Risk factors, molecular analysis and treatment outcomes of amikacin-resistant Mycobacterium avium complex pulmonary disease Article Swipe
Tatsuya Kodama
,
Akio Aono
,
Keiji Fujiwara
,
Koji Furuuchi
,
Masashi Ito
,
Keisuke Kamada
,
Fumiya Watanabe
,
Kinuyo Chikamatsu
,
Yuriko Igarashi
,
Yoshiro Murase
,
Hideo Ogata
,
Yuji Shiraishi
,
Takashi Yoshiyama
,
Ken Ohta
,
Satoshi Mitarai
,
Kozo Morimoto
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1183/23120541.01084-2024
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1183/23120541.01084-2024
Background Although the incidence of amikacin (AMK)-resistant Mycobacterium avium complex (MAC) pulmonary disease (PD) is suspected to have increased, limited data are available on AMK-resistant MAC-PD. This study evaluated the risk factors associated with AMK resistance, the molecular characteristics of the AMK-resistant isolates, and treatment outcomes of patients with AMK-resistant MAC-PD. Methods This retrospective case–control study included 73 patients with severe and refractory MAC-PD who had a history of aminoglycoside drug use. Patients with initial and repeat AMK minimum inhibitory concentration (MIC) ≥64 μg·mL −1 were classified as AMK-resistant. To clarify the clinical outcomes and prognosis, an observational study was conducted. 21 patients with AMK resistance (AMK-resistant) and 52 controls (AMK-susceptible) were analysed. Results In all cases of AMK resistance where previous isolates were available, the AMK MICs were elevated compared to the levels prior to aminoglycoside administration. In the multivariate analysis of risk factors, clarithromycin resistance (OR 6.31, 95% CI 1.68–23.7) and >12 months of total duration of aminoglycoside use (OR 4.69, 95% CI 1.09–20.2) were identified as independent risk factors for AMK resistance. 12 (57%) out of 21 AMK-resistant isolates were found to have mutations in the rrs region. There was a significant difference between the AMK-resistant and AMK-susceptible groups in terms of worsening outcomes, including the introduction of home oxygen therapy (38% versus 12%; p=0.01) and 3-year mortality (33% versus 10%; p=0.02). Conclusions Better management strategies for patients with severe and refractory MAC-PD are crucial. This includes placing a strong emphasis on preventing AMK resistance.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1183/23120541.01084-2024
- OA Status
- gold
- Cited By
- 1
- References
- 26
- Related Works
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- OpenAlex ID
- https://openalex.org/W4407215827
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4407215827Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1183/23120541.01084-2024Digital Object Identifier
- Title
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Risk factors, molecular analysis and treatment outcomes of amikacin-resistant Mycobacterium avium complex pulmonary diseaseWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-02-06Full publication date if available
- Authors
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Tatsuya Kodama, Akio Aono, Keiji Fujiwara, Koji Furuuchi, Masashi Ito, Keisuke Kamada, Fumiya Watanabe, Kinuyo Chikamatsu, Yuriko Igarashi, Yoshiro Murase, Hideo Ogata, Yuji Shiraishi, Takashi Yoshiyama, Ken Ohta, Satoshi Mitarai, Kozo MorimotoList of authors in order
- Landing page
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https://doi.org/10.1183/23120541.01084-2024Publisher landing page
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://doi.org/10.1183/23120541.01084-2024Direct OA link when available
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Medicine, Amikacin, Internal medicine, Odds ratio, Confidence interval, Incidence (geometry), Mycobacterium abscessus, Drug resistance, Retrospective cohort study, Surgery, Antibiotics, Microbiology, Mycobacterium, Pathology, Tuberculosis, Physics, Optics, BiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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1Total citation count in OpenAlex
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2025: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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