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Frontiers in Cellular and Infection... 2023We aimed to evaluate the activity of PBTZ169 and pretomanid against non-tuberculous mycobacteriosis (NTM) and .
OBJECTIVES
We aimed to evaluate the activity of PBTZ169 and pretomanid against non-tuberculous mycobacteriosis (NTM) and .
METHODS
The minimum inhibitory concentrations (MICs) of 11 antibiotics, against slow-growing mycobacteria (SGMs) and rapid-growing mycobacteria (RGMs) were tested using the microplate alamarBlue assay. The activities of bedaquiline, clofazimine, moxifloxacin, rifabutin, PBTZ169 and pretomanid against four common NTMs were assessed in murine models.
RESULTS
PBTZ169 and pretomanid had MICs of >32 μg/mL against most NTM reference and clinical strains. However, PBTZ169 was bactericidal against (3.33 and 1.49 log10 CFU reductions in the lungs and spleen, respectively) and (2.29 and 2.24 CFU reductions in the lungs and spleen, respectively) in mice, and bacteriostatic against Mycobacterium avium and . Pretomanid dramatically decreased the CFU counts of (3.12 and 2.30 log10 CFU reductions in the lungs and spleen, respectively), whereas it showed moderate inhibition of and . Bedaquiline, clofazimine, and moxifloxacin showed good activities against four NTMs and . Rifabutin did not inhibit and in mice.
CONCLUSION
PBTZ169 appears to be a candidate for treating four common NTM infections. Pretomanid was more active against , and than against .
Topics: Animals; Mice; Mycobacterium abscessus; Mycobacterium avium; Mycobacterium fortuitum; Mycobacterium chelonae; Clofazimine; Moxifloxacin; Mice, Inbred BALB C; Anti-Bacterial Agents; Nontuberculous Mycobacteria; Mycobacterium Infections; Rifabutin; Mycobacterium Infections, Nontuberculous; Microbial Sensitivity Tests
PubMed: 37077530
DOI: 10.3389/fcimb.2023.1115530 -
Mikrobiyoloji Bulteni Apr 2023Infections related to the rapidly growing mycobacteria (RGM), which are common in the environment, have clinical significance as they can affect both immunocompromised...
Infections related to the rapidly growing mycobacteria (RGM), which are common in the environment, have clinical significance as they can affect both immunocompromised and immunocompetent patients. Treatment of RGM related infections is difficult, because they are resistant to many of the first-line tuberculosis agents, require a long-term multiple drug regimen, which is costly, and is associated with drugrelated toxicities. The aim of this study was to investigate the in vitro antimicrobial susceptibility profiles of RGM isolated in Dokuz Eylül University Hospital and also to reveal epidemiological data. A total of 58 isolates [(Mycobacterium fortuitum (n= 35), Mycobacterium abscessus (n= 19) and Mycobacterium chelonae (n= 4)], which were isolated in Dokuz Eylül University Hospital between 2013 and 2018, were subjected to in vitro testing for nine antimicrobial agents (amikacin, cefoxitin, ciprofloxacin, clarithromycin, doxycycline, imipenem, linezolid, moxifloxacin and tobramycin) with the broth microdilution method recommended by the Clinical and Laboratory Standards Institute (CLSI). For M.abscessus; 73.68% of the isolates were found susceptible to amikacin; 73.68% of isolates were susceptible to clarithromycin at early reading and only 21.05% of them remained susceptible at late reading time. No resistance to imipenem were observed. M.abscessus isolates were highly resistant to tobramycin, doxycycline and fluoroquinolones. Antibiotic susceptibility testing of M.chelonae isolates demonstrated 100% susceptibility for amikacin, clarithromycin and tobramycin. No resistance to linezolid, imipenem and moxifloxacin were observed. None of the isolates were susceptible to cefoxitin. Ciprofloxacin and doxycycline also showed poor in vitro activity against M.chelonae isolates. For M.fortuitum clarithromycin susceptibility decreased from 32.35% to 2.94% after an additional incubation until 14 days. All tested isolates of the M.fortuitum were susceptible to amikacin, ciprofloxacin and moxifloxacin. None of the M.fortuitum isolates exhibited resistance to cefoxitin and imipenem. Most of the M.fortuitum isolates were resistant to tobramycin and doxycycline. When the results were evaluated together, RGM isolates in this study were highly susceptible to amikacin; and were highly resistant to doxycycline. In conclusion, this study supported that the status of antimicrobial susceptibilities were different between species and also showed the importance for hospitals to know susceptibility patterns of isolates in their region. It should be noted that accurate species determination is critical for treatment as well as susceptibility status of rapidly growing mycobacteria to the antimicrobials in use.
