minocycline and Mycobacterium-Infections

Mycobacterium abscessus is the most pathogenic and chemotherapy-resistant rapid-growing mycobacterium. It is commonly associated with contaminated traumatic skin wounds and with post-surgical soft tissue infections. It is also one of the mycobacteria that are most often isolated from cystic fibrosis patients. It is essential to differentiate this species from the formerly indistinct "M. chelonae-complex", as chemotherapy is especially difficult in M. abscessussenso strictu. Clarithromycin or azithromycin are the only regular oral antimycobacterial agents with an effect on M. abscessus, and should preferably be supplemented with other drugs since long-term monotherapy may cause resistance. Amikacin is a major parenteral drug against M. abscessus that should also be given in combination with another drug. The recently introduced drug tigecycline may prove to be an important addition to chemotherapy, but has yet to be fully clinically evaluated as an antimycobacterial agent. Surgery can be curative, or at least helpful, in the healing of M. abscessus infection, and if conducted, it should include the removal of all foreign or necrotic material. There is increasing awareness of M. abscessus as an emerging pathogen.

Topics: Administration, Oral; Amikacin; Anti-Bacterial Agents; Azithromycin; Clarithromycin; Cystic Fibrosis; Drug Resistance, Bacterial; Drug Therapy, Combination; Humans; Microbial Sensitivity Tests; Minocycline; Mycobacterium; Mycobacterium Infections; Respiratory Tract Infections; Skin; Soft Tissue Infections; Species Specificity; Surgical Wound Infection; Tigecycline; Tuberculosis, Cutaneous; Wounds and Injuries

Minocycline belongs to the second generation class of cyclines. It was synthesized in 1967 and marketed in 1972. Minocycline has an antiinfectious activity with a spectrum similar to that of other cyclines, notably against Chlamydias, Treonema and Proprionibacterium acenes. The antiinflammatory activity is associated with this antiinfectious action is greater than that of first generation cyclines with specifically a modulator effect on epidermal cytokines. The pharmokinetics of minocycline is characterized by an excellent absorption, a long half-life and an important lipophilic property inducing good tissue distribution. Clinical trials of minocycline have mainly been performed in sexually transmissible diseases and in acne, a field where randomized studies are the most frequent. These trials show that the effect of minocycline is not stronger than first generation cyclines or doxycycline, but that the action is quicker than that of tetracycline at the dose of 500 mg a day. Minocycline is also efficient in nocardiasis, mycobacteriosis, leprosy, Lyme disease, pyoderma gangrenosum, autoimmune bullous dermatitis, Carteaud disease, and prurigo. However, the effect of minocycline in these different conditions has always been evaluated in open trials with a small number of patients. The usual side effects of cyclines, i.e. digestive problems, fungal infections, are less frequent than with first generation cyclines. No photosensitivity has been demonstrated although pigmentations have been described. Dizziness is a specific side effect of minocycline. Furthermore, rare but severe side effects have been reported, including hypersensitivity syndrome, autoimmune hepatitis, and lupus. Regular indications for minocycline in dermatology are acne and three sexually transmissible diseases (mycoplasm, chlamydia, treponema). Proposed dosage is 100 mg per day in sexually transmissible disease with a reduction to 50 mg per day after 15 days in acne.

Topics: Acne Vulgaris; Anti-Bacterial Agents; Autoimmune Diseases; Cytokines; Drug Administration Schedule; Humans; Leprosy; Lyme Disease; Minocycline; Mycobacterium Infections; Nocardia Infections; Prurigo; Pyoderma Gangrenosum; Research Design; Sexually Transmitted Diseases; Skin Diseases, Vesiculobullous; Treatment Outcome

Zebrafish (Danio rerio) are a popular model organism used in a growing number of research fields. Maintaining healthy, disease-free laboratory fish is important for the integrity of many of these studies. Mycobacteriosis is a chronic bacterial infection caused by several Mycobacterium spp. and is the second most common disease found in laboratory zebrafish. Current mycobacteriosis control measures recommend the removal of infected fish and in severe outbreaks, depopulation. These measures can be effective, but less disruptive measures should be assessed for controlling mycobacteriosis, particularly when valuable and rare lines of fish are affected. Here, the in vivo efficacy of two drug candidates, tigecycline (1 μg g

Topics: Animals; Anti-Bacterial Agents; Clarithromycin; Female; Fish Diseases; Male; Minocycline; Mycobacterium chelonae; Mycobacterium Infections; Tigecycline; Time Factors; Zebrafish

