Variability of macrolide-resistant profile in Mycobacterium avium complex pulmonary disease

Antimicrob Agents Chemother. 2024 Nov 6;68(11):e0121324. doi: 10.1128/aac.01213-24. Epub 2024 Oct 8.

Abstract

This single-center retrospective study aimed to analyze the variability of macrolide resistance (MR) in 68 patients with Mycobacterium avium complex pulmonary disease. Among 25 patients treated without macrolides, 13 (52%) reverted to macrolide-susceptible (MS) profiles. Only one (2%) of 43 patients who continued macrolide treatment showed this change. We compared 30 MR isolates with recent specimens. Among them, seven shifted to MS (five attributed to clonally related strains; two resulting from reinfection or polyclonal infection).

Keywords: Mycobacterium avium complex; drug resistance; macrolide resistance; non-tuberculous mycobacteria; variable number tandem repeat; whole-genome sequence.

MeSH terms

  • Aged
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Drug Resistance, Bacterial*
  • Female
  • Humans
  • Lung Diseases / drug therapy
  • Lung Diseases / microbiology
  • Macrolides* / pharmacology
  • Macrolides* / therapeutic use
  • Male
  • Microbial Sensitivity Tests*
  • Middle Aged
  • Mycobacterium avium Complex* / drug effects
  • Mycobacterium avium-intracellulare Infection* / drug therapy
  • Mycobacterium avium-intracellulare Infection* / microbiology
  • Retrospective Studies

Substances

  • Macrolides
  • Anti-Bacterial Agents