ethionamide and Mycobacterium-Infections

Topics: Aminosalicylic Acids; Collapse Therapy; Cycloserine; Ethambutol; Ethionamide; Humans; Isoniazid; Microbial Sensitivity Tests; Mycobacterium Infections; Pneumonectomy; Preoperative Care; Streptomycin; Viomycin

Spontaneous mutants of Mycobacterium tuberculosis that were resistant to the anti-tuberculosis drugs ethionamide and isoniazid were isolated and found to map to mshA, a gene encoding the first enzyme involved in the biosynthesis of mycothiol, a major low-molecular-weight thiol in M. tuberculosis. Seven independent missense or frameshift mutations within mshA were identified and characterized. Precise null deletion mutations of the mshA gene were generated by specialized transduction in three different strains of M. tuberculosis. The mshA deletion mutants were defective in mycothiol biosynthesis, were only ethionamide-resistant and required catalase to grow. Biochemical studies suggested that the mechanism of ethionamide resistance in mshA mutants was likely due to a defect in ethionamide activation. In vivo, a mycothiol-deficient strain grew normally in immunodeficient mice, but was slightly defective for growth in immunocompetent mice. Mutations in mshA demonstrate the non-essentiality of mycothiol for growth in vitro and in vivo, and provide a novel mechanism of ethionamide resistance in M. tuberculosis.

Topics: Amino Acid Sequence; Animals; Antitubercular Agents; Bacterial Proteins; Catalase; Corynebacterium glutamicum; Cysteine; Drug Resistance, Bacterial; Ethionamide; Glycopeptides; Glycosyltransferases; Humans; Inositol; Isoniazid; Mice; Mice, Inbred C57BL; Mice, SCID; Microbial Sensitivity Tests; Mixed Function Oxygenases; Molecular Sequence Data; Mycobacterium Infections; Mycobacterium tuberculosis; Sequence Alignment; Sequence Deletion; Tuberculosis, Multidrug-Resistant

The incidence and pattern of extrathoracic tuberculosis in the Siberian and Far Eastern areas are analyzed. The statements are illustrated by two clinical cases.

Topics: Adult; Antitubercular Agents; Catchment Area, Health; Ethionamide; Female; Humans; Male; Middle Aged; Mycobacterium Infections; Russia; Skin Diseases; Tuberculosis

We report a 6 year experience (1979-1984) of isolating Mycobacterium malmoense in the north-east of England. Eleven subjects were involved of whom 10 had active infection--9 pulmonary, one cervical adenitis. The 11 new isolates represent 0.7% of all new mycobacterial isolates during this period and 10% of new non-tuberculous isolates. In all but 2 cases there was pre-existing pulmonary disease and/or a recognised predisposing factor to mycobacterial infection. The organisms were generally insensitive to isoniazid but sensitive to both rifampicin and ethionamide. The results of chemotherapy are described.

Topics: Adult; Drug Therapy, Combination; England; Ethionamide; Female; Humans; Infant; Lung Diseases; Lymphadenitis; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Rifampin; Tuberculosis, Pulmonary

Topics: Animals; Drug Evaluation, Preclinical; Ethionamide; Kanamycin; Male; Mice; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Sulfisoxazole

The case is presented of a 48-year-old woman who, in association with repeated septic temperatures, developed abscesses in the region of the right shoulder and in the right ankly. Histological examination from excisates revealed caseous tuberculoid granulomas. Mycobacterium fortuitum was isolated from the pus of both abscesses. Although the Mycobacterium fortuitum was resistant to nine commonly used tuberculostatics, it was found to be sensitive to ethionamide and capreomycine. The use of these two drugs in combination with local measures proved successful.

Topics: Ankle; Capreomycin; Ethionamide; Female; Humans; Immobilization; Middle Aged; Mycobacterium; Mycobacterium Infections; Shoulder

Two outbreaks of postoperative wound infections by organisms of the Mycobacterium fortuitum complex have focused attention on this notoriously drug resistant organism. In this report 2 cases are presented which developed infections with this organism, one of which responded to systemic antimicrobials despite discouraging in vitro sensitivities. Surgical debridement must remain the choice of treatment; however, systemic antibiotics may prove effective in some cases.

Topics: Adult; Antitubercular Agents; Drug Resistance, Microbial; Ethambutol; Ethionamide; Humans; Isoniazid; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium; Mycobacterium Infections; Rifampin; Surgical Wound Infection

The clinical records of 7 patients referred to the National Jewish Hospital and Research Center over a 6-year period for evaluation of an abnormal chest x-ray and repeated sputum isolates of rapidly growing mycobacteria (Runyon's Group IV) were reviewed to determine the potential pathogenicity of these organisms. Mycobacterium fortuitum was isolated from 5 patients and Mycobacterium chelonei from 2. Haemoptysis, cough and weight loss were prominent in 6. Three had rheumatoid arthritis. Although two demonstrated cutaneous anergy, lymphocyte responsiveness to PHA was normal. PPD-F was not useful in skin testing or in the in vitro evaluation of lymphocyte function. Histologic examination of the lungs of 2 patients demonstrated caseating granulomata. One patient died of massive pulmonary haemorrhage soon after intiation of therapy. Multi-drug treatment regimens generally resulted in progressive sterilization of the sutum and improvement in the appearance of the chest x-ray. We conclude that some rapidly growing mycobacteria can cause potentially fatal cavitary lung disease and that intensive anti-tuberculosis therapy may successfully alter its course.

