Volume 27, Number 3—March 2021
Bedaquiline as Treatment for Disseminated Nontuberculous Mycobacteria Infection in 2 Patients Co-Infected with HIV
|Drug||MIC, mg/L||CLSI interpretation|
||Month 0: 16||Sensitive|
|Month 3: 32
|Clarithromycin||>16||Resistant (phenotype suggestive of inducible resistance)|
||Month 0: 32||Resistant|
|Month 3: 16
|Tigecycline||2||No defined breakpoints|
*MICs were obtained for the initial isolate of the patient at month 0, and again at month 3. Where duplicated, values were consistent, except for amikacin and linezolid, where both MICs are included. CLSI, Clinical and Laboratory Standards Institute.
- Holland SM. Nontuberculous mycobacteria. Am J Med Sci. 2001;321:49–55.
- Brown-Elliott BA, Nash KA, Wallace RJ Jr. Antimicrobial susceptibility testing, drug resistance mechanisms, and therapy of infections with nontuberculous mycobacteria. Clin Microbiol Rev. 2012;25:545–82.
- Millar BC, Moore JE. Antimycobacterial strategies to evade antimicrobial resistance in the nontuberculous mycobacteria. Int J Mycobacteriol. 2019;8:7–21.
- Pym AS, Diacon AH, Tang S-J, Conradie F, Danilovits M, Chuchottaworn C, et al.; TMC207-C209 Study Group. Bedaquiline in the treatment of multidrug- and extensively drug-resistant tuberculosis. Eur Respir J. 2016;47:564–74.
- M24Ed3 susceptibility testing of mycobacteria, Nocardia spp., and other aerobic Actinomycetes, 3rd ed. Wayne (PA): Clinical and Laboratory Standards Institute [cited 2020 Nov 6]. https://clsi.org/standards/products/microbiology/documents/m24
- Schön T, Chryssanthou E. Minimum inhibitory concentration distributions for Mycobacterium avium complex-towards evidence-based susceptibility breakpoints. Int J Infect Dis. 2017;55:122–4.
- Benson CA, Williams PL, Currier JS, Holland F, Mahon LF, MacGregor RR, et al.; AIDS Clinical Trials Group 223 Protocol Team. A prospective, randomized trial examining the efficacy and safety of clarithromycin in combination with ethambutol, rifabutin, or both for the treatment of disseminated Mycobacterium avium complex disease in persons with acquired immunodeficiency syndrome. Clin Infect Dis. 2003;37:1234–43.
- Bax HI, Bakker-Woudenberg IA, Ten Kate MT, Verbon A, de Steenwinkel JE. Tigecycline potentiates clarithromycin activity against Mycobacterium avium in vitro. Antimicrob Agents Chemother. 2016;60:2577–9.
- Diacon AH, Pym A, Grobusch MP, de los Rios JM, Gotuzzo E, Vasilyeva I, et al.; TMC207-C208 Study Group. Multidrug-resistant tuberculosis and culture conversion with bedaquiline. N Engl J Med. 2014;371:723–32.
- Aguilar-Ayala DA, Cnockaert M, André E, Andries K, Gonzalez-Y-Merchand JA, Vandamme P, et al. In vitro activity of bedaquiline against rapidly growing nontuberculous mycobacteria. J Med Microbiol. 2017;66:1140–3.
- Martin A, Godino IT, Aguilar-Ayala DA, Mathys V, Lounis N, Villalobos HR. In vitro activity of bedaquiline against slow-growing nontuberculous mycobacteria. J Med Microbiol. 2019;68:1137–9.
- Cholo MC, Mothiba MT, Fourie B, Anderson R. Mechanisms of action and therapeutic efficacies of the lipophilic antimycobacterial agents clofazimine and bedaquiline. J Antimicrob Chemother. 2017;72:338–53.
- Lounis N, Gevers T, Van den Berg J, Vranckx L, Andries K. ATP synthase inhibition of Mycobacterium avium is not bactericidal. Antimicrob Agents Chemother. 2009;53:4927–9.
- Alexander DC, Vasireddy R, Vasireddy S, Philley JV, Brown-Elliott BA, Perry BJ, et al. Emergence of mmpT5 variants during bedaquiline treatment of Mycobacterium intracellulare lung disease. J Clin Microbiol. 2017;55:574–84.
- Ruth MM, Sangen JJN, Remmers K, Pennings LJ, Svensson E, Aarnoutse RE, et al. A bedaquiline/clofazimine combination regimen might add activity to the treatment of clinically relevant non-tuberculous mycobacteria. J Antimicrob Chemother. 2019;74:935–43.