Topics: Humans; Anti-Bacterial Agents; Amikacin; Clarithromycin; Cefoxitin; Linezolid; Doxycycline; Moxifloxacin; Mycobacterium; Tobramycin; Ciprofloxacin; Imipenem; Microbial Sensitivity Tests; Nontuberculous Mycobacteria; Mycobacterium Infections, Nontuberculous
PubMed: 37067207
DOI: 10.5578/mb.20239917 -
Brazilian Journal of Microbiology :... Jun 2023Periprosthetic joint infection (PJI) remains one of the most common complications of total knee arthroplasty. Although mainly caused by Staphylococcus aureus and other...
Periprosthetic joint infection (PJI) remains one of the most common complications of total knee arthroplasty. Although mainly caused by Staphylococcus aureus and other Gram-positive microorganisms, occasionally, commensal or environmental bacteria are reported as causative agents of these infections. The present work aimed to report a case of PJI caused by an imipenem-resistant Mycobacterium senegalense strain. A bacterial strain isolated from the culture of intraoperative samples was observed by optical microscopy after Gram and Ziehl-Neelsen staining. The species identification was performed by mass spectrometry analysis and partial sequencing of the heat shock protein 65 (hsp65) gene. The antimicrobial profile of the clinical isolate was determined according to the Clinical and Laboratory Standards Institute. Mass spectrometry and gene sequencing analysis identified the bacterial isolate as Mycobacterium fortuitum complex and M. senegalense, respectively. The isolated was found exhibiting an imipenem-resistant profile. The accurate and timely identification, as well as investigation of the antimicrobial susceptibility profile, of fast-growing nontuberculous mycobacteria species are crucial for establishing the prompt and correct treatment of the infection, particularly in cases of patients at greater risk for opportunistic and severe infections.
Topics: Humans; Imipenem; Nontuberculous Mycobacteria; Staphylococcal Infections; Bacteria; Anti-Bacterial Agents
PubMed: 37020078
DOI: 10.1007/s42770-023-00960-0 -
Nontuberculous mycobacteria isolation from sputum specimens: A retrospective analysis of 1061 cases.International Journal of... 2023In recent years, with the development of laboratory methods, the frequency of nontuberculosis mycobacteria (NTM) infections has increased. The primary aim of this study...
BACKGROUND
In recent years, with the development of laboratory methods, the frequency of nontuberculosis mycobacteria (NTM) infections has increased. The primary aim of this study was to evaluate the clinical significance of therapeutic drug monitoring (TDM) growths in respiratory samples, and the secondary aim was to evaluate the treatment regimens and treatment outcomes of treatment for TDM disease.
METHODS
This study was a retrospective cohort study. Persons with NTM growth in respiratory samples admitted to the reference hospital between 2009 and 2020 were included in this study. Samples detected as NTM by the immunochromatographic rapid diagnostic test, those requested by the clinicians, species were determined by the hsp65PCRREA method. The subjects were classified into 3 groups: patients with NTM infection who received treatment (135, 12.7%), those followed up without treatment (690, 65.1%), and a last group of patients with Mycobacterium tuberculosis (TB) complex strains were isolated and received TB treatment (236, 22.2%). Initiating NTM treatment was decided in accordance with the American Thoracic Society recommendations.
RESULTS
The mean ± standard deviation age of patients was 53.8 ± 16.5 years, and 749 (70.6%) were male. In total, 278 (26.2%) out of 1061 cases had identified, and the most frequent species were MAC (81; Mycobacterium avium: 39, Mycobacterium intracellulare: 39, and MAC: 3), Mycobacterium abscessus (67), Mycobacterium kansasii (48), Mycobacterium fortuitum (23), Mycobacterium chelonae (12), Mycobacterium gordonae (11), and Mycobacterium szulgai (11). In the NTM treatment group, 116 (85.9%) of 135 patients had multiple culture positivity. Previous TB treatment history had 51 (37.8%) of 135 patients, respiratory comorbidities were evident in 37 (27.4%) of 135 patients. Thorax computed tomography imaging in 84 patients revealed nodule 38 (45.2%), consolidation 46 (54.8%), cavity 52 (61.9%), and bronchiectasis 27 (32.1%). Treatment results in the NTM treatment group were as follows: ongoing treatment 14 (10.4%), cure 64 (47.4%), default 33 (24.4%), exitus 19 (14.1%), recurrence 3 (2.2%), and refractory disease 2 (1.5%).
