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Treatment of non-tuberculosis mycobacteria skin infections

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Drug resistance profiles and related gene mutations in slow-growing non-tuberculous mycobacteria isolated in regional tuberculosis reference laboratories of Iran: a three year cross-sectional study

Sousan Akrami et al.

Summary: Limited studies on antibiotic resistance patterns and gene mutations in slowly growing mycobacteria (SGM) species have been conducted in Iran. This study aimed to investigate the antibiotic susceptibility profiles and mutations in relevant genes among SGM isolates from Iran. Results showed various resistance patterns and gene mutations in SGM isolates, and further research using whole-genome sequencing is needed to gain a clearer understanding of the molecular origins of drug resistance in SGM.

PATHOGENS AND GLOBAL HEALTH (2023)

Article Medicine, General & Internal

Case report: Subcutaneous Mycobacterium haemophilum infection in an immunocompetent patient after lipolysis injections

Linan Ni et al.

Summary: This article describes a rare case of subcutaneous infection caused by M. haemophilum in an immunocompetent female after lipolysis injections at an unqualified beauty salon, suggesting that this bacteria can also be a potential causative agent of adverse events in medical aesthetics. In addition, M. haemophilum caused lesions not only at the injection sites and adjacent areas but also invaded distant sections through the subcutaneous sinus tracts. Therefore, early diagnosis and appropriate treatment are crucial in preventing further deterioration and improving prognosis.

FRONTIERS IN MEDICINE (2023)

Review Critical Care Medicine

The Other Nontuberculous Mycobacteria Clinical Aspects of Lung Disease Caused by Less Common Slowly Growing Nontuberculous Mycobacteria Species

Marie Yan et al.

Summary: Slowly growing nontuberculous mycobacteria (NTM) are a diverse group of environmental organisms, many of which are important human pathogens. This review focuses on less common, but notable, species of slowly growing NTM with respect to lung disease. The specific organisms highlighted include Mycobacterium kansasii, Mycobacterium xenopi, Mycobacterium malmoense, Mycobacterium simiae, and Mycobacterium szulgai. The diagnosis and management of NTM pulmonary disease require a nuanced approach that takes into consideration the unique characteristics of each species.
Review Pharmacology & Pharmacy

Recent advances in mycobacterial membrane protein large 3 inhibitor drug design for mycobacterial infections

E. Jeffrey North et al.

Summary: This paper summarizes the mechanism, therapeutic potential, and different classes of MmpL3 inhibitors currently under development, as well as the available assays to study the inhibition of MmpL3 by these compounds. MmpL3 has emerged as a target with high therapeutic value, and several classes of MmpL3 inhibitors are currently being developed, with one drug candidate (SQ109) undergoing a Phase 2b clinical study. However, the hydrophobic character of most MmpL3 series identified to date poses a significant obstacle to their development due to poor bioavailability. Moreover, there is a need for more high-throughput and informative assays to further understand the mechanism of action of MmpL3 inhibitors and optimize analogues.

EXPERT OPINION ON DRUG DISCOVERY (2023)

Article Medicine, General & Internal

Non-tuberculous mycobacterial infections in patients with end-stage renal disease: prevalence, risk factors, and mortality

Eszter Toth et al.

Summary: NTM disease in the population with end-stage renal disease (ESRD) was investigated to determine risk factors and mortality. Hemodialysis and white race were found to be protective factors, while HIV infection, history of any transplant, diabetes, rheumatologic disease, and liver disease were associated with increased risk for NTM diagnosis. Any NTM diagnosis was significantly associated with increased mortality.

JOURNAL OF INVESTIGATIVE MEDICINE (2023)

Article Immunology

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Qi Liu et al.

Summary: This study investigated the clinical and immunologic characteristics of non-tuberculous mycobacterial pulmonary disease (NTM-PD) patients. The results showed that NTM-PD patients had compromised immune function, non-specific clinical symptoms, high drug resistance, and significantly reduced numbers of immune cells.

FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY (2023)

Article Microbiology

Genomic characteristics of Mycobacterium tuberculosis isolates of cutaneous tuberculosis

You-Ming Mei et al.

Summary: This study investigated the pathogens associated with the occurrence and different types of cutaneous tuberculosis through the analysis of genomic characteristics of 58 Mycobacterium tuberculosis strains isolated over the last 20 years. The findings revealed that cutaneous tuberculosis and pulmonary tuberculosis shared similar genotypes and genomic composition. The drug-resistance rate was lower in cutaneous tuberculosis strains, and several SNPs in metabolism-related genes showed a strong correlation with different infection sites. Thus, while large genomic changes in M. tuberculosis isolates may not significantly affect the different infection sites of TB, the significant difference in SNPs of drug resistance genes and metabolism-related genes should be given more attention.