Topics: Adult; Aged; Antitubercular Agents; Ethionamide; Female; Humans; Lung Diseases; Male; Microbial Sensitivity Tests; Middle Aged; Mycobacterium; Mycobacterium Infections; Tetracycline

Atypical mycobacterial infections may give rise to various clinical difficulties. Case reports of six patients--three adult patients with pulmonary lesions, two children with cervical lymphadentis and one patient in whom the atypical mycobacterium appeared to be present as a commensal--illustrate these difficulties. Determination of the significance of the organism and differentiation of condition from tuberculosis and others requires consideration of the clinical picture, the results of skin testing, histologic features and cultural characteristics. Three patients, including the two children, were treated with a combination of surgery and chemotherapy, with satisfactory results. An elderly patient with chronic bronchitis and a pulmonary infection due to M. kansasii was treated successfully with antiuberculosis agents alone. Chemotherapy is being tried on a fifth patient with cavitary disease due to M. intracellulare, but is seems likely that an operation will also be required.

Topics: Adult; Aged; Child, Preschool; Cycloserine; Diagnosis, Differential; Ethambutol; Ethionamide; Female; Humans; Isoniazid; Lung; Lung Diseases; Lymph Nodes; Lymphadenitis; Male; Mycobacterium Infections; Skin Tests; Sputum; Tuberculosis, Pulmonary

Topics: Capreomycin; Child; Drug Resistance, Microbial; Ethambutol; Ethionamide; Humans; Isoniazid; Kanamycin; Lung Diseases; Lymphadenitis; Mycobacterium; Mycobacterium Infections; Rifampin; Skin Diseases, Infectious; Sputum; Streptomycin

Topics: Adolescent; Adult; Aged; Anemia; Biopsy; Blood Cell Count; Child; Child, Preschool; Cycloserine; Diagnosis, Differential; Ethionamide; Fever; Hepatomegaly; Humans; Infant; Leukocytosis; Middle Aged; Mycobacterium; Mycobacterium Infections; Skin Tests; Thrombocytopenia; Thrombocytosis

Topics: Abscess; Biopsy, Needle; Child, Preschool; Ethionamide; Female; Humans; Microbial Sensitivity Tests; Mycobacterium Infections; Thyroidectomy; Thyroiditis

Topics: Adolescent; Adult; Aged; Aminosalicylic Acids; Antitubercular Agents; Child; Cycloserine; Ethambutol; Ethionamide; Female; Follow-Up Studies; Humans; Isoniazid; Lung Diseases; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Pneumonectomy; Pyrazinamide; Rifampin; Sputum; Streptomycin

Topics: Adult; Antitubercular Agents; Cycloserine; Drug Combinations; Drug Resistance, Microbial; Ethionamide; Female; Humans; Lung Diseases; Male; Mycobacterium; Mycobacterium Infections; Oxytetracycline; Tetracycline

Topics: Adult; Amputation, Surgical; Amputation, Traumatic; Arm Injuries; Drainage; Drug Resistance, Microbial; Ethionamide; Humans; Isoniazid; Kanamycin; Leg Injuries; Male; Military Medicine; Mycobacterium Infections; Surgical Wound Infection; Tetracycline; Tuberculin Test; United States; Vietnam; Wound Infection

Topics: Aniline Compounds; Animals; Dapsone; Disease Models, Animal; Drug Combinations; Ethionamide; Humans; Isoniazid; Leprosy; Mice; Models, Biological; Mycobacterium Infections; Phenazines; Pyrazines; Rabbits; Rifampin; Sulfonamides; Trimethoprim

Topics: Biopsy; Bronchoscopy; Child, Preschool; Diagnosis, Differential; Ethionamide; Female; Humans; Lung Diseases; Mycobacterium; Mycobacterium Infections; Rifampin; Tuberculosis, Pulmonary

Topics: Administration, Oral; Animals; Dapsone; Demeclocycline; Ethionamide; Female; Isoniazid; Mice; Mice, Inbred Strains; Mycobacterium Infections; Phenylthiourea; Pyrazines; Rifampin; Sulfonamides

Topics: Animals; Drug Resistance, Microbial; Drug Synergism; Ethionamide; Female; Heart; Isoniazid; Kidney; Mice; Mice, Inbred Strains; Mycobacterium Infections; Rifampin; Streptomycin

Topics: Adult; Amphotericin B; Animals; Cycloserine; Diagnosis, Differential; Ethambutol; Ethionamide; Female; Fishes; Hobbies; Humans; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Skin; Skin Diseases, Infectious; Sporotrichosis; Vancomycin

