Treatment of nonpulmonary infections due to Mycobacterium fortuitum and Mycobacterium chelonei on the basis of in vitro susceptibilities. 1985

R J Wallace, and J M Swenson, and V A Silcox, and M G Bullen

One hundred twenty-three patients with nonpulmonary infections due to Mycobacterium fortuitum or Mycobacterium chelonei were treated by wound debridement and with chemotherapy on the basis of in vitro susceptibilities of the organism. Of 76 patients with infections caused by M. fortuitum, 13 required no therapy or were adequately treated with surgery alone. Patients with active localized disease received single drug therapy (usually with a sulfonamide) for a mean period of 10.6 weeks for cellulitis and seven months for osteomyelitis. Patients with extensive disease received amikacin or amikacin plus cefoxitin (mean, four weeks) followed by a sulfonamide (mean, six months). The 47 patients with infections caused by M. chelonei received no therapy or were treated with surgery alone (6); with amikacin (10), erythromycin (6), doxycycline (3), or cefoxitin (1); or with amikacin plus cefoxitin followed by cefoxitin alone for a total of 10-12 weeks (20); or other multiple-drug regimens (1). Surgery was performed on 74 (60%) patients. Schlichter tests or serum drug levels were determined for 81 (66%) patients. Response to therapy was excellent; 68 (90%) infections with M. fortuitum and 34 (72%) with M. chelonei were successfully treated. Cultures became negative within six weeks of chemotherapy, except for sternal osteomyelitis, for which cultures were not negative until up to 14 weeks. Follow-up for a mean period of 12 months following therapy was possible in 80% of cases. Relapses were rare except in patients with disseminated disease, and drug resistance developed in only one patient. These studies demonstrate the value of routine susceptibility testing of these mycobacterial species and the benefit of chemotherapy on the basis of in vitro susceptibilities.

