1887

Abstract

Macrolide susceptibility differs between subspecies in the complex, likely due to differences in (41) sequevars. Patients with complex infection generally show poor clinical outcomes in response to antibiotic treatment. Here, the association between genotype and treatment outcome was investigated.

We collected 69 isolates from 35 patients with non-cystic fibrosis bronchiectasis: 24 had complex lung disease and non-cystic fibrosis bronchiectasis, and 11 were colonized. Outcome analysis was performed in the 24 infected patients. Molecular analyses, including (41) and sequencing, and variable-number tandem-repeat (VNTR) analysis of 69 isolates, from 24 infected and 11 colonized patients, were performed to elucidate the influence of genotype on antibiotic susceptibility.

Among the 24 patients, 18 (14 infected with subsp. and 4 with subsp. ) showed unfavourable outcomes; six (three infected with subsp. and three with subsp. ) exhibited favourable outcomes. Patients with unfavourable outcomes showed acquired clarithromycin resistance (33.3 vs 0 %), mixed sequevars (38.9 vs 16.7 %) and differing VNTR patterns between initial and serial isolates (33.3 vs 16.7 %). In contrast, in the 11 colonized patients, subsp. C28 (sequevar 02) and subsp. were the most prevalent subspecies.

Patients infected with multiple sequevars and genotypes were more likely to exhibit treatment failure and/or recurrence. The precise identification of subspecies and analyses of mycobacterial characteristics may help to predict treatment outcomes in patients with complex lung disease.

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2018-01-01
2020-01-25
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