Topics: Acids; Anti-Bacterial Agents; Antitubercular Agents; Depression, Chemical; Ethionamide; Hydrogen-Ion Concentration; Mycobacterium; Mycobacterium Infections; Pyruvates; Stimulation, Chemical

Topics: Aminosalicylic Acids; Child; Drug Resistance, Microbial; Erythromycin; Ethionamide; Humans; Isoniazid; Lymphadenitis; Male; Mycobacterium; Mycobacterium Infections; Neck; Streptomycin

Topics: Administration, Oral; Animals; Body Weight; Drug Combinations; Ethambutol; Ethionamide; Guinea Pigs; Isoniazid; Lung; Mycobacterium; Mycobacterium Infections; Phenylthiourea; Pneumoconiosis; Radiography; Time Factors; Tuberculosis, Pulmonary

Topics: Animals; Drug Combinations; Drug Resistance, Microbial; Ethambutol; Ethionamide; Isoniazid; Mice; Mycobacterium Infections; Phenylthiourea; Rifampin; Streptomycin; Time Factors; Tuberculosis

Topics: Aminosalicylic Acids; Animals; Anti-Bacterial Agents; Cycloserine; Ethambutol; Ethionamide; Injections, Subcutaneous; Isoniazid; Kanamycin; Lung; Male; Mice; Mycobacterium Infections; Spleen; Streptomycin; Sulfonamides

Topics: Adult; Aged; Drug Resistance, Microbial; Ethionamide; Female; Hospitalization; Humans; Isoniazid; Lung Diseases; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Prognosis; Radiography; Sputum; Streptomycin

Topics: Cycloserine; England; Environment; Ethionamide; Humans; Lung Diseases; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Pneumoconiosis; Pulmonary Emphysema; Radiography; Respiratory Tract Infections; Sputum; Tuberculin Test

Topics: Adolescent; Aminosalicylic Acids; Diagnosis, Differential; Drug Resistance, Microbial; Ethambutol; Ethionamide; Female; Humans; Isoniazid; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Pyridoxine; Skin Diseases, Infectious; Sporotrichosis; Streptomycin

Topics: Animals; Antitubercular Agents; Cycloserine; Dapsone; Disease Models, Animal; Drug Synergism; Ethambutol; Ethionamide; Mice; Mycobacterium Infections; Phenylthiourea; Rabbits; Streptomycin; Thioacetazone

Topics: Bone Marrow; Candidiasis; Child, Preschool; Eczema; Ethionamide; Female; Humans; Kanamycin; Macrophages; Mononuclear Phagocyte System; Mycobacterium Infections; Prednisone; Thrombocytopenia; Tuberculin Test

Topics: Adult; Aged; Bursitis; Ethionamide; Female; Finger Joint; Humans; Joint Diseases; Male; Middle Aged; Mycobacterium Infections; Streptomycin; Synovitis; Tendinopathy; Tendons; Tuberculin Test; Wrist Joint

Topics: Animals; Coal; Dust; Ethambutol; Ethionamide; Guinea Pigs; Isoniazid; Lung Diseases; Mycobacterium; Mycobacterium Infections; Pneumoconiosis; Radiography

Topics: Aminosalicylic Acid; Aminosalicylic Acids; Antitubercular Agents; Child; Cycloserine; Ethionamide; Isoniazid; Kanamycin; Mycobacterium Infections; Prednisone; Pyrazinamide; Streptomycin; Tuberculosis; Tuberculosis, Cardiovascular; Tuberculosis, Meningeal; Tuberculosis, Miliary; Tuberculosis, Osteoarticular; Tuberculosis, Pleural; Tuberculosis, Pulmonary; Tuberculosis, Urogenital; Viomycin

Topics: Classification; Cycloserine; Drug Resistance; Drug Resistance, Microbial; Epidemiology; Ethionamide; Humans; Kanamycin; Lung Diseases; Microbiology; Mycobacterium; Mycobacterium Infections; Tuberculosis; Tuberculosis, Pulmonary

Topics: Adrenal Cortex Hormones; Aminosalicylic Acid; Aminosalicylic Acids; Child; Cycloserine; Drug Resistance; Drug Resistance, Microbial; Ethambutol; Ethionamide; Isoniazid; Kanamycin; Mycobacterium Infections; Pharmacology; Prognosis; Pyrazinamide; Streptomycin; Surgical Procedures, Operative; Thiosemicarbazones; Toxicology; Tuberculosis; Tuberculosis, Miliary; Tuberculosis, Pulmonary; Viomycin

Topics: Aminosalicylic Acid; Aminosalicylic Acids; Bacteriological Techniques; Biomedical Research; Diagnosis; Ethionamide; Isoniazid; Mice; Mycobacterium; Mycobacterium Infections; Mycobacterium ulcerans; Pharmacology; Phenazines; Skin Ulcer; Streptomycin; Thiosemicarbazones; Uganda; Viomycin