Treatment of XXXX due to Mycobacterium fortuitum and Mycobacterium chelonei on the basis of in vitro susceptibilities.

@entity1 @entity66 @entity11682 @entity4034 @entity2929 @entity2688 @entity4509 @entity3403 @entity281 @entity3398
One hundred twenty-three @entity1 with @entity281 due to Mycobacterium fortuitum or Mycobacterium chelonei were treated by wound debridement and with chemotherapy on the basis of in vitro susceptibilities of the organism. Of 76 @entity1 with @entity281 caused by M. fortuitum, 13 required no therapy or were adequately treated with surgery alone. @entity1 with active localized disease received single drug therapy (usually with a @entity11682 ) for a mean period of 10.6 weeks for @entity2688 and seven months for @entity4034 . @entity1 with @entity66 received @entity4509 or @entity4509 plus @entity3398 (mean, four weeks) followed by a @entity11682 (mean, six months). The 47 @entity1 with @entity281 caused by M. chelonei received no therapy or were treated with surgery alone (6); with @entity4509 (10), @entity2929 (6), @entity3403 (3), or @entity3398 (1); or with @entity4509 plus @entity3398 followed by @entity3398 alone for a total of 10-12 weeks (20); or other multiple-drug regimens (1). Surgery was performed on 74 (60%) @entity1 . Schlichter tests or serum drug levels were determined for 81 (66%) @entity1 . Response to therapy was excellent; 68 (90%) @entity281 with M. fortuitum and 34 (72%) with M. chelonei were successfully treated. Cultures became negative within six weeks of chemotherapy, except for sternal @entity4034 , for which cultures were not negative until up to 14 weeks. Follow-up for a mean period of 12 months following therapy was possible in 80% of cases. Relapses were rare except in @entity1 with disseminated disease, and drug resistance developed in only one @entity1 . These studies demonstrate the value of routine susceptibility testing of these mycobacterial species and the benefit of chemotherapy on the basis of in vitro susceptibilities.