CONCLUSION
This is a large case series evaluating the clinical significance of NTM growths and NTM treatment in Turkey. The clinical significance of NTM growth in respiratory samples is low. Treatment success rates of NTM patients who are treated are low. Treatment defaults and mortality rates are high. New drugs and new regimens are needed.
Topics: Humans; Male; Adult; Middle Aged; Aged; Female; Mycobacterium Infections, Nontuberculous; Retrospective Studies; Sputum; Mycobacterium; Mycobacterium chelonae
PubMed: 36926764
DOI: 10.4103/ijmy.ijmy_10_23 -
Microbial Cell Factories Mar 20239α-hydroxyandrost-4-ene-3,17-dione (9-OHAD) is a significant intermediate for the synthesis of glucocorticoid drugs. However, in the process of phytosterol...
Improving the production of 9α-hydroxy-4-androstene-3,17-dione from phytosterols by 3-ketosteroid-Δ-dehydrogenase deletions and multiple genetic modifications in Mycobacterium fortuitum.
BACKGROUND
9α-hydroxyandrost-4-ene-3,17-dione (9-OHAD) is a significant intermediate for the synthesis of glucocorticoid drugs. However, in the process of phytosterol biotransformation to manufacture 9-OHAD, product degradation, and by-products restrict 9-OHAD output. In this study, to construct a stable and high-yield 9-OHAD producer, we investigated a combined strategy of blocking Δ‑dehydrogenation and regulating metabolic flux.
RESULTS
Five 3-Ketosteroid-Δ-dehydrogenases (KstD) were identified in Mycobacterium fortuitum ATCC 35855. KstD2 showed the highest catalytic activity on 3-ketosteroids, followed by KstD3, KstD1, KstD4, and KstD5, respectively. In particular, KstD2 had a much higher catalytic activity for C9 hydroxylated steroids than for C9 non-hydroxylated steroids, whereas KstD3 showed the opposite characteristics. The deletion of kstDs indicated that KstD2 and KstD3 were the main causes of 9-OHAD degradation. Compared with the wild type M. fortuitum ATCC 35855, MFΔkstD, the five kstDs deficient strain, realized stable accumulation of 9-OHAD, and its yield increased by 42.57%. The knockout of opccr or the overexpression of hsd4A alone could not reduce the metabolic flux of the C22 pathway, while the overexpression of hsd4A based on the knockout of opccr in MFΔkstD could remarkably reduce the contents of 9,21 ‑dihydroxy‑20‑methyl‑pregna‑4‑en‑3‑one (9-OHHP) by-products. The inactivation of FadE28-29 leads to a large accumulation of incomplete side-chain degradation products. Therefore, hsd4A and fadE28-29 were co-expressed in MFΔkstDΔopccr successfully eliminating the two by-products. Compared with MFΔkstD, the purity of 9-OHAD improved from 80.24 to 90.14%. Ultimately, 9‑OHAD production reached 12.21 g/L (83.74% molar yield) and the productivity of 9-OHAD was 0.0927 g/L/h from 20 g/L phytosterol.
CONCLUSIONS
KstD2 and KstD3 are the main dehydrogenases that lead to 9-OHAD degradation. Hsd4A and Opccr are key enzymes regulating the metabolic flux of the C19- and C22-pathways. Overexpression of fadE28-29 can reduce the accumulation of incomplete degradation products of the side chains. According to the above findings, the MF-FA5020 transformant was successfully constructed to rapidly and stably accumulate 9-OHAD from phytosterols. These results contribute to the understanding of the diversity and complexity of steroid catabolism regulation in actinobacteria and provide a theoretical basis for further optimizing industrial microbial catalysts.
Topics: Phytosterols; Mycobacterium fortuitum; Androstenedione; Oxidoreductases; Steroids
PubMed: 36922830
DOI: 10.1186/s12934-023-02052-y -
Antimicrobial Agents and Chemotherapy Apr 2023Mycobacterium fortuitum represents one of the most clinically relevant rapid-growing mycobacterial species. Treatments are complex due to antibiotic resistance and to...
