キクチ　ケン   Kikuchi Ken   菊池　賢    所属   医学部 医学科（東京女子医科大学病院）    職種   教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Pulmonary infection due to fluoroquinolone-resistant Mycolicibacterium fortuitum: a case report.
掲載誌名	正式名：BMC infectious diseases 略　 称：BMC Infect Dis ISSNコード：14712334/14712334
掲載区分	国外
巻・号・頁	20(1),pp.866
著者・共著者	Kurokawa Kana, Harada Norihiro, Sasano Hitoshi, Takagi Haruhi, Takei Satomi, Nakamura Ayako, Kamada Keisuke, Yoshida Atsushi, Kikuchi Ken, Takahashi Kazuhisa
発行年月	2020/11
概要	BACKGROUND:Mycolicibacterium fortuitum is a species of the rapidly growing mycobacteria that can cause pulmonary infection. It is susceptible to multiple antibiotics both in vitro and in clinical practice, so that any combination of susceptible drugs is effective. However, we encountered a case of infection due to fluoroquinolone-resistant M. fortuitum. In this study, we report the case and describe the mechanism of resistance.CASE PRESENTATION:A 65-year-old man with a history of total gastrectomy and immunosuppressant treatment for rheumatoid arthritis developed a recurrence of pulmonary infection caused by M. fortuitum. He was treated with clarithromycin and levofloxacin as a first-line treatment, based on the favorable susceptibility at that time. After recurrence, a high minimum inhibitory concentration to fluoroquinolones was detected. DNA sequencing of the pathogen showed the substitution of serine for tryptophan at residue 83 in the gyrA gene. He was successfully treated with a combination of other antibiotics.CONCLUSION:This is the first report on the treatment of fluoroquinolone-resistant M. fortuitum and investigation of the mechanism of resistance. We suggest that the susceptibility test remains effective for determining the next line of treatment after a pathogen has acquired resistance, and resistance to fluoroquinolones in M. fortuitum can be attributed to a single change of amino acid.
DOI	10.1186/s12879-020-05596-1
PMID	33213390