Research Article

Clinical significance and antibiotic susceptibilities of nontuberculous mycobacteria from patients in Crete, Greece

† Author for correspondence

Department of Pediatrics, Democritus University of Thrace, Alexandroupolis, Greece

Department of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, University Hospital of Heraklion, 711, 10 Heraklion, Crete, Greece.

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Email the corresponding author at zgitti@gmail.com

George Samonis

Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece

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Published Online:30 Sep 2011https://doi.org/10.2217/fmb.11.91

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Abstract

Aim: To describe the clinical significance and antibiotic susceptibilities of nontuberculous mycobacteria (NTM) isolated from patients in Crete, Greece between January 2000 and December 2009. Patients & Methods: NTM identification was performed using conventional bacteriological methods and confirmed by molecular characterization with commercially available assays. Rare and novel species were identified by sequencing of the 16SrRNA and of the hsp65 genes. Antibiotic susceptibility testing was performed by E-test. Rapidly growing (RGM) and slowly growing (SGM) NTM were tested against 14 antimicrobials, including nine common ones, except for Mycobacterium avium and Mycobacterium intracellulare (MAC) complex isolates that were tested only against azithromycin, clarithromycin, linezolid and moxifloxacin. Results: During the study period, 290 positive samples for NTM were recovered from 207 patients. Among the positive samples, 150 were identified as SGM and 57 as RGM. Overall, 50 patients met American Thoracic Society criteria for disease due to NTM, 42 by SGM and eight by RGM. Risk factors in patients with NTM disease were underlying lung diseases, mainly chronic obstructive pulmonary disease and asthma, smoking, rheumatoid arthritis, AIDS, alcohol or drug abuse, malignancies and bronchiectasis. The most common disease–causing species were the MAC complex (n = 25) followed by Mycobacterium kansasii (n = 10). Amikacin was the most active drug for RGM with 100% susceptibility. Macrolides were very active against isolates of the MAC complex, while tigecycline had excellent activity in vitro against RGM. M. kansasii was the most susceptible NTM species in vitro. Conclusion: Our study is the first to describe the clinical significance, risk factors and susceptibility patterns of NTM isolates in a Greek population.

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Published online 30 September 2011

Published in print September 2011

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Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

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