less than 5 μg/ml].Conclusion: Due to high frequency of ethambutol resistance in rapid- and slow-growing species of NTM, treatment strategy in this group of patients should be undertaken with caution and more effective drug should be considered.

Keywords


  1. Jarzembowski JA, Young MB. Nontuberculous mycobacterial infections. Arch Pathol Lab Med 2008; 132(8): 1333-41.
  2. Bodle EE, Cunningham JA, Della-Latta P, Schluger NW, Saiman L. Epidemiology of nontuberculous mycobacteria in patients without HIV infection, New York City. Emerg Infect Dis 2008; 14(3): 390-6.
  3. Wu TS, Lu CC, Lai HC. Current situations on identification of nontuberculous mycobacteria. J Biomed Lab Sci 2009; 21(1): 1-6.
  4. Falkinham JO 3rd. Nontuberculous mycobacteria in the environment. Clin Chest Med 2002; 23(3): 529-51.
  5. Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007; 175(4): 367-416.
  6. van Ingen J, Boeree MJ, van Soolingen D, Mouton JW. Resistance mechanisms and drug susceptibility testing of nontuberculous mycobacteria. Drug Resist Updat 2012; 15(3): 149-61.
  7. Alcaide F, Pfyffer GE, Telenti A. Role of embB in natural and acquired resistance to ethambutol in mycobacteria. Antimicrob Agents Chemother 1997; 41(10): 2270-3.
  8. da Silva Telles MA, Chimara E, Ferrazoli L, Riley LW. Mycobacterium kansasii: antibiotic susceptibility and PCR-restriction analysis of clinical isolates. J Med Microbiol 2005; 54(Pt 10): 975-9.
  9. Shen X, Shen GM, Wu J, Gui XH, Li X, Mei J, et al. Association between embB codon 306 mutations and drug resistance in Mycobacterium tuberculosis. Antimicrob Agents Chemother 2007; 51(7): 2618-20.
  10. Plinke C, Rusch-Gerdes S, Niemann S. Significance of mutations in embB codon 306 for prediction of ethambutol resistance in clinical Mycobacterium tuberculosis isolates. Antimicrob Agents Chemother 2006; 50(5): 1900-2.
  11. Aubry A, Jarlier V, Escolano S, Truffot-Pernot C, Cambau E. Antibiotic susceptibility pattern of Mycobacterium marinum. Antimicrob Agents Chemother 2000; 44(11): 3133-6.
  12. Zignol M, van Gemert W, Falzon D, Sismanidis C, Glaziou P, Floyd K, et al. Surveillance of anti-tuberculosis drug resistance in the world: an updated analysis, 2007-2010. Bull World Health Organ 2012; 90(2): 111-119D.
  13. Guo JH, Xiang WL, Zhao QR, Luo T, Huang M, Zhang J, et al. Molecular characterization of drug-resistant mycobacterium tuberculosis isolates from Sichuan Province in china. Jpn J Infect Dis 2008; 61(4): 264-8.
  14. Falkinham JO. The changing pattern of nontuberculous mycobacterial disease. Can J Infect Dis 2003; 14(5): 281-6.
  15. Dorman S, Subramanian A. Nontuberculous mycobacteria in solid organ transplant recipients. Am J Transplant 2009; 9(Suppl 4): S63-S69.
  16. Wang HX, Yue J, Han M, Yang JH, Gao RL, Jing LJ, et al. Nontuberculous mycobacteria: susceptibility pattern and prevalence rate in Shanghai from 2005 to 2008. Chin Med J (Engl) 2010; 123(2): 184-7.
  17. Swenson JM, Thornsberry C, Silcox VA. Rapidly growing mycobacteria: testing of susceptibility to 34 antimicrobial agents by broth microdilution. Antimicrob Agents Chemother 1982; 22(2): 186-92.
  18. van Ingen J, van der Laan T, Dekhuijzen R, Boeree M, van Soolingen D. In vitro drug susceptibility of 2275 clinical non-tuberculous Mycobacterium isolates of 49 species in The Netherlands. Int J Antimicrob Agents 2010; 35(2): 169-73.
  19. Wallace RJ Jr., Dalovisio JR, Pankey GA. Disk diffusion testing of susceptibility of Mycobacterium fortuitum and Mycobacterium chelonei to antibacterial agents. Antimicrob Agents Chemother 1979; 16(5): 611-4.