FRONTIERS IN MICROBIOLOGY (2023)

Article Biochemistry & Molecular Biology

Understanding the Phage-Host Interaction Mechanism toward Improving the Efficacy of Current Antibiotics in Mycobacterium abscessus

Mylene Gorzynski et al.

Summary: Pulmonary infections caused by Mycobacterium abscessus (MAB) have been increasing in incidence. The use of bacteriophages (phages) in clinics is emerging as a novel treatment strategy for drug-resistant MAB infections. This study deepens our understanding of phage-mycobacteria interaction mechanisms and identifies therapeutic phages that can lower bacterial fitness and attenuate MAB intrinsic resistance mechanism via targeted therapy.

BIOMEDICINES (2023)

Article Infectious Diseases

Omadacycline pharmacokinetics/pharmacodynamics in the hollow fiber model and clinical validation of efficacy to treat pulmonary Mycobacterium abscessus disease

Sanjay Singh et al.

Summary: Based on experimental and retrospective clinical studies, it was found that a daily dose of 300 mg of omadacycline achieved good efficacy and had minimal toxicity in the treatment of pulmonary Mab disease. This finding provides a scientific basis for the clinical use of omadacycline.

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS (2023)

Article Microbiology

A Rabbit Model to Study Antibiotic Penetration at the Site of Infection for Nontuberculous Mycobacterial Lung Disease: Macrolide Case Study

Firat Kaya et al.

Summary: This study found that the rabbit model of active tuberculosis reproduces key features of human NTM-PD and provides an acceptable surrogate model for studying antibiotic penetration and efficacy. The research also revealed that the clinical activity of clarithromycin is limited by pharmacodynamic factors.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2022)

Article Pharmacology & Pharmacy

Telacebec: an investigational antibacterial for the treatment of tuberculosis (TB)

Bei Shi Lee et al.

Summary: Tuberculosis is a severe infectious disease that is a major global health concern. Telacebec, a novel antibiotic, shows promise as a potential treatment for multidrug-resistant tuberculosis. Phase 2 clinical trials have demonstrated its efficacy, favorable pharmacokinetic properties, and low risk of adverse effects.

EXPERT OPINION ON INVESTIGATIONAL DRUGS (2022)

Editorial Material Medicine, General & Internal

Disseminated Mycobacterium chelonae Infection, Including Discitis

Yusuke Watanabe et al.

INTERNAL MEDICINE (2022)

Article Microbiology

Clinical and Microbiological Characteristics of Mycobacterium kansasii Pulmonary Infections in China

Yinjuan Guo et al.

Summary: The study investigated 60 isolates of M. kansasii from China, showing that all isolates belonged to molecular type I with great genetic diversity. The isolates were sensitive to rifabutin.

MICROBIOLOGY SPECTRUM (2022)

Article Dermatology

Skin infection by Mycobacterium marinum-- diagnostic and therapeutic challenge

Angelica Seidel et al.

Summary: The number of skin infections caused by atypical mycobacteria has been increasing in recent decades. This report presents a case of cutaneous infection caused by Mycobacterium marinum in a young and immunocompetent patient, with a prolonged evolution, diagnosed through a skin lesion culture. The patient was treated with multidrug therapy and achieved satisfactory results. A brief literature review is also provided.

ANAIS BRASILEIROS DE DERMATOLOGIA (2022)

Article Infectious Diseases

An octopus gift: Mycobacterium marinum multiple skin lesions

Niccolo Riccardi et al.

Summary: Mycobacterium marinum is a pathogenic bacterium that can cause infections ranging from skin to systemic infections. Clinical suspicion and prompt diagnosis are crucial for appropriate treatment and prevention of sequelae.

INFECTION (2022)

Editorial Material Immunology

Drug development challenges in nontuberculous mycobacterial lung disease: TB to the rescue

Veronique Dartois et al.

Summary: Nontuberculous mycobacterial pulmonary disease (NTM-PD) is currently treated with repurposed drugs that have limitations such as long chemotherapy duration, toxicity, parenteral administration, and low cure rates. There is a pressing need for more effective, tolerated, and oral antibiotics for the treatment of NTM-PD. Drawing lessons from tuberculosis treatment can aid in discovering curative oral regimens for NTM-PD.

