Mycobacterium Abscessus Alt Tür Abscessus İzolatlarının İlaç Duyarlılık Paterninin Belirlenmesi

Abstract

Mycobacterium abscessus complex that is one of the most important rapid growing nontuberculous mycobacteria can lead to pulmonary and extrapulmonary infections and treatment of these infections is difficult due to antimicrobial resistance of this mycobacteria to most of antimicrobials. Especially treatment of Mycobacterium abscessus complex infection in patients with underlying disease such as cystic fibrosis and immunocompromised cancer and transplant patients is very difficult and long. In recent years, an increase in the number of infections caused by Mycobacterium abscessus complex has been reported in many countries around the world. Mycobacterium abscessus complex has three subspecies that are Mycobacterium abscessus supspecies abscessus, Mycobacterium abscessus supspecies massiliense and Mycobacterium abscessus supspecies bolletii and their drug susceptibility patterns differ from each other. The aim of this study is to determine antibiotic susceptibility patterns of Mycobacterium abscessus subspecies abscessus isolates with broth microdilution reference method and to demonstrate clarithromycin resistance both phenotypically with susceptibility test and genotypically with real time polymerase chain reaction. As a result of this study, of the 55 Mycobacterium abscessus supspecies abscessus isolates, 87.3% clarithromycin, 81.9% ciprofloxacin, 40% imipenem, 30.9% tobramycin, 29.1% moxifloxacin, 7.2% cefoxitin and 5.4% amikacin resistance were detected. Of the 55 Mycobacterium abscessus subspecies abscessus isolates tested with antibiotic susceptibility test, 7 were detected as susceptible to clarithromycin. Acquired and inducible clarithromycin resistance was detected in 15 and 33 isolates respectively. In the erm(41) and rrl real time polymerase chain reaction experiments to investigate molecular clarithromycin resistance of these isolates, melting curves consistent with their drug susceptibility profile have been shown.