e171092461e71c0ab0b388c0eb16daf8 microorganisms-11-02897.pdf 53ed651330b140d937efb529bc3125a4ac7aedf7 microorganisms-11-02897.pdf 05b8e90826af766dd8fbaac3654459b17ee6f601f66fb176ee427d74ead96776 microorganisms-11-02897.pdf Title: Analysis of Phenotypic and Genotypic Susceptibility to Clarithromycin and Amikacin of Mycobacterium abscessus Complex Strains Isolated from Cystic Fibrosis Patients Subject: Mycobacterium abscessus complex infections are ever on the rise. To curb their increasing evolution, we performed an in-depth study of 43 clinical isolates of cystic fibrosis patients obtained from 2009 to 2020. We identified their subspecies, uncovered their genotypic resistance profiles, characterised their antibiotic-resistant genes, and assessed their phenotypic antibiotic susceptibilities. The phenotypic and genotypic methods showed total agreement in terms of resistance to clarithromycin and amikacin. Of the 43 clinical strains, 28 belonged to M. abscessus subsp. abscessus (65.1%), 13 to M. abscessus subsp. massiliense (30.2%), and 2 to M. abscessus subsp. bolletii (4.6%). The resistant rates for clarithromycin and amikacin, the two main drugs against M. abscessus complex pulmonary infections, were 64.2% and 14.2%, respectively. We found three strains of M. abscessus subsp. abscessus that showed heteroresistance in the rrl and rrs genes, and these strains also presented double-resistance since they were macrolide- and aminoglycoside-resistant. M. abscessus subsp. abscessus showed a high minimum inhibitory concentration (MIC) and a resistant percentage larger than or equal to 88% to cefoxitin, ciprofloxacin, moxifloxacin, doxycycline, imipenem, and trimethoprim-sulfamethoxazole. These results show a panorama of the high resistance of Mycobacterium abscessus complex to current drugs for cystic fibrosis patients. Thus, other treatment methods are urgently needed. Keywords: Mycobacterium; clarithromycin; amikacin Author: Juan Carlos Cao Yao, Jesús Navas Méndez and María Teresa Tórtola Fernández Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Dec 1 10:02:37 2023 CET ModDate: Fri Dec 1 10:07:06 2023 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 10 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 558295 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MEIAAK+URWPalladioL-Bold Type 1 Custom yes yes no 10 0 YINXUS+URWPalladioL-Roma Type 1 Custom yes yes no 15 0 BRUZGU+URWPalladioL-Ital Type 1 Custom yes yes no 19 0 GSMHDM+URWPalladioL-BoldItal Type 1 Custom yes yes no 23 0 KPNHET+VnURWPalladioL Type 1 Custom yes yes no 27 0 DGBDNV+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 SIXRFS+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 50 0 WVIODX+CMSY10 Type 1 Builtin yes yes no 75 0 OGBIBO+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 86 0 OGBLLB+PalatinoLinotype-Italic TrueType MacRoman yes yes no 92 0 OGBICO+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 95 0 OGBIKM+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 101 0 OGBIKN+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 107 0 OGBIKO+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 110 0 OGBIKP+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 113 0 OGBKBK+PalatinoLinotype-Roman TrueType MacRoman yes yes no 116 0 OVNEXW+EURM10 Type 1 Builtin yes yes no 130 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-06-11 03:57:14 CEST RepresentationInformation: microorganisms-11-02897.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-06-10 20:16:59 CEST Size: 558295 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 303 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Strains Destination: subsection.2.1 Item: Title: Isolation and Identification Destination: subsection.2.2 Item: Title: Smooth and Rough Morphotypes Destination: subsection.2.3 Item: Title: Susceptibility Testing Destination: subsection.2.4 Item: Title: erm(41), rrl, and rrs PCR for Sequencing Destination: subsection.2.5 Item: Title: Results Destination: section.3 Children: Item: Title: Identification of Isolates Destination: subsection.3.1 Item: Title: Smooth and Rough Morphotypes Destination: subsection.3.2 Item: Title: Genotyping of the erm and rrl Genes and Susceptibility Testing to Clarithromycin Destination: subsection.3.3 Item: Title: Genotyping of the rrs Gene and Susceptibility Testing to Amikacin Destination: subsection.3.4 Item: Title: Phenotypic Antibiotic Susceptibility Testing Destination: subsection.3.5 Item: Title: Discussion Destination: section.4 Item: Title: References Destination: section.5 Info: Title: Analysis of Phenotypic and Genotypic Susceptibility to Clarithromycin and Amikacin of Mycobacterium abscessus Complex Strains Isolated from Cystic Fibrosis Patients Author: Juan Carlos Cao Yao, Jesús Navas Méndez and María Teresa Tórtola Fernández Subject: Mycobacterium abscessus complex infections are ever on the rise. To curb their increasing evolution, we performed an in-depth study of 43 clinical isolates of cystic fibrosis patients obtained from 2009 to 2020. We identified their subspecies, uncovered their genotypic resistance profiles, characterised their antibiotic-resistant genes, and assessed their phenotypic antibiotic susceptibilities. The phenotypic and genotypic methods showed total agreement in terms of resistance to clarithromycin and amikacin. Of the 43 clinical strains, 28 belonged to M. abscessus subsp. abscessus (65.1%), 13 to M. abscessus subsp. massiliense (30.2%), and 2 to M. abscessus subsp. bolletii (4.6%). The resistant rates for clarithromycin and amikacin, the two main drugs against M. abscessus complex pulmonary infections, were 64.2% and 14.2%, respectively. We found three strains of M. abscessus subsp. abscessus that showed heteroresistance in the rrl and rrs genes, and these strains also presented double-resistance since they were macrolide- and aminoglycoside-resistant. M. abscessus subsp. abscessus showed a high minimum inhibitory concentration (MIC) and a resistant percentage larger than or equal to 88% to cefoxitin, ciprofloxacin, moxifloxacin, doxycycline, imipenem, and trimethoprim-sulfamethoxazole. These results show a panorama of the high resistance of Mycobacterium abscessus complex to current drugs for cystic fibrosis patients. Thus, other treatment methods are urgently needed. 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