|Year : 2019 | Volume
| Issue : 2 | Page : 92-94
Drug resistance pattern of Mycobacterium abscessus: Change of pattern in 20-year period after the first report of human pulmonary infection in Thailand
Beuy Joob1, Viroj Wiwanitkit2
1 Medical Academic Center, Bangkok, Thailand
2 Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India; Department of Biological Science, Joseph Ayobabalola University, Ikeii-Arakeji, Osun State, Nigeria
|Date of Submission||10-Feb-2019|
|Date of Decision||13-Mar-2019|
|Date of Acceptance||18-Apr-2019|
|Date of Web Publication||17-Jun-2019|
Dr. Beuy Joob
Medical Academic Center, Bangkok
Source of Support: None, Conflict of Interest: None
Background: Mycobacterium abscessus is a new emerging problematic mycobacterial infection seen in several countries including Thailand, a tropical country in Indochina, at present. This infection usually has the problem of antibiotic resistance. Methods: The authors hereby review and reappraise the pattern of drug resistance pattern of M. abscessus to study the change of pattern in 20-year period after the first report of human pulmonary infection in Thailand. Results: The drug resistance pattern is observable, and there are some remained nonresistant drugs. Conclusion: In our setting, drug resistance of M. abscessus has been an important problem for a long time. Nevertheless, there is still no much change of the pattern of drug resistance.
Keywords: Drug, Mycobacterium abscessus, resistance
|How to cite this article:|
Joob B, Wiwanitkit V. Drug resistance pattern of Mycobacterium abscessus: Change of pattern in 20-year period after the first report of human pulmonary infection in Thailand. Biomed Biotechnol Res J 2019;3:92-4
|How to cite this URL:|
Joob B, Wiwanitkit V. Drug resistance pattern of Mycobacterium abscessus: Change of pattern in 20-year period after the first report of human pulmonary infection in Thailand. Biomed Biotechnol Res J [serial online] 2019 [cited 2019 Jul 20];3:92-4. Available from: http://www.bmbtrj.org/text.asp?2019/3/2/92/260479
| Introduction|| |
Apart from Mycobacterium tuberculosis infection, there are also other important mycobacterial infections that are the present medical concern. Mycobacterium abscessus is a new emerging problematic mycobacterial infection seen in several countries including Thailand, a tropical country in Indochina, at present., The pathogen is a rapid-growing mycobacterial pathogen. This infection usually has the problem of antibiotic resistance. According to a recent report by Kobayashi et al., drug resistance is related to the sputum negative conversion.
To manage this new emerging infection, effective diagnostic tool and therapeutic approach are needed. The good effective antibiotic is required for effective management of the infected patient. As noted by Cusumano et al., the good monitoring system for the epidemiology and drug resistance pattern of the pathogen is very important in strategies planning for the management of M. abscessus infection. Here, the authors perform a situation analysis on the available data in an endemic area of mycobacterial infection.
| Methods|| |
This study is a retrospective study. First, the authors preformed a literature on local and international databases on M. abscessus in Thailand. The reports containing the data on drug resistance pattern of M. abscessus were collected for further study. The authors hereby reviewed and reappraised the pattern of drug resistance pattern of M. abscessus to study the change of pattern in 20-year period (1999–2018) after the first report of human pulmonary infection in Thailand. The present appraisal is a retrospective summative analysis on the published public available data and it requires no written informed consent or ethical approval.
| Results|| |
According to the study, there are at least three official reports on the pattern of drug resistance pattern of M. abscessus.,, The drug resistance pattern is observable and presented in [Table 1]. Based on the data, there are some remained nonresistant drugs. Amikacin is still the drug that remains susceptibility property whereas there is a significant reduction of percent of nonresistance for netilmicin and imipenem (from 100% to 0%; P < 0.01, proportional t-test).
|Table 1: Drug resistance pattern for Mycobacterium abscessus in a report from Thailand|
Click here to view
| Discussion|| |
Thailand, a tropical country, presently has a very high prevalence of mycobacterial infection. Not only tuberculosis but also nontuberculosis mycobacterial diseases are still the present public health consideration in this area. The drug resistance problem becomes an important problem to be managed. M. abscessus infection is a new emerging problematic infection in several settings including to our setting, Thailand. In our country, the first case report of pulmonary infection caused by M. abscessus was reported in 1999. After that, there have been continuous sporadic case reports of this disease.
Regarding the drug resistance pattern, the first study on M. abscessus species collected from environmental sample showed that there were resistances to penicillins and cephalosporins in all studied samples, and some samples also posed resistance property to netilmicin. Focusing on the report from a clinical specimen, the first reports during 2013 showed that all samples are susceptible to several drugs including amikacin, netilmicin, and imipenem., However, the newest study in 2018 showed that only amikacin still remained nonresistance property. The resistance to netilmicin is also observed at present, and this finding can support the first observation on the tendency for netilmicin resistance. In fact, the problem of drug resistance and failure of M. abscessus infection is widely reported. The rate of successful outcome of the treatment is usually low. The alteration in genetic structure of the pathogen is common and is also proposed for the association with clinical epidemiology including drug resistance.
Based on the present finding, the recommended drug of choice for the management of M. abscessus infection is amikacin. This is concordant with the recent report in 2017 from Korea. As recommended by Lee et al., once daily 15 mg/kg/day of amikacin for 4 weeks is the effective therapeutic option for the management of M. abscessus infection. The use of new regimens such as combination of clarithromycin, imipenem, and tigecycline for the management of atypical mycobacterial infection might not be applicable to our setting since there is already an emerging observation on imipenem resistance. In fact, the reconsideration on the use of several antibiotics including macrolide for the management of M. abscessus infection and drug resistance is the big issue worldwide.
| Conclusion|| |
In our setting, drug resistance of M. abscessus has been an important problem for a long time. Nevertheless, there is still no much change in the pattern of drug resistance.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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