Rational Choice of Antibiotics and Media for Mycobacterium avium Complex Drug Susceptibility Testing

The Clinical and Laboratory Standards Institute recommends the use of Mueller Hinton (MH) medium to perform drug susceptibility testing (DST) of Mycobacterium avium complex (MAC) using the microdilution method. For MAC, there has been no study on the impact of media on the determination of minimum i...

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Main Authors: Jérémy Jaffré, Alexandra Aubry, Thomas Maitre , Florence Morel, Florence Brossier, Jérôme Robert, Wladimir Sougakoff, Nicolas Veziris, the CNR-MyRMA (Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux)
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-02-01
Series:Frontiers in Microbiology
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Online Access:https://www.frontiersin.org/article/10.3389/fmicb.2020.00081/full
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author Jérémy Jaffré
Jérémy Jaffré
Alexandra Aubry
Alexandra Aubry
Thomas Maitre 
Florence Morel
Florence Morel
Florence Brossier
Florence Brossier
Jérôme Robert
Jérôme Robert
Wladimir Sougakoff
Wladimir Sougakoff
Nicolas Veziris
Nicolas Veziris
Nicolas Veziris
the CNR-MyRMA (Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux)
author_facet Jérémy Jaffré
Jérémy Jaffré
Alexandra Aubry
Alexandra Aubry
Thomas Maitre 
Florence Morel
Florence Morel
Florence Brossier
Florence Brossier
Jérôme Robert
Jérôme Robert
Wladimir Sougakoff
Wladimir Sougakoff
Nicolas Veziris
Nicolas Veziris
Nicolas Veziris
the CNR-MyRMA (Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux)
author_sort Jérémy Jaffré
collection DOAJ
description The Clinical and Laboratory Standards Institute recommends the use of Mueller Hinton (MH) medium to perform drug susceptibility testing (DST) of Mycobacterium avium complex (MAC) using the microdilution method. For MAC, there has been no study on the impact of media on the determination of minimum inhibitory concentrations (MICs) of antibiotics other than clarithromycin. This study aimed at determining the impact of two media used for DST of MAC and at augmenting the number of pertinent MICs for MAC species encountered in clinical practice. MICs of antibiotics used for the treatment of MAC infections were determined for 158 clinical MAC isolates (80 M. avium, 40 M. intracellulare, 35 M. chimaera, two M. yongonense and one M. timonense) in MH and 7H9 broths using the SLOMYCO SensititreTM system (TREK Diagnostic Systems, East Grinstead, United Kingdom). The modal MICs determined in both media were the same for linezolid, moxifloxacin, rifabutin and amikacin but not for clarithromycin, rifampin and ethambutol. The kappa test for MICs converted to susceptibility categories showed an excellent agreement for clarithromycin, a moderate agreement for linezolid and a weak agreement for moxifloxacin and amikacin. For amikacin, 7H9 allowed a better distinction (fewer intermediate strains) of wild-type populations than MH. Existing breakpoints for linezolid and moxifloxacin are spread through the distribution of MICs for wild-type populations. The only breakpoints that can be used rationally are those for amikacin and clarithromycin. For amikacin, 7H9 performs better than MH, whereas both media perform equally for clarithromycin. Given that testing in 7H9, as opposed to MH, allows easier MIC measurements and yields greater reproducibility, we propose the use of 7H9 medium for DST of MAC.
