NTM Mycobacterium avium Mycobacterium intracellulare Complex
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1 NTM Mycobacterium aviummycobacterium intracellulare Complex 1) 1) 1) 1) 2) 1) 2) Mycobacterium avium Mycobacterium intracellulare 6 MIC NTM MIC 1 3 NTM 5 MIC MIC M. avium 1 M. intracellulare 1 MIC 2 MIC M. avium M. intracellulare M. avium NTM MIC Key words: NTM, MAC, MIC Mycobacterium aviummycobacterium intracellulare complex (MAC) 1) (AIDS) AIDS 2) MAC 3) (CAM) (AZM) ( ) 211 TEL: FAX: tmgoto-tuk@umin.net MAC (EB) 24) MAC in vitro MAC 510) CAM AZM 11) NTM MAC MIC 12) Middlebrook 7H9 9 2 [SM], EB, [KM]: mg/l; Vol. 16 No
2 68 [INH], [RFP], [LVFX], CAM: mg/l; [ETH], [AMK]: mg/l; ph 6.6 CAM 7.4 MAC American Type Culture Collection (ATCC) MIC 12) NTM MAC MIC MIC MIC M. avium M. intracellulare M. avium 1 MIC NTM 1 30 Middlebrook 7H9 McFarland No OD 530 nm ml 35 7 MIC MIC 5 2 NTM NTM NTM MIC MIC 5 12) MIC MIC MIC log 2 MIC / MIC MIC MIC NTM 2 MIC 2 1) MIC MIC 5 MIC MIC MIC 2) MIC MIC MIC 1 5 MIC Wilcoxon p0.05 MIC 12 CAM MIC 2 mg/l CAM 11) MIC NTM M. avium INH 1 M. intracellulare ETH 2 M. avium RFP 3 M. intracellulare RFP 6 CAM 1 AMK 3 MIC (Table 1A) M. avium KM 1 M. intracel- 8 Vol. 16 No
3 NTM 69 lulare INH 1 (Table 1B) MIC MIC M. avium EBKMINHETH, M. intracellulare SMEBKMINHLVFXETH M. intracellulare ETH M. avium SM AMK, M. intracellulare CAM MIC M. avium KM INHAMK, M. intracellulare INH M. avium AMK M. intracellulare MIC M. avium SMEBKMRFPLVFXCAM ETH M. intracellulare SM EB KM AMK MIC M. avium EB M. avium SMKM LVFX CAM AMK M. intracellulare SMINHLVFXCAM MIC (Table 2) NTM MAC MIC MIC MIC MIC MIC NTM MIC MIC 1 M. avium1 KM M. intracellulare 1 INH MIC 2 MAC M. avium (ATCC25291) RFP M. intracellulare (ATCC13950) INH 12) MIC MIC MIC M. avium RFP MIC M. avium RFP MIC MIC NTM M. avium EB NTM NTM NTM NTM MAC MIC MAC MIC tailing 3) NTM MIC tailing MIC Vol. 16 No
4 70 Table 1. The numbers of strains exhibiting corresponding MICs (A) and distribution ranges of MICs (B). A Bacteria Agents M. avium SM EB 3 3 KM INH RFP LVFX CAM TH AMK M. intracellulare SM 1 5 EB KM INH RFP 6 LVFX CAM TH AMK B Bacteria Agents Distribution ranges of MICs M. avium SM 6 EB 1 5 KM INH 4 2 RFP 2 4 LVFX 3 3 CAM 2 4 TH 6 AMK 4 2 M. intracellulare SM 2 4 EB 1 4 KM 2 4 INH RFP 4 2 LVFX 3 3 CAM 3 3 TH 2 4 AMK Vol. 16 No
5 NTM 71 Table 2. The numbers of strains with corresponding distribution ranges of MICs in each group and before and after guidance Distribution ranges Bacteria Agents Groups Guidance p Values M. avium SM inexperienced pre post experienced pre post EB inexperienced pre post experienced pre post KM inexperienced pre post experienced pre post INH inexperienced pre post experienced pre post RFP inexperienced pre- 8 9 post experienced pre post LVFX inexperienced pre post experienced pre post CAM inexperienced pre post experienced pre- 9 8 post- 17 TH inexperienced pre post experienced pre post AMK inexperienced pre post experienced pre post M. intracellulare SM inexperienced pre post experienced pre post EB inexperienced pre post experienced pre post Vol. 16 No
6 72 Table 2. (continued) Distribution ranges Bacteria Agents Groups Guidance p Values M. intracellulare KM inexperienced pre post experienced pre post INH inexperienced pre post experienced pre post RFP inexperienced pre post experienced pre post LVFX inexperienced pre post experienced pre- 9 9 post CAM inexperienced pre post experienced pre post TH inexperienced pre post experienced pre- 9 9 post AMK inexperienced pre post experienced pre post The total numbers of plates for M. avium were 17 because one plate was contaminated and could not be evaluated. : no significance AIDS MAC MAC SM EB RFP 3 INH 4 13) INH MAC 3) NTM MIC MAC 12 Vol. 16 No
