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Pulmonary infection due to fluoroquinolone-resistant Mycolicibacterium fortuitum: a case report
BACKGROUND: Mycolicibacterium fortuitum is a species of the rapidly growing mycobacteria that can cause pulmonary infection. It is susceptible to multiple antibiotics both in vitro and in clinical practice, so that any combination of susceptible drugs is effective. However, we encountered a case of...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678322/ https://www.ncbi.nlm.nih.gov/pubmed/33213390 http://dx.doi.org/10.1186/s12879-020-05596-1 |
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author | Kurokawa, Kana Harada, Norihiro Sasano, Hitoshi Takagi, Haruhi Takei, Satomi Nakamura, Ayako Kamada, Keisuke Yoshida, Atsushi Kikuchi, Ken Takahashi, Kazuhisa |
author_facet | Kurokawa, Kana Harada, Norihiro Sasano, Hitoshi Takagi, Haruhi Takei, Satomi Nakamura, Ayako Kamada, Keisuke Yoshida, Atsushi Kikuchi, Ken Takahashi, Kazuhisa |
author_sort | Kurokawa, Kana |
collection | PubMed |
description | BACKGROUND: Mycolicibacterium fortuitum is a species of the rapidly growing mycobacteria that can cause pulmonary infection. It is susceptible to multiple antibiotics both in vitro and in clinical practice, so that any combination of susceptible drugs is effective. However, we encountered a case of infection due to fluoroquinolone-resistant M. fortuitum. In this study, we report the case and describe the mechanism of resistance. CASE PRESENTATION: A 65-year-old man with a history of total gastrectomy and immunosuppressant treatment for rheumatoid arthritis developed a recurrence of pulmonary infection caused by M. fortuitum. He was treated with clarithromycin and levofloxacin as a first-line treatment, based on the favorable susceptibility at that time. After recurrence, a high minimum inhibitory concentration to fluoroquinolones was detected. DNA sequencing of the pathogen showed the substitution of serine for tryptophan at residue 83 in the gyrA gene. He was successfully treated with a combination of other antibiotics. CONCLUSION: This is the first report on the treatment of fluoroquinolone-resistant M. fortuitum and investigation of the mechanism of resistance. We suggest that the susceptibility test remains effective for determining the next line of treatment after a pathogen has acquired resistance, and resistance to fluoroquinolones in M. fortuitum can be attributed to a single change of amino acid. |
format | Online Article Text |
id | pubmed-7678322 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-76783222020-11-20 Pulmonary infection due to fluoroquinolone-resistant Mycolicibacterium fortuitum: a case report Kurokawa, Kana Harada, Norihiro Sasano, Hitoshi Takagi, Haruhi Takei, Satomi Nakamura, Ayako Kamada, Keisuke Yoshida, Atsushi Kikuchi, Ken Takahashi, Kazuhisa BMC Infect Dis Case Report BACKGROUND: Mycolicibacterium fortuitum is a species of the rapidly growing mycobacteria that can cause pulmonary infection. It is susceptible to multiple antibiotics both in vitro and in clinical practice, so that any combination of susceptible drugs is effective. However, we encountered a case of infection due to fluoroquinolone-resistant M. fortuitum. In this study, we report the case and describe the mechanism of resistance. CASE PRESENTATION: A 65-year-old man with a history of total gastrectomy and immunosuppressant treatment for rheumatoid arthritis developed a recurrence of pulmonary infection caused by M. fortuitum. He was treated with clarithromycin and levofloxacin as a first-line treatment, based on the favorable susceptibility at that time. After recurrence, a high minimum inhibitory concentration to fluoroquinolones was detected. DNA sequencing of the pathogen showed the substitution of serine for tryptophan at residue 83 in the gyrA gene. He was successfully treated with a combination of other antibiotics. CONCLUSION: This is the first report on the treatment of fluoroquinolone-resistant M. fortuitum and investigation of the mechanism of resistance. We suggest that the susceptibility test remains effective for determining the next line of treatment after a pathogen has acquired resistance, and resistance to fluoroquinolones in M. fortuitum can be attributed to a single change of amino acid. BioMed Central 2020-11-19 /pmc/articles/PMC7678322/ /pubmed/33213390 http://dx.doi.org/10.1186/s12879-020-05596-1 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Kurokawa, Kana Harada, Norihiro Sasano, Hitoshi Takagi, Haruhi Takei, Satomi Nakamura, Ayako Kamada, Keisuke Yoshida, Atsushi Kikuchi, Ken Takahashi, Kazuhisa Pulmonary infection due to fluoroquinolone-resistant Mycolicibacterium fortuitum: a case report |
title | Pulmonary infection due to fluoroquinolone-resistant Mycolicibacterium fortuitum: a case report |
title_full | Pulmonary infection due to fluoroquinolone-resistant Mycolicibacterium fortuitum: a case report |
title_fullStr | Pulmonary infection due to fluoroquinolone-resistant Mycolicibacterium fortuitum: a case report |
title_full_unstemmed | Pulmonary infection due to fluoroquinolone-resistant Mycolicibacterium fortuitum: a case report |
title_short | Pulmonary infection due to fluoroquinolone-resistant Mycolicibacterium fortuitum: a case report |
title_sort | pulmonary infection due to fluoroquinolone-resistant mycolicibacterium fortuitum: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678322/ https://www.ncbi.nlm.nih.gov/pubmed/33213390 http://dx.doi.org/10.1186/s12879-020-05596-1 |
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