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spelling doaj.art-5b788b0763b74658a7dafcfd9d3c1c0b2022-12-22T03:15:13ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2020-02-011110.3389/fmicb.2020.00081499003Rational Choice of Antibiotics and Media for Mycobacterium avium Complex Drug Susceptibility TestingJérémy Jaffré0Jérémy Jaffré1Alexandra Aubry2Alexandra Aubry3Thomas Maitre 4Florence Morel5Florence Morel6Florence Brossier7Florence Brossier8Jérôme Robert9Jérôme Robert10Wladimir Sougakoff11Wladimir Sougakoff12Nicolas Veziris13Nicolas Veziris14Nicolas Veziris15the CNR-MyRMA (Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux)AP-HP (Assistance Publique Hôpitaux de Paris), Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, FranceINSERM, U1135, Centre d’Immunologie et des Maladies Infectieuses, Sorbonne Université, Cimi-Paris, Paris, FranceAP-HP (Assistance Publique Hôpitaux de Paris), Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, FranceINSERM, U1135, Centre d’Immunologie et des Maladies Infectieuses, Sorbonne Université, Cimi-Paris, Paris, FranceAP-HP (Assistance Publique Hôpitaux de Paris), Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, FranceAP-HP (Assistance Publique Hôpitaux de Paris), Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, FranceINSERM, U1135, Centre d’Immunologie et des Maladies Infectieuses, Sorbonne Université, Cimi-Paris, Paris, FranceAP-HP (Assistance Publique Hôpitaux de Paris), Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, FranceINSERM, U1135, Centre d’Immunologie et des Maladies Infectieuses, Sorbonne Université, Cimi-Paris, Paris, FranceAP-HP (Assistance Publique Hôpitaux de Paris), Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, FranceINSERM, U1135, Centre d’Immunologie et des Maladies Infectieuses, Sorbonne Université, Cimi-Paris, Paris, FranceAP-HP (Assistance Publique Hôpitaux de Paris), Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, FranceINSERM, U1135, Centre d’Immunologie et des Maladies Infectieuses, Sorbonne Université, Cimi-Paris, Paris, FranceAP-HP (Assistance Publique Hôpitaux de Paris), Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié Salpêtrière, Paris, FranceINSERM, U1135, Centre d’Immunologie et des Maladies Infectieuses, Sorbonne Université, Cimi-Paris, Paris, FranceAP-HP (Assistance Publique Hôpitaux de Paris), Groupe Hospitalier Universitaire, Sorbonne Université, Hôpital Saint-Antoine, Paris, FranceThe Clinical and Laboratory Standards Institute recommends the use of Mueller Hinton (MH) medium to perform drug susceptibility testing (DST) of Mycobacterium avium complex (MAC) using the microdilution method. For MAC, there has been no study on the impact of media on the determination of minimum inhibitory concentrations (MICs) of antibiotics other than clarithromycin. This study aimed at determining the impact of two media used for DST of MAC and at augmenting the number of pertinent MICs for MAC species encountered in clinical practice. MICs of antibiotics used for the treatment of MAC infections were determined for 158 clinical MAC isolates (80 M. avium, 40 M. intracellulare, 35 M. chimaera, two M. yongonense and one M. timonense) in MH and 7H9 broths using the SLOMYCO SensititreTM system (TREK Diagnostic Systems, East Grinstead, United Kingdom). The modal MICs determined in both media were the same for linezolid, moxifloxacin, rifabutin and amikacin but not for clarithromycin, rifampin and ethambutol. The kappa test for MICs converted to susceptibility categories showed an excellent agreement for clarithromycin, a moderate agreement for linezolid and a weak agreement for moxifloxacin and amikacin. For amikacin, 7H9 allowed a better distinction (fewer intermediate strains) of wild-type populations than MH. Existing breakpoints for linezolid and moxifloxacin are spread through the distribution of MICs for wild-type populations. The only breakpoints that can be used rationally are those for amikacin and clarithromycin. For amikacin, 7H9 performs better than MH, whereas both media perform equally for clarithromycin. Given that testing in 7H9, as opposed to MH, allows easier MIC measurements and yields greater reproducibility, we propose the use of 7H9 medium for DST of MAC.https://www.frontiersin.org/article/10.3389/fmicb.2020.00081/fulldrug susceptibility testingMycobacterium avium complexSLOMYCO SensititreTM7H9Mueller Hintonclarithromycin
spellingShingle Jérémy Jaffré
Jérémy Jaffré
Alexandra Aubry
Alexandra Aubry
Thomas Maitre 
Florence Morel
Florence Morel
Florence Brossier
Florence Brossier
Jérôme Robert
Jérôme Robert
Wladimir Sougakoff
Wladimir Sougakoff
Nicolas Veziris
Nicolas Veziris
Nicolas Veziris
the CNR-MyRMA (Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux)
Rational Choice of Antibiotics and Media for Mycobacterium avium Complex Drug Susceptibility Testing
Frontiers in Microbiology
drug susceptibility testing
Mycobacterium avium complex
SLOMYCO SensititreTM
7H9
Mueller Hinton
clarithromycin
title Rational Choice of Antibiotics and Media for Mycobacterium avium Complex Drug Susceptibility Testing
title_full Rational Choice of Antibiotics and Media for Mycobacterium avium Complex Drug Susceptibility Testing
title_fullStr Rational Choice of Antibiotics and Media for Mycobacterium avium Complex Drug Susceptibility Testing
title_full_unstemmed Rational Choice of Antibiotics and Media for Mycobacterium avium Complex Drug Susceptibility Testing
title_short Rational Choice of Antibiotics and Media for Mycobacterium avium Complex Drug Susceptibility Testing
title_sort rational choice of antibiotics and media for mycobacterium avium complex drug susceptibility testing
topic drug susceptibility testing
Mycobacterium avium complex
SLOMYCO SensititreTM
7H9
Mueller Hinton
clarithromycin
url https://www.frontiersin.org/article/10.3389/fmicb.2020.00081/full
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