The synergetic effect of Imipenem-clarithromycin combination in the Mycobacteroides abscessus complex View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-10-19

AUTHORS

Satomi Takei, Hiroaki Ihara, Shinsaku Togo, Ayako Nakamura, Yuichi Fujimoto, Junko Watanabe, Kana Kurokawa, Kohei Shibayama, Issei Sumiyoshi, Yusuke Ochi, Moe Iwai, Takahiro Okabe, Masayoshi Chonan, Shigeki Misawa, Akimichi Ohsaka, Kazuhisa Takahashi

ABSTRACT

BACKGROUND: Nontuberculous mycobacteria (NTM) are ubiquitous organisms and the incidence of NTM infections has been increasing in recent years. Mycobacteroides abscessus (M. abscessus) is one of the most antimicrobial-resistant NTM; however, no reliable antibiotic regimen can be officially advocated. We evaluated the efficacy of clarithromycin in combination with various antimicrobial agents against the M. abscessus complex. RESULTS: Twenty-nine clinical strains of M. abscessus were isolated from various clinical samples. Of the isolates, 10 (34.5%) were of M. abscessus subsp. abscessus, 18 (62.1%) of M. abscessus subsp. massiliense, and 1 (3.4%) of M. abscessus subsp. bolletii. MICs of three antimicrobial agents (amikacin, imipenem, and moxifloxacin) were measured with or without clarithromycin. The imipenem-clarithromycin combination significantly reduced MICs compared to clarithromycin and imipenem monotherapies, including against resistant strains. The association between susceptibility of the M. abscessus complex and each combination of agents was significant (p = 0.001). Adjusted residuals indicated that the imipenem-clarithromycin combination had the synergistic effect (adjusted residual = 3.1) and suppressed the antagonistic effect (adjusted residual = - 3.1). In subspecies of M. abscessus complex, the association with susceptibility of M. abscessus subsp. massiliense was similarly statistically significant (p = 0.036: adjusted residuals of synergistic and antagonistic effect respectively: 2.6 and - 2.6). The association with susceptibility of M. abscessus subsp. abscessus also showed a similar trend but did not reach statistical significance. CONCLUSION: Our data suggest that the imipenem-clarithromycin combination could be the recommended therapeutic choice for the treatment of M. abscessus complex owing to its ability to restore antimicrobial susceptibility. More... »

PAGES

316

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12866-020-02000-5

DOI

http://dx.doi.org/10.1186/s12866-020-02000-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1131882799

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33076820


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24 schema:description BACKGROUND: Nontuberculous mycobacteria (NTM) are ubiquitous organisms and the incidence of NTM infections has been increasing in recent years. Mycobacteroides abscessus (M. abscessus) is one of the most antimicrobial-resistant NTM; however, no reliable antibiotic regimen can be officially advocated. We evaluated the efficacy of clarithromycin in combination with various antimicrobial agents against the M. abscessus complex. RESULTS: Twenty-nine clinical strains of M. abscessus were isolated from various clinical samples. Of the isolates, 10 (34.5%) were of M. abscessus subsp. abscessus, 18 (62.1%) of M. abscessus subsp. massiliense, and 1 (3.4%) of M. abscessus subsp. bolletii. MICs of three antimicrobial agents (amikacin, imipenem, and moxifloxacin) were measured with or without clarithromycin. The imipenem-clarithromycin combination significantly reduced MICs compared to clarithromycin and imipenem monotherapies, including against resistant strains. The association between susceptibility of the M. abscessus complex and each combination of agents was significant (p = 0.001). Adjusted residuals indicated that the imipenem-clarithromycin combination had the synergistic effect (adjusted residual = 3.1) and suppressed the antagonistic effect (adjusted residual = - 3.1). In subspecies of M. abscessus complex, the association with susceptibility of M. abscessus subsp. massiliense was similarly statistically significant (p = 0.036: adjusted residuals of synergistic and antagonistic effect respectively: 2.6 and - 2.6). The association with susceptibility of M. abscessus subsp. abscessus also showed a similar trend but did not reach statistical significance. CONCLUSION: Our data suggest that the imipenem-clarithromycin combination could be the recommended therapeutic choice for the treatment of M. abscessus complex owing to its ability to restore antimicrobial susceptibility.
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31 schema:keywords MIC
32 Mycobacteroides abscessus
33 NTM infection
34 ability
35 abscessus
36 abscessus complex
37 abscessus subsp
38 agents
39 antagonistic effect
40 antibiotic regimen
41 antimicrobial agents
42 antimicrobial susceptibility
43 antimicrobial-resistant NTM
44 association
45 choice
46 clarithromycin
47 clinical samples
48 clinical strains
49 combination
50 combination of agents
51 complexes
52 data
53 effect
54 efficacy
55 efficacy of clarithromycin
56 imipenem monotherapy
57 imipenem-clarithromycin combination
58 incidence
59 infection
60 isolates
61 massiliense
62 monotherapy
63 mycobacteria
64 nontuberculous mycobacteria
65 organisms
66 recent years
67 regimen
68 reliable antibiotic regimen
69 residuals
70 resistant strains
71 samples
72 significance
73 similar trend
74 statistical significance
75 strains
76 subsp
77 subspecies
78 susceptibility
79 synergetic effect
80 synergistic effect
81 therapeutic choice
82 treatment
83 trends
84 ubiquitous organisms
85 years
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