JOURNAL OF EXPERIMENTAL MEDICINE (2022)

Article Oncology

5-aminolevulinic acid-photodynamic therapy ameliorates cutaneous granuloma by killing drug-resistant Mycobacterium marinum

Zhiya Yang et al.

Summary: The study demonstrates the efficacy of ALA-PDT in directly killing M. marinum. The cutaneous lesions caused by M. marinum on mouse paws were fully recovered 4 weeks after ALA-PDT treatment. ALA-PDT was also effective in patients with cutaneous infection caused by drug-resistant M. marinum.

PHOTODIAGNOSIS AND PHOTODYNAMIC THERAPY (2022)

Article Multidisciplinary Sciences

Bacteriophage treatment of disseminated cutaneous Mycobacterium chelonae infection

Jessica S. Little et al.

Summary: The use of bacteriophage in combination with antimicrobial therapy was effective in improving disease response in a patient with multidrug-resistant M. chelonae infection. Despite the development of neutralizing antibodies against the bacteriophage, the patient continued to show stable improvement with no evidence of bacterial resistance to the phage.

NATURE COMMUNICATIONS (2022)

Article Infectious Diseases

Identification and drug susceptibility testing of the subspecies of Mycobacterium avium complex clinical isolates in mainland China

Yuanchun Li et al.

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JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE (2022)

Article Infectious Diseases

Pulmonary and Disseminated Mycobacterium avium Complex Cases Confirmed by Tissue-Direct Polymerase Chain Reaction-Based Nucleic Acid Lateral Flow Immunoassay of Formalin-Fixed Paraffin-Embedded Tissues

Daisuke Fukushi et al.

Summary: This study reports the successful detection of MAC genes in paraffin-embedded tissue sections using tdPCR-NALFIA. While Ziehl-Neelsen staining and culture tests are commonly used for diagnosing mycobacterial infection, tdPCR-NALFIA may serve as a rapid auxiliary diagnostic tool.

INFECTION AND DRUG RESISTANCE (2022)

Article Immunology

Treatment and Outcome of Culture-Confirmed Mycobacterium marinum Disease

Louise Hendrikx et al.

Summary: This retrospective cohort study analyzed the clinical characteristics, treatment methods, and outcomes of 40 cases of Mycobacterium marinum infection in the Netherlands from 2011 to 2018. The study found that prolonged and susceptibility-guided treatment resulted in a 90% cure rate. Combination therapy with ethambutol and a macrolide was effective for moderate infections.

OPEN FORUM INFECTIOUS DISEASES (2022)

Article Infectious Diseases

Searching for new therapeutic options for the uncommon pathogen Mycobacterium chimaera: an open drug discovery approach

Daire Cantillon et al.

Summary: The study aimed to find new inhibitory compounds and drug repurposing opportunities for M chimaera, which may lead to improved outcomes compared to current therapeutic options. Screening identified several compounds with inhibitory effects on M chimaera, some of which also showed activity against other mycobacteria.

LANCET MICROBE (2022)

Article Infectious Diseases

A clinical case and a review of Mycobacterium fortuitum infections direct diagnosis approach and treatment in a patient with leg fractures

Jun Wang et al.

Summary: This study presents a case of Mycobacterium fortuitum infection, successfully treated by isolating and confirming the pathogen, providing a reference for the treatment of patients with open fractures.

JOURNAL OF INFECTION IN DEVELOPING COUNTRIES (2022)

Editorial Material Microbiology

Nontuberculous Mycobacteria: Ecology and Impact on Animal and Human Health

Ivo Pavlik et al.

Summary: Non-tuberculous mycobacteria (NTM) are environmentally saprophytic and potentially pathogenic bacteria that can cause serious mycobacterioses. NTM infections mainly come from soil or water sources, including water-borne, air-borne, or water-related infections. NTM can be transmitted through water, air, and soil, and can be found in soil, water aerosols, and dust particles. NTM infections have significant clinical relevance in both humans and animals.

MICROORGANISMS (2022)

Review Biochemistry & Molecular Biology

Fragment-Based Drug Discovery against Mycobacteria: The Success and Challenges

Namdev S. Togre et al.

Summary: The emergence of drug-resistant mycobacteria is a global threat that requires the development of new potent anti-mycobacterial drugs. Fragment-based drug discovery (FBDD) has been recognized as a popular approach to identify potent fragment molecules using virtual, computational, and biophysical methods. FBDD overcomes the limitations of traditional methods and is important for combating NTM and Mtb infections.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2022)

Article Dermatology

Diagnosis and therapy of Mycobacterium marinum: a single-center 21-year retrospective analysis

Katharina Strobel et al.