Mycobacterium fortuitum represents one of the most clinically relevant rapid-growing mycobacterial species. Treatments are complex due to antibiotic resistance and to severe side effects of effective drugs, prolonged time of treatment, and co-infection with other pathogens. Herein, we explored the activity of NITD-916, a direct inhibitor of the enoyl-ACP reductase InhA of the type II fatty acid synthase in Mycobacterium tuberculosis. We found that this compound displayed very low MIC values against a panel of M. fortuitum clinical strains and exerted potent antimicrobial activity against M. fortuitum in macrophages. Remarkably, the compound was also highly efficacious in a zebrafish model of infection. Short duration treatments were sufficient to significantly protect the infected larvae from M. fortuitum-induced killing, which correlated with reduced bacterial burdens and abscesses. Biochemical analyses demonstrated an inhibition of synthesis of mycolic acids. Resolving the crystal structure of the InhA in complex with NAD and NITD-916 confirmed that NITD-916 is a direct inhibitor of InhA. Importantly, single nucleotide polymorphism leading to a G96S substitution in InhA conferred high resistance levels to NITD-916, thus resolving its target in M. fortuitum. Overall, these findings indicate that NITD-916 is highly active against M. fortuitum both and and should be considered in future preclinical evaluations for the treatment of M. fortuitum pulmonary diseases.
Topics: Animals; Mycobacterium fortuitum; Zebrafish; Mycobacterium tuberculosis; Mycolic Acids; Oxidoreductases
PubMed: 36920188
DOI: 10.1128/aac.01607-22 -
IDCases 2023Nontuberculous mycobacteria (NTM) are mycobacterial species other than Mycobacterium tuberculous and Mycobacterium leprae [1]. They are environmental organisms which...
Nontuberculous mycobacteria (NTM) are mycobacterial species other than Mycobacterium tuberculous and Mycobacterium leprae [1]. They are environmental organisms which have been implicated in a wide array of clinical syndromes. Here we describe a case of a Mycobacterium fortuitum complex liver abscess in a liver transplant recipient.
PubMed: 36860283
DOI: 10.1016/j.idcr.2023.e01722 -
Infection Control and Hospital... Aug 2023We describe a case of healthcare-associated bloodstream infection due to . Whole-genome sequencing showed that the same strain was isolated from the shared shower water...
We describe a case of healthcare-associated bloodstream infection due to . Whole-genome sequencing showed that the same strain was isolated from the shared shower water of the unit. Nontuberculous mycobacteria frequently contaminate hospital water networks. Preventative actions are needed to reduce the exposure risk for immunocompromised patients.
Topics: Humans; Mycobacterium fortuitum; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Cross Infection; Water; Sepsis; Catheters
PubMed: 36804097
DOI: 10.1017/ice.2022.263 -
PloS One 2023The infiltration of foreign materials not approved for medical purposes or of modeling substances used in soft tissue to modify the anatomical appearance for aesthetic...
The infiltration of foreign materials not approved for medical purposes or of modeling substances used in soft tissue to modify the anatomical appearance for aesthetic purposes represents a serious health problem. These procedures lead to the development of delayed complications, including infections. The objective of this study was to characterize infections in patients with adverse reactions to the use of modeling substances in Cali, Colombia. A cross-sectional and descriptive study was used to determine the frequency of bacterial and fungal infections associated with complications from and adverse reactions to the use of modeling substances in 113 patients. We identified microorganisms in 22 patients and a frequency of 68.1% monomicrobial infections and 31.8% polymicrobial infections. The microorganisms identified in our study included Bacillus cereus, Mycobacterium fortuitum, and Pseudomonas stutzeri, among other microorganisms. The presence of adverse effects derived from the use of illegal modeling substances has been demonstrated; among these effects, infections occur with high frequency and place the health of the patient at risk and increase problems in health care.
Topics: Humans; Colombia; Cross-Sectional Studies; Bacteria; Mycoses; Soft Tissue Infections
PubMed: 36757960
DOI: 10.1371/journal.pone.0277958 -
The American Journal of Dermatopathology Mar 2023
Topics: Humans; Mycobacterium fortuitum; Skin Diseases, Bacterial; Mycobacterium Infections, Nontuberculous
PubMed: 36729795
DOI: 10.1097/DAD.0000000000002336