7 NTM 73 1) ) Gordin, F. M., C. R. Horsburgh, Jr Mycobacterium avium complex. p , In: Principles and Practices of Infectious Diseases, 6th ed. (G. L. Mandell, J. E. Bennett, R. Dolin, et al. ed.), Elsevier, Philadelphia. 3) Heifets L Susceptibility testing of Mycobacterium avium complex isolates. Antimicrob. Agents Chemother. 40: ) American Thoracic Society Diagnosis and treatment of disease caused by nontuberculous mycobacteria. Am. J. Respir. Crit. Care Med. 156: S1S25. 5) Yajko, D. M., P. S. Nassos, W. K. Hadley Broth microdilution testing of susceptibilities to 30 antimicrobial agents of Mycobacterium avium strains from patients with acquired immune deficiency syndrome. Antimicrob. Agents Chemother. 31: ) Gomez-Flores, R., S. Gupta, R. Tamez-Gurtta, et al Determination of MIC for Mycobacterium aviumm. intracellulare complex in liquid medium by a colorimetric method. J. Clin. Microbiol. 33: ) Sison, J. P., Y. Yao, C. A. Kemper, et al Treatment of Mycobacterium avium complex infection: do the results of in vitro susceptibility tests predict therapeutic outcome in humans? J. Infect. Dis. 173: ) Fabry, W., E. N. Schmid, R. Ansorg Comparison of the E test and a proportion dilution method for susceptibility testing of Mycobacterium avium complex. J. Med. Microbiol. 44: ) Bownds, S. E., T. A. Kurzynski, M. A. Norden, et al Rapid susceptibility testing for nontuberculosis mycobacteria using flow cytometry. J. Clin. Microbiol. 34: ) 2004 ATP 14: ) The National Committee for Clinical Laboratory Standards Susceptibility testing of mycobacteria, nocardiae, and other aerobic actinomycetes: Approved standard. M24-A. Vol. 23, No ) 2002 Middlebrook 4 Nontuberculous mycobacteria BrothMIC NTM 50: ) : The Reproducibility of MIC Measured with BrothMIC NTM against Mycobacterium aviumm. intracellulare Complex Miki Goto, 1) Mayumi Ichikawa, 1) Masahiro Watanabe, 1) Shunsuke Shibuya, 1) Shigemi Hitomi 2) 1) Department of Clinical Laboratory, University of Tsukuba Hospital 2) Department of Infectious Diseases, Institute of Clinical Medicine We examined the reproducibility of minimum inhibitory concentration (MIC) measured with Broth- MIC NTM using six clinical isolates of Mycobacterium avium and six of Mycobacterium intracellulare. Three plates per isolate were inoculated and MIC were measured in each plate by two groups of examiners, either experienced or inexperienced ones in determining MIC with BrothMIC NTM, before and after guidance for MIC determination. The ranges of MICs measured by the experienced ones after guidance were more than fourfold in kanamycin against one M. avium and isoniazide against one M. intracellulare. The reproducibility of MIC by the experienced ones was better than that by the inexperienced ones in streptomycin, ethambutol, kanamycin, rifampicin, levofloxacin, clarithromycin, and ethionamide against M. avium and in streptomycin, ethambutol, kanamycin, and amikacin against M. intracellulare. The reproducibility by the inexperienced group improved only in ethambutol against M. avium after guidance. We conclude that prior trainings for optical measurement of MIC are indispensable to use BrothMIC NTM. Vol. 16 No
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