UI MeSH Term Description Entries
D008297 Male Males
D008826 Microbial Sensitivity Tests Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses). Bacterial Sensitivity Tests,Drug Sensitivity Assay, Microbial,Minimum Inhibitory Concentration,Antibacterial Susceptibility Breakpoint Determination,Antibiogram,Antimicrobial Susceptibility Breakpoint Determination,Bacterial Sensitivity Test,Breakpoint Determination, Antibacterial Susceptibility,Breakpoint Determination, Antimicrobial Susceptibility,Fungal Drug Sensitivity Tests,Fungus Drug Sensitivity Tests,Sensitivity Test, Bacterial,Sensitivity Tests, Bacterial,Test, Bacterial Sensitivity,Tests, Bacterial Sensitivity,Viral Drug Sensitivity Tests,Virus Drug Sensitivity Tests,Antibiograms,Concentration, Minimum Inhibitory,Concentrations, Minimum Inhibitory,Inhibitory Concentration, Minimum,Inhibitory Concentrations, Minimum,Microbial Sensitivity Test,Minimum Inhibitory Concentrations,Sensitivity Test, Microbial,Sensitivity Tests, Microbial,Test, Microbial Sensitivity,Tests, Microbial Sensitivity
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009161 Mycobacterium A genus of gram-positive, aerobic bacteria. Most species are free-living in soil and water, but the major habitat for some is the diseased tissue of warm-blooded hosts. Mycobacteria
D009164 Mycobacterium Infections Infections with bacteria of the genus MYCOBACTERIUM. Infections, Mycobacterium,Infection, Mycobacterium,Mycobacterium Infection
D009165 Mycobacterium Infections, Nontuberculous Infections with nontuberculous mycobacteria (atypical mycobacteria): M. kansasii, M. marinum, M. scrofulaceum, M. flavescens, M. gordonae, M. obuense, M. gilvum, M. duvali, M. szulgai, M. intracellulare (see MYCOBACTERIUM AVIUM COMPLEX;), M. xenopi (littorale), M. ulcerans, M. buruli, M. terrae, M. fortuitum (minetti, giae), M. chelonae, M. leprae. Mycobacterium Infections, Atypical,Atypical Mycobacterial Infection, Disseminated,Atypical Mycobacterial Infection, Familial Disseminated,Atypical Mycobacteriosis, Familial,Atypical Mycobacteriosis, Familial Disseminated,Atypical Mycobacterium Infections,Infections, Atypical Mycobacterium,Mycobacterium abscessus Infection,Atypical Mycobacterium Infection,Familial Atypical Mycobacterioses,Familial Atypical Mycobacteriosis,Infection, Mycobacterium abscessus,Infections, Mycobacterium abscessus,Mycobacterioses, Familial Atypical,Mycobacteriosis, Familial Atypical,Mycobacterium Infection, Atypical,Mycobacterium Infection, Nontuberculous,Mycobacterium abscessus Infections,Nontuberculous Mycobacterium Infection,Nontuberculous Mycobacterium Infections
D009170 Nontuberculous Mycobacteria So-called atypical species of the genus MYCOBACTERIUM that do not cause tuberculosis. They are also called tuberculoid bacilli, i.e.: M. abscessus, M. buruli, M. chelonae, M. duvalii, M. flavescens, M. fortuitum, M. gilvum, M. gordonae, M. intracellulare (see MYCOBACTERIUM AVIUM COMPLEX;), M. kansasii, M. marinum, M. obuense, M. scrofulaceum, M. szulgai, M. terrae, M. ulcerans, M. xenopi. Atypical Mycobacteria,Mycobacteria, Atypical,Mycobacterium duvalii,Mycobacterium flavescens,Mycobacterium gilvum,Mycobacterium gordonae,Mycobacterium obuense,Mycobacterium szulgai,Mycobacterium terrae,Mycolicibacter terrae,Mycolicibacterium duvalii,Mycolicibacterium flavescens,Mycolicibacterium gilvum,Mycolicibacterium obuense,Tuberculoid Bacillus,Atypical Mycobacterium,Mycobacterium, Atypical,Non-Tuberculous Mycobacteria,Nontuberculous Mycobacterium
D002440 Cefoxitin A semisynthetic cephamycin antibiotic resistant to beta-lactamase. Cefoxitin Sodium,MK-306,Mefoxin,Mefoxitin,Méfoxin,MK 306,MK306,Sodium, Cefoxitin
D004338 Drug Combinations Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. Drug Combination,Combination, Drug,Combinations, Drug
D004917 Erythromycin A bacteriostatic antibiotic macrolide produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. Erycette,Erymax,Erythromycin A,Erythromycin C,Erythromycin Lactate,Erythromycin Phosphate,Ilotycin,T-Stat,Lactate, Erythromycin,Phosphate, Erythromycin,T Stat,TStat

Related Publications

R J Wallace, and J M Swenson, and V A Silcox, and M G Bullen
March 1978, The Journal of infectious diseases,
R J Wallace, and J M Swenson, and V A Silcox, and M G Bullen
February 1985, Antimicrobial agents and chemotherapy,
R J Wallace, and J M Swenson, and V A Silcox, and M G Bullen
June 1982, Tubercle,
R J Wallace, and J M Swenson, and V A Silcox, and M G Bullen
August 1986, European journal of clinical microbiology,
R J Wallace, and J M Swenson, and V A Silcox, and M G Bullen
January 1981, Reviews of infectious diseases,
R J Wallace, and J M Swenson, and V A Silcox, and M G Bullen
May 1983, Journal of clinical microbiology,
R J Wallace, and J M Swenson, and V A Silcox, and M G Bullen
March 1978, The American review of respiratory disease,
R J Wallace, and J M Swenson, and V A Silcox, and M G Bullen
August 1984, European journal of clinical microbiology,
R J Wallace, and J M Swenson, and V A Silcox, and M G Bullen
January 1981, Journal of clinical microbiology,
R J Wallace, and J M Swenson, and V A Silcox, and M G Bullen
January 1981, Reviews of infectious diseases,
Copied contents to your clipboard!