Phenotypic amikacin resistance may not indicate poor response to amikacin in Mycobacterium avium complex pulmonary disease

L M Minuk; S K Brode; M Mehrabi; M K Sharma; M Stobart; H Soualhine; T K Marras

doi:10.1128/aac.00084-24

Phenotypic amikacin resistance may not indicate poor response to amikacin in Mycobacterium avium complex pulmonary disease

Antimicrob Agents Chemother. 2024 May 17:e0008424. doi: 10.1128/aac.00084-24. Online ahead of print.

Authors

L M Minuk¹, S K Brode^{1

2

3}, M Mehrabi⁴, M K Sharma^{5

6}, M Stobart⁶, H Soualhine^{5

6

7}, T K Marras^{1

2}

Affiliations

¹ Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
² Division of Respirology, Department of Medicine, University Health Network, Mount Sinai Hospital, Toronto, Ontario, Canada.
³ Division of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada.
⁴ Division of Respirology, Department of Medicine, Toronto Western Hospital, Toronto, Ontario, Canada.
⁵ National Reference Centre for Mycobacteriology, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.
⁶ Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada.
⁷ McGill International TB Centre, McGill University, Montreal, Quebec, Canada.

PMID: 38758004
DOI: 10.1128/aac.00084-24

Abstract

When using amikacin to treat Mycobacterium avium complex pulmonary disease (MAC-PD), a minimum inhibitory concentration resistance breakpoint of ≥64 mcg/mL is recommended. We explored whether amikacin resistance characterized by phenotypic drug susceptibility testing was associated with clinical outcomes or mutational resistance in a retrospective cohort of patients with MAC-PD. Despite little aminoglycoside exposure, amikacin resistance was common in our MAC-PD patients but was not associated with worse outcomes or rrs gene mutations.

Keywords: Mycobacterium avium; amikacin; antimicrobial resistance; mycobacterial infection (pulmonary).