Summary: Background: M. marinum infections are rare in Europe. Objective: Assess the clinical spectrum, diagnosis, treatment, and outcome. Method: Retrospective study of 18 infected patients. Results: Most patients had aquatic exposure and upper body involvement. No invasive infections detected and a long diagnostic delay. Histology showed granulomatous inflammation, and culture confirmed M. marinum infection. Treatment successful, but some patients lost to follow-up.

JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT (2022)

Article Microbiology

In Vitro and In Vivo Activity of Gepotidacin against Drug-Resistant Mycobacterial Infections

Mohammad Naiyaz Ahmad et al.

Summary: This study demonstrates that gepotidacin has potent activity against mycobacterial pathogens, including M. tuberculosis and NTM, and can bypass existing resistance mechanisms. It exhibits concentration-dependent bactericidal activity, synergizes with other drugs, and reduces bacterial load similarly to amikacin in intracellular assays. Importantly, M. fortuitum ATCC 6841 is unable to develop resistance to gepotidacin. In a murine infection model, gepotidacin significantly reduces bacterial load in various organs at a lower concentration compared to amikacin.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2022)

Article Infectious Diseases

Clinical Presentations of Nontuberculous Mycobacteria as Suspected and Drug-Resistant Tuberculosis: Experience from a Tertiary Care Center in Eastern India

Sivasankar Das et al.

Summary: The present study reports a series of NTM infections presenting as suspected TB. The clinical features of NTM disease often overlap with that of tuberculosis, making diagnosis and treatment challenging for physicians. The study emphasizes the urgent need for better diagnostic and drug susceptibility testing facilities, as well as standardized treatment protocols for NTM disease.

INTERNATIONAL JOURNAL OF MYCOBACTERIOLOGY (2022)

Article Immunology

Incidence of Nontuberculous Mycobacterial Pulmonary Infection, by Ethnic Group, Hawaii, USA, 2005-2019

Rebekah A. Blakney et al.

Summary: Differences in the risk for nontuberculous mycobacterial pulmonary infection (NTM-PI) among ethnic populations in Hawaii were examined. The study found that being underweight and self-identifying as Asian were associated with an increased risk for NTM-PI.

EMERGING INFECTIOUS DISEASES (2022)

Article Infectious Diseases

A Comparative Genomics Approach for Shortlisting Broad-Spectrum Drug Targets in Nontuberculous Mycobacteria

Aishwarya Swain et al.

Summary: This study aimed to identify broad-spectrum drug targets in NTM using a comparative genomics approach and found 15 potential candidates that were core proteins, pathogen-specific, essential, and druggable. These targets, including enzymes, carrier proteins, and regulators, could be utilized for designing inhibitors to discover antimicrobial agents.

MICROBIAL DRUG RESISTANCE (2021)

Review Immunology

The New Frontier of Host-Directed Therapies for Mycobacterium avium Complex

Nathan P. Crilly et al.

Summary: Mycobacterium avium complex (MAC) is a significant cause of morbidity and mortality, with treatment requiring a combination of antibiotics over an extended period. Even after infection eradication, patients may still experience residual lung dysfunction. Recent focus has been on developing new therapies to accelerate pathogen clearance and reduce lung damage.

FRONTIERS IN IMMUNOLOGY (2021)

Article Microbiology

Drug Susceptibility Distributions of Mycobacterium chimaera and Other Nontuberculous Mycobacteria

Bettina Schulthess et al.

Summary: Recent research using the MGIT 960/EpiCenter TB eXiST platform determined the antibiotic susceptibility patterns of 48 clinical M. chimaera isolates and 139 other nontuberculous mycobacteria. The findings showed similar susceptibility of M. chimaera and other members of the M. avium complex to various drugs, while M. kansasii exhibited increased susceptibility to the same drugs. Further studies are needed to establish the correlation of in vitro susceptibility and clinical outcomes.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2021)

Review Pharmacology & Pharmacy

Therapeutic Drug Monitoring in Non-Tuberculosis Mycobacteria Infections

Jan-Willem Alffenaar et al.

Summary: Nontuberculous mycobacteria can cause a range of infections, from mild to life-threatening. The complexity of treatment, potential resistance, toxicity, and high failure rate make therapy difficult. Therapeutic drug monitoring may help optimize treatment, but guidance for this condition is currently limited.

