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JAC Advance Access originally published online on July 7, 2009
Journal of Antimicrobial Chemotherapy 2009 64(3):511-514; doi:10.1093/jac/dkp238
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Original research

Clinical manifestations, antibiotic susceptibility and molecular analysis of Mycobacterium kansasii isolates from a university hospital in Taiwan

Ting-Shu Wu1,2, Hsieh-Shong Leu1, Cheng-Hsun Chiu3, Ming-Hsun Lee1, Ping-Cherng Chiang1, Tsu-Lan Wu4, Ju-Hsin Chia4, Lin-Hui Su4, An-Jing Kuo4 and Hsin-Chih Lai2,5,*

1 Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, No. 5 Fusing St, Gueishan Shiang 33305, Taoyuan, Taiwan 2 Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, No. 259 Wenhwa 1st Road, Gueishan Shiang 33302, Taoyuan, Taiwan 3 Department of Pediatrics, Chang Gung Memorial Hospital, No. 5 Fusing St, Gueishan Shiang 33305, Taoyuan, Taiwan 4 Department of Laboratory Medicine, Chang Gung Memorial Hospital, No. 5 Fusing St, Gueishan Shiang 33305, Taoyuan, Taiwan 5 Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, No. 259 Wenhwa 1st Road, Gueishan Shiang 33302, Taoyuan, Taiwan

Received 24 March 2009; accepted 11 June 2009

* Corresponding author. Department of Medical Biotechnology and Laboratory Science, No. 259 Wenhwa 1st Road, Gueishan Shiang 33302, Taoyuan, Taiwan. Tel: +886-3-2118800; Fax: +886-3-2118700; E-mail: hclai{at}mail.cgu.edu.tw

Objectives: Mycobacterium kansasii causes a variety of infections. Although previous reports on the prognosis of antimicrobial therapy have been mostly satisfactory, problems involving treatment failure or relapse have been encountered. The purpose of this study was to establish a relationship between the clinical treatment outcomes of M. kansasii infections and bacterial drug susceptibility, and their clonality.

Methods: A total of 37 M. kansasii clinical isolates and clinical information on 34 patients were retrospectively collected in a tertiary medical centre in Taiwan. Bacterial drug susceptibility was determined by the microdilution method. The phylogenetic relationship was analysed by PFGE analysis.

Results: Results of PFGE typing revealed a major cluster (cluster I) and eight other divergent patterns. Two/three strains leading to treatment failure were also multidrug resistant and belonged to cluster I.

Conclusions: A relationship between high drug resistance and genetic relatedness of some M. kansasii strains was established. This was associated with clinical treatment failure.

Keywords: non-tuberculous mycobacteria , susceptibility tests , multidrug resistance , clonality


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