Comparing minimum inhibitory concentrations of amikacin for pulmonary Mycobacterium avium complex disease: An analysis of culture media differences

Atsuho Morita, Ho Namkoong, Yoshifumi Uwamino, Satoshi Mitarai, Akio Aono, Takanori Asakura, Kazuma Yagi, Hiromu Tanaka, Shuhei Azekawa, Kensuke Nakagawara, Masanori Kaji, Genta Nagao, Hirofumi Kamata, Hiromichi Matsushita, Koichi Fukunaga, Naoki Hasegawa

研究成果: Article査読

抄録

Mycobacterium avium complex (MAC) is considered a paramount microbe, especially in East Asia, including Japan. The commonly used commercial Minimum Inhibitory Concentrations (MIC) assay using Middlebrook 7H9 (7H9) medium deviates from the latest Clinical and Laboratory Standards Institute (CLSI) guidelines. Alternatively, measurement with cation-adjusted Mueller-Hinton broth (CAMHB) that conforms to CLSI standards is not yet widely available. Following the approval and commercialization of amikacin liposome inhalation suspension (ALIS) in 2021, a more precise evaluation of amikacin (AMK) susceptibility in MAC is necessary for treatment decisions. In the present study, 33 sputum samples were extracted from 27 patients, and MICs of AMK were compared between the frequently used 7H9 and the recommended CAMHB of the isolated MAC strains. The history of exposure to aminoglycosides for each sample was also added as clinical information. The findings indicated that there was only an 18% concordance rate in MIC between the two media, with 19 samples (58%) indicating lower MICs in 7H9 relative to CAMHB. The 17 samples had a history of exposure to aminoglycosides for periods ranging from 1.5 to 28 months. Specifically, 10 samples were exposed to amikacin by inhalation and intravenous injection, and the remaining seven samples had a history of ALIS inhalation. Samples with a prior utilization of aminoglycosides were significantly predisposed to developing resistance to ALIS compared to those without such a history (P = 0.046). Physicians are encouraged to scrutinize the findings of susceptibility testing utilizing CLSI-endorsed MIC assay using CAMHB medium to ascertain the optimal therapeutic approach.

本文言語English
ページ(範囲)159-163
ページ数5
ジャーナルJournal of Infection and Chemotherapy
30
2
DOI
出版ステータスPublished - 2024 2月

ASJC Scopus subject areas

  • 微生物学(医療)
  • 感染症
  • 薬理学(医学)

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