CLINICAL PHARMACOKINETICS (2021)

Review Biology

Drug Resistance in Nontuberculous Mycobacteria: Mechanisms and Models

Saloni Saxena et al.

Summary: The review focuses on the rise in infections caused by nontuberculous mycobacteria (NTM) and their resistance to conventional antibiotics, proposing strategies to develop better therapies against them. It suggests accelerating the drug development pipeline by utilizing a combination of computational, laboratory and animal testing methods. The review also highlights the importance of understanding NTM virulence and developing new effective antimicrobial therapies.

BIOLOGY-BASEL (2021)

Article Immunology

Drug susceptibiity testing of nontuberculous mycobacteria by broth microdilution method

Megha Sharma et al.

Summary: - The incidence of nontuberculous mycobacteria (NTM) has been increasing in recent years, with different treatment methods compared to Mycobacterium tuberculosis. Drug Susceptibility Testing (DST) of NTM is crucial for proper treatment, although the methods are different from those used for Mycobacterium tuberculosis and are not widely available. Results from DST of 122 NTM isolates showed varying sensitivities to different drugs, with rapid growing mycobacteria showing good sensitivity to Amikacin and Moxifloxacin, while slow growing mycobacteria had lower sensitivity to Rifampicin, Moxifloxacin, and Clarithromycin. The Resazurin Microtitre Assay (REMA) method of DST showed excellent concordance with the standard method, providing a useful alternative for testing NTM sensitivity.

INDIAN JOURNAL OF MEDICAL MICROBIOLOGY (2021)

Article Multidisciplinary Sciences

Population genomics provides insights into the evolution and adaptation to humans of the waterborne pathogen Mycobacterium kansasii

Tao Luo et al.

Summary: A population genomics analysis of Mycobacterium kansasii reveals municipal water as a main source of infection and shows that nearly 80% of infections are due to closely-related strains, forming a main cluster that originated in the 1900s. Bioinformatic analyses suggest that certain genes may have contributed to the pathogen's success and adaptation to the human host.

NATURE COMMUNICATIONS (2021)

Article Dermatology

Non-tuberculous cutaneous mycobacterioses

Lais Bastos Nogueira et al.

Summary: Non-tuberculous mycobacteriosis refers to diseases caused by pathogenic mycobacteria other than Mycobacterium tuberculosis and Mycobacterium leprae, known for environmental distribution in water and soil. The incidence is increasing worldwide, especially in skin infections, due to immunosuppression and new medications affecting immune function. The article provides a detailed review of the epidemiology, microbiology, and clinical characteristics of these diseases, as well as practical considerations for diagnosis and treatment.

ANAIS BRASILEIROS DE DERMATOLOGIA (2021)

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Dalin Rifat et al.

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Chanchal Kumar et al.

Summary: The study found that the most common RGM isolated from skin and soft-tissue infections were Mycobacterium abscessus, Mycobacterium fortuitum, and Mycobacterium chelonae. However, there is still limited knowledge about the drug susceptibility profile of these potential pathogens, with only a small percentage of reports testing drug susceptibility.

INTERNATIONAL JOURNAL OF MYCOBACTERIOLOGY (2021)

Article Infectious Diseases

Bloodstream infections with rapidly growing nontuberculous mycobacteria

Isin Yagmur Comba et al.

Summary: This study retrospectively reviewed 32 patients with RGM BSI, finding that compared to other RGM BSI, MABC BSI is more likely to be secondary to skin and soft tissue infection, associated with higher death rates and requiring longer hospital stay.

JOURNAL OF CLINICAL TUBERCULOSIS AND OTHER MYCOBACTERIAL DISEASES (2021)

Article Infectious Diseases

Successful treatment of rapid growing mycobacterial infections with source control alone: Case series

Igor Dumic et al.

Summary: Rapidly growing mycobacterial infections are increasingly recognized as pathogens in both immunocompromised and immunocompetent individuals, with pulmonary infections being the most common, but affecting any organ. Treatment is costly, prolonged, and antimicrobial resistance poses a significant challenge to successful outcomes. Source control coupled with antimicrobials is key in treatment.

IDCASES (2021)

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Kelly M. Pennington et al.

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JOURNAL OF CLINICAL TUBERCULOSIS AND OTHER MYCOBACTERIAL DISEASES (2021)

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Katarina Trcko et al.

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B. Koushk-Jalali et al.

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Alan V. Nguyen et al.

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Rebecca C. Philips et al.

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Yu Mi Wi

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Betty A. Forbes et al.

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Esther L. M. Schoutrop et al.

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