Towards clinical breakpoints for non-tuberculous mycobacteria - Determination of epidemiological cut off values for the Mycobacterium avium complex and Mycobacterium abscessus using broth microdilution
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Towards clinical breakpoints for non-tuberculous mycobacteria - Determination of epidemiological cut off values for the Mycobacterium avium complex and Mycobacterium abscessus using broth microdilution. / Fröberg, Gabrielle; Maurer, Florian P; Chryssanthou, Erja; Fernström, Louise; Benmansour, Hanaa; Boarbi, Samira; Mengshoel, Anne Torunn; Keller, Peter Michael; Viveiros, Miguel; Machado, Diana; Fitzgibbon, Margaret M; Mok, Simone; Werngren, Jim; Cirillo, Daniela Maria; Alcaide, Fernando; Hyyryläinen, Hanne-Leena; Aubry, Alexandra; Andres, Sönke; Nadarajan, Darshaalini; Svensson, Erik; Turnidge, John; Giske, Christian G; Kahlmeter, Gunnar; Cambau, Emmanuelle; van Ingen, Jakko; Schön, Thomas; EUCAST AMST and ESCMYC study groups.
In: CLIN MICROBIOL INFEC, Vol. 29, No. 6, 06.2023, p. 758-764.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Towards clinical breakpoints for non-tuberculous mycobacteria - Determination of epidemiological cut off values for the Mycobacterium avium complex and Mycobacterium abscessus using broth microdilution
AU - Fröberg, Gabrielle
AU - Maurer, Florian P
AU - Chryssanthou, Erja
AU - Fernström, Louise
AU - Benmansour, Hanaa
AU - Boarbi, Samira
AU - Mengshoel, Anne Torunn
AU - Keller, Peter Michael
AU - Viveiros, Miguel
AU - Machado, Diana
AU - Fitzgibbon, Margaret M
AU - Mok, Simone
AU - Werngren, Jim
AU - Cirillo, Daniela Maria
AU - Alcaide, Fernando
AU - Hyyryläinen, Hanne-Leena
AU - Aubry, Alexandra
AU - Andres, Sönke
AU - Nadarajan, Darshaalini
AU - Svensson, Erik
AU - Turnidge, John
AU - Giske, Christian G
AU - Kahlmeter, Gunnar
AU - Cambau, Emmanuelle
AU - van Ingen, Jakko
AU - Schön, Thomas
AU - EUCAST AMST and ESCMYC study groups
N1 - Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.
PY - 2023/6
Y1 - 2023/6
N2 - OBJECTIVE: For non-tuberculous mycobacteria (NTM), minimum inhibitory concentration (MIC) distributions of wild-type isolates have not been systematically evaluated despite their importance for establishing antimicrobial susceptibility testing (AST) breakpoints.METHODS: We gathered MIC distributions for drugs used against the Mycobacterium avium complex (MAC) and Mycobacterium abscessus (MAB) obtained by commercial broth microdilution (SLOMYCOI and RAPMYCOI) from 12 laboratories. Epidemiological cut-off values (ECOFFs) and tentative ECOFFs (TECOFFs) were determined by EUCAST methodology including quality control (QC) strains.RESULTS: The clarithromycin ECOFF was 16 mg/L for M. avium (n = 1271) whereas TECOFFs were 8 mg/L for M. intracellulare (n = 415) and 1 mg/L for MAB (n = 1014) confirmed by analysing MAB subspecies without inducible macrolide resistance (n = 235). For amikacin, the ECOFFs were 64 mg/L for MAC and MAB. For moxifloxacin, the WT spanned >8 mg/L for both MAC and MAB. For linezolid, the ECOFF and TECOFF were 64 mg/L for M. avium and M. intracellulare, respectively. Current CLSI breakpoints for amikacin (16 mg/L), moxifloxacin (1 mg/L) and linezolid (8 mg/L) divided the corresponding WT distributions. For QC M. avium and M. peregrinum, ≥95% of MIC values were well within recommended QC ranges.CONCLUSION: As a first step towards clinical breakpoints for NTM, (T)ECOFFs were defined for several antimicrobials against MAC and MAB. Broad wild-type MIC distributions indicate a need for further method refinement which is now under development within the EUCAST subcommittee for anti-mycobacterial drug susceptibility testing. In addition, we showed that several CLSI NTM breakpoints are not consistent in relation to the (T)ECOFFs.
AB - OBJECTIVE: For non-tuberculous mycobacteria (NTM), minimum inhibitory concentration (MIC) distributions of wild-type isolates have not been systematically evaluated despite their importance for establishing antimicrobial susceptibility testing (AST) breakpoints.METHODS: We gathered MIC distributions for drugs used against the Mycobacterium avium complex (MAC) and Mycobacterium abscessus (MAB) obtained by commercial broth microdilution (SLOMYCOI and RAPMYCOI) from 12 laboratories. Epidemiological cut-off values (ECOFFs) and tentative ECOFFs (TECOFFs) were determined by EUCAST methodology including quality control (QC) strains.RESULTS: The clarithromycin ECOFF was 16 mg/L for M. avium (n = 1271) whereas TECOFFs were 8 mg/L for M. intracellulare (n = 415) and 1 mg/L for MAB (n = 1014) confirmed by analysing MAB subspecies without inducible macrolide resistance (n = 235). For amikacin, the ECOFFs were 64 mg/L for MAC and MAB. For moxifloxacin, the WT spanned >8 mg/L for both MAC and MAB. For linezolid, the ECOFF and TECOFF were 64 mg/L for M. avium and M. intracellulare, respectively. Current CLSI breakpoints for amikacin (16 mg/L), moxifloxacin (1 mg/L) and linezolid (8 mg/L) divided the corresponding WT distributions. For QC M. avium and M. peregrinum, ≥95% of MIC values were well within recommended QC ranges.CONCLUSION: As a first step towards clinical breakpoints for NTM, (T)ECOFFs were defined for several antimicrobials against MAC and MAB. Broad wild-type MIC distributions indicate a need for further method refinement which is now under development within the EUCAST subcommittee for anti-mycobacterial drug susceptibility testing. In addition, we showed that several CLSI NTM breakpoints are not consistent in relation to the (T)ECOFFs.
KW - Humans
KW - Mycobacterium avium Complex
KW - Anti-Bacterial Agents/pharmacology
KW - Nontuberculous Mycobacteria
KW - Amikacin/pharmacology
KW - Mycobacterium abscessus
KW - Moxifloxacin/pharmacology
KW - Linezolid/pharmacology
KW - Mycobacterium avium-intracellulare Infection/microbiology
KW - Microbial Sensitivity Tests
KW - Drug Resistance, Bacterial
KW - Macrolides/pharmacology
KW - Mycobacterium tuberculosis
KW - Mycobacterium Infections, Nontuberculous/drug therapy
KW - Mycobacterium avium
U2 - 10.1016/j.cmi.2023.02.007
DO - 10.1016/j.cmi.2023.02.007
M3 - SCORING: Journal article
C2 - 36813087
VL - 29
SP - 758
EP - 764
JO - CLIN MICROBIOL INFEC
JF - CLIN MICROBIOL INFEC
SN - 1198-743X
IS - 6
ER -