Antimicrobial susceptibility analysis of isepamicin combination treatments in Mycobacterium abscessus species

Yukari Kato; Hiroaki Ihara; Satomi Takei; Ayako Nakamura; Yuichi Fujimoto; Tetsuya Handoh; Kana Kurokawa; Yuta Arai; Kohei Shibayama; Issei Sumiyoshi; Yusuke Ochi; Junko Watanabe; Kazuaki Hoshi; Shigeki Misawa; Shinsaku Togo; Toshio Naito; Yoko Tabe; Takashi Miida; Kazuhisa Takahashi

doi:10.1016/j.jctube.2024.100464

Antimicrobial susceptibility analysis of isepamicin combination treatments in Mycobacterium abscessus species

J Clin Tuberc Other Mycobact Dis. 2024 Jul 15:36:100464. doi: 10.1016/j.jctube.2024.100464. eCollection 2024 Aug.

Authors

Yukari Kato¹, Hiroaki Ihara^{1

2}, Satomi Takei³, Ayako Nakamura⁴, Yuichi Fujimoto¹, Tetsuya Handoh³, Kana Kurokawa¹, Yuta Arai¹, Kohei Shibayama¹, Issei Sumiyoshi¹, Yusuke Ochi¹, Junko Watanabe¹, Kazuaki Hoshi^{1

5}, Shigeki Misawa⁶, Shinsaku Togo^{1

7}, Toshio Naito⁸, Yoko Tabe³, Takashi Miida³, Kazuhisa Takahashi¹

Affiliations

¹ Department of Respiratory Medicine, Graduate School of Medicine, Juntendo University, Faculty of Medicine, Tokyo, Japan.
² Koto Hospital, Tokyo, Japan.
³ Department of Clinical Laboratory Medicine, Graduate School of Medicine, Juntendo University, Faculty of Medicine, Tokyo, Japan.
⁴ Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.
⁵ Leading Center for the Development and Research of Cancer Medicine, Graduate School of Medicine, Juntendo University, Faculty of Medicine, Tokyo, Japan.
⁶ Department of Clinical Laboratory Technology, Juntendo University, Faculty of Medical Science, Tokyo, Japan.
⁷ Research Institute for Diseases of Old Ages, Graduate School of Medicine, Juntendo University, Faculty of Medicine, Tokyo, Japan.
⁸ Department of General Medicine, Graduate School of Medicine, Juntendo University, Faculty of Medicine, Tokyo, Japan.

Abstract

This study evaluated the antimicrobial potency of the combination of isepamicin (ISP) for Mycobacterium abscessus species (MABS). 34 clinical MABS strains were isolated from clinical samples. Of them, 11 (32.4 %) were M. abscessus subsp. abscessus (Mab), 22 (64.7 %) were M. abscessus subsp. massiliense (Mma), and one (2.9 %) was M. abscessus subsp. bolletii (Mbo). We compared susceptibility to sitafloxacin (STFX)-ISP and clarithromycin (CLR)-ISP combinations with those of the antimicrobial agents alone, and synergistic effects were observed in 41.2 % and 17.6 % when treated with STFX-ISP and CLR-ISP. By hierarchical cluster analysis, the isolates divided into treatment-sensitive and treatment-resistant groups. Non-Mma or rough colony isolates were significantly likely to belong to the treatment-sensitive group (p = 0.024, p < 0.001, respectively). These results suggest that the ISP-containing combination could be a new therapeutic strategy for MABS, especially in cases of non-Mma: treatment-refractory subspecies, and rough morphotypes: high-virulence morphotypes.

Keywords: Clarithromycin; Fractional inhibitory concentration index; Isepamicin; Mycobacterium abscessus; Sitafloxacin.