Identification and Antimicrobial Susceptibilities for Patients with Non-tuberculous Mycobacteria Infection in Jeju Island: Single-Center Retrospective Study

Misun Kim; Sang Taek Heo; Jaechun Lee; Jong Hoo Lee; Miok Kim; Changhwan Kim; Gil Myeong Seong; Myeong Jin Kang; Jeong Rae Yoo

doi:10.3947/ic.2023.0052

Identification and Antimicrobial Susceptibilities for Patients with Non-tuberculous Mycobacteria Infection in Jeju Island: Single-Center Retrospective Study

Infect Chemother. 2024 Mar;56(1):13-24. doi: 10.3947/ic.2023.0052. Epub 2023 Aug 16.

Authors

Misun Kim^{1

2}, Sang Taek Heo^{1

2}, Jaechun Lee^{1

2}, Jong Hoo Lee^{1

2}, Miok Kim^{1

2}, Changhwan Kim^{1

2}, Gil Myeong Seong¹, Myeong Jin Kang³, Jeong Rae Yoo^{1

4}

Affiliations

¹ Department of Internal Medicine, Jeju National University Hospital, Jeju, Korea.
² Department of Internal Medicine, Jeju National University, College of Medicine, Jeju, Korea.
³ Department of Nursing, Jeju National University Hospital, Jeju, Korea.
⁴ Department of Internal Medicine, Jeju National University, College of Medicine, Jeju, Korea. mdyoojr@gmail.com.

Abstract

Background: The distribution of species and characteristics of non<bold>-</bold>tuberculous mycobacteria (NTM) differ, and surveillance data for changes in antimicrobial susceptibilities of NTM is insufficient. This study analyzed the changes in antimicrobial susceptibility trends across NTM species and assessed the appropriateness of empirical antimicrobial drugs for NTM.

Materials and methods: We retrospectively analyzed the clinical characteristics, including demographics, distribution of NTM species, antimicrobial drug susceptibilities, and outcomes, at a teaching hospital in Jeju Island from 2009 - 2022.

Results: Overall, 342 patients were included in the analysis; 93.0% were classified into the pulmonary group (PG) and 7.0% into the extrapulmonary group (EPG). The isolation rate of Mycobacterium avium was significantly higher in PG (36.8% vs. 0%, P = 0.001), while that of Mycobacterium fortuitum was significantly higher in EPG (4.5% vs. 31.3%, P = 0.001). The antimicrobial susceptibility rate is higher against clarithromycin (89.9%) and amikacin (83.3%) and lower against rifampin (54.7%) and ethambutol (28.1%). The susceptibility rate to clarithromycin was over 80%, but those to rifampin and ethambutol showed decreasing annual trends. Of the 162 patients who received empirical antimicrobial therapy, actual antimicrobial susceptibility rates were high (90.1%) using empirical macrolide, and relatively low using ethambutol and rifampin (28.0% and 58.8%, respectively).

Conclusion: This is the first study of analysis of the distribution, baseline characteristics, and antimicrobial susceptibility of isolated NTM species in pulmonary and extrapulmonary patients in Jeju Island over 10 years. Policies that continuously monitor changes in susceptibility rate are required to ensure effective treatment strategies.

Keywords: Antimicrobial susceptibility; Jeju Island; Nontuberculous mycobacteria; Species identification.

Grants and funding

2022-15/JNUH/Jeju National University Hospital/Korea