Report On Unacceptable Residues Of Antibiotics - amazonia.fiocruz.br

Metrics details. 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. In this study, we report the case and describe the mechanism of resistance. A year-old man with a history of total gastrectomy and immunosuppressant treatment for rheumatoid arthritis developed a recurrence of pulmonary infection caused by M. 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.

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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. This is the first report on the treatment of fluoroquinolone-resistant M. 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. Peer Review reports.

Non-tuberculous mycobacteria NTM are widespread in the natural environment, including natural waters, engineered water systems, and soils [ 1 ]. They can affect many organs and cause diseases, such as pulmonary disease, lymphadenitis, cutaneous disease, and disseminated disease [ 2 ].

Of these, pulmonary infection is the most common clinical manifestation [ 2 ]. The most common pathogens for lung disease are Mycobacterium avium complex and Mycobacteroides abscessusbut Mycolicibacterium fortuitum is also important [ 3 ]. One characteristic of M.

Background

Several previous cases have reported that combining antibiotics, including quinolones, successfully completed the treatment [ 56 ]. There is no report about the treatment of resistant M. The most common mechanism of quinolone resistance in mycobacteria is due to mutations in the gyrA and gryB genes of DNA gyrase [ 7 ]. These mutations involved a conserved region called the quinolone resistance-determining regions QRDR [ 7 ].

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However, there have been no reports on M. We describe a rare case of pulmonary disease due to fluoroquinolone-resistant M. In addition, we investigate the mechanism of resistance of M. A year-old man height He underwent surgical lung biopsy for evaluation of a 3-year history of unchanged reticular shadow observed in his chest. Histopathological analysis showed uniform involvement of alveolar wall fibrosis with lymphoid follicles, which was consistent with a diagnosis of collagen vascular disease-associated interstitial pneumonia CVD-IP.]