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Volume 19, Number 3—March 2013

Letter

Mycobacterium kyorinense Infection

Hiroaki OhnishiComments to Author , Shota Yonetani, Satsuki Matsushima, Hiroo Wada, Kei Takeshita, Daisuke Kuramochi, Paulo Cesar de Souza Caldas, Carlos Eduardo Dias Campos, Bianca Porphirio da Costa, Jesus Pais Ramos, Shinichirou Mikura, Eriko Narisawa, Akira Fujita, Yasunori Funayama, Yoshihiro Kobashi, Yumi Sakakibara, Yukako Ishiyama, Shunji Takakura, Hajime Goto, and Takashi Watanabe
Author affiliations: Author affiliations: Kyorin University School of Medicine, Tokyo, Japan (H. Ohnishi, S. Yonetani, S. Matsushima, H. Wada, H. Goto, Y. Ishayama, T. Watanabe); Kitasato University–Kitasato Institute Hospital, Tokyo (K. Takeshita); International University of Health and Welfare Hospital, Tochigi, Japan (D. Kuramochi); Centro de Referência Prof. Helio Fraga, Rio De Janeiro, Brazil (P.C.d.S Caldas, C.E.D. Campos, B.P. da Costa, J.P. Ramos); Tokyo Metropolitan Tama Medical Center, Tokyo (S. Mikura, E. Narisawa, A. Fujita); Tsukuba Gakuen Hospital, Ibaraki, Japan (Y. Funayama); Kawasaki Medical School, Okayama, Japan (Y. Kobashi); Toshiba Hospital, Tokyo (Y. Sakakibara); Kyoto University Graduate School of Medicine, Kyoto, Japan (S. Takakura)

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Table

Clinical characteristics of patients infected with Mycobacterium kyorinense and antimicrobial susceptibility of the organism*

Characteristic
Patient/strain no.
1†
2‡
3‡
4
5
6
7
8
9
10
11§
Year of diagnosis 2005 2006 2008 2008 2009 2009 2010 2010 2011 2011 2007
Age, y 89 64 70 81 50 67 72 48 66 60 26
Sex M F M M M M M F M M M
Major infection site Lung Lung Lung Lung Lymph node Lung Lung Joint Lung Lung Lung
Specimen Sputum Sputum Sputum BAL Pus BAL Sputum Pus Sputum Sputum Sputum
Coexisting disease COPD Breast cancer None None MDS None None RA, SLE None COPD NA
Country
Japan
Japan
Japan
Japan
Japan
Japan
Japan
Japan
Japan
Japan
Brazil
AM drug MIC, μg/mL
STR 0.25 0.25 0.25 S ND 0.25 0.125 0.5 0.25 0.5 S
EMB 4 4 2 R 128 2 1 2 4 4 S
KAN 0.5 1 0.25 S ND 0.5 0.5 0.5 0.5 0.5 ND
INH 16 16 32 R 2 0.5 8 4 1 4 R
RIF 32 32 32 R 32 32 32 32 32 32 R
LVX 0.125 0.125 0.03 R 0.25 0.06 0.06 0.125 0.125 0.25 ND
CLR 0.03 0.03 0.03 ND 0.03 0.03 ND ND 0.03 0.125 ND
AMK
0.5
0.5
0.5
ND
0.5
1
ND
0.5
0.5
0.5
S
Clinical efficacy of AM drug combination
Efficacious None None None None CLR, RIF, LVX, AMK CLR, STR, MXF None LVX, EMB, CLR RIF, CLR, LVX CLR, LVX NA
Nonefficacious BIP None RFB, EMB, CLR INH, EMB, RIF None RIF, EMB, CLR, RIF, AZM, LVX CLR, RIF, EMB INH, RIF, EMB INH, RIF, EMB RFB, EMB NA
Outcome Dead Dead Dead Dead Alive Alive Alive Alive Alive Alive Dead

*BAL, bronchoalveolar lavage; COPD, chronic obstructive pulmonary disease; MDS, myelodysplastic syndrome; RA, rheumatoid arthritis; SLE, systemic lupus erythematosus; NA, not available; AM, antimicrobial; STR, streptomycin; S, sensitive; ND, not done; EMB, ethambutol; R, resistant; KAN, kanamycin; INH, isoniazid; RIF, rifampin; LVX, levofloxacin; CLR, clarithromycin; AMK, amikacin; AM, antimicrobial; RFB, rifabutin; MXF, moxifloxacin; BIP, biapenem; AZM, azithromycin.
†Reported in (1,2).
‡Reported in (1).
§Reported in (3).
¶Strains 1–10 (except for 4): assayed by broth microdilution MIC for nontuberculosis mycobacteria (BrothMIC NTM; Kyokuto Pharmaceutical Industrial Co., Ltd., Tokyo, Japan). Strains 4 and 11: susceptibility test performed by using Vite Spectrum SR (Kyokuto Pharmaceutical Industrial Co., Ltd.) and BACTEC MGIT 960 Mycobacterial Detection System (Becton, Dickinson and Company, Franklin Lakes, NJ, USA), respectively; therefore, numeric MIC data were not available for these strains.

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