The prognosis of Mycobacterium abscessus infections is poor due to the lack of effective drug treatment. The objective of this study was to set up an animal model suitable to test antibiotic activity against M. abscessus.. The following mouse strains were evaluated: Swiss, BALB/c, C57BL/6, nude, beige, A/J, and GKO. Antibiotic activity was tested for clarithromycin, amikacin, cefoxitin, tigecycline, and bedaquiline (TMC207). Finally, we evaluated the 3-drug combination clarithromycin, cefoxitin, and amikacin.. Nude and GKO mice fulfilled criteria for the model but only nude mice offered sufficient availability for large therapeutic experiments. Among the 3 drugs usually combined for treatment of M. abscessus infection, cefoxitin was the most active because it improved survival and reduced bacillary loads in spleen whereas clarithromycin and amikacin prevented death but had little impact on bacillary loads. The triple-drug combination was not more active than cefoxitin alone. Tigecycline displayed bactericidal activity whereas bedaquiline was almost inactive.. Nude mice are an adequate model for in vivo chemotherapy studies. Among tested drugs, cefoxitin and tigecycline showed promising in vivo activity against M. abscessus. The best drug combination remains to be determined.

Topics: Animals; Anti-Bacterial Agents; Colony Count, Microbial; Diarylquinolines; Disease Models, Animal; Female; Kidney; Lung; Male; Mice; Mice, Inbred C57BL; Mice, Nude; Microbial Sensitivity Tests; Minocycline; Mycobacterium; Mycobacterium Infections; Spleen; Statistics, Nonparametric; Tigecycline

This study was performed to detect LfrA and Tap efflux pumps among clinical isolates of non-pigmented rapidly growing mycobacteria (NPRGM). Gene detection was performed using polymerase chain reaction (PCR) with specific primers designed for each gene. Susceptibility of the strains to doxycycline, tigecycline and ciprofloxacin was analysed using the broth microdilution reference technique. In total, 166 clinical isolates were included in the study. The lfrA gene was detected in four strains (2.4%), comprising two strains of Mycobacterium chelonae (6.7% of this species), one Mycobacterium fortuitum (1.1%) and one Mycobacterium mucogenicum (14.3%). The tap gene was detected in 109 strains (65.7%), comprising 3 Mycobacterium abscessus (33.3%), 12 M. chelonae (40%), 75 M. fortuitum (84.3%), 2 Mycobacterium mageritense (40%), 15 Mycobacterium peregrinum (68.2%), 1 Mycobacterium alvei and 1 Mycobacterium porcinum; no strains of M. mucogenicum were tap-positive. No differences between tap-positive and -negative strains were observed for resistance to doxycycline (Fisher's exact test, P=0.055). lfrA is rare among clinical isolates of NPRGM, whilst tap is found more commonly. No correlation was detected between the presence of the efflux pumps and resistance to quinolones or tetracyclines.

Topics: Anti-Bacterial Agents; Antiporters; Bacterial Proteins; Ciprofloxacin; DNA Primers; DNA, Bacterial; Doxycycline; Drug Resistance, Multiple, Bacterial; Humans; Membrane Transport Proteins; Microbial Sensitivity Tests; Minocycline; Mycobacterium; Mycobacterium Infections; Polymerase Chain Reaction; Spain; Tigecycline

Topics: Anti-Bacterial Agents; Culture Media; Humans; Microbial Sensitivity Tests; Minocycline; Mycobacterium; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Tigecycline

We evaluated the in vitro activities of tigecycline and 10 other antibiotics against clinical isolates of nonpigmented rapidly growing mycobacteria. Fifteen collection strains and 165 clinical isolates were included in the study. Tigecycline showed the highest activity among all antibiotics studied: all the strains were inhibited by 1 mg/liter.

Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Humans; In Vitro Techniques; Microbial Sensitivity Tests; Minocycline; Mycobacterium; Mycobacterium Infections; Pigmentation; Species Specificity; Tigecycline

Mycobacterium mucogenicum is a recently characterized organism that rarely may cause human infections. This rapidly growing mycobacterium is commonly identified in tap water. Both immunosuppressed and immunocompetent patients may develop infections from Mycobacterium mucogenicum. Some patients have experienced lethal disease, including sepsis. Infections occurring in the skin and soft tissues have been described only after a preceding injury. We present the first case of infection with Mycobacterium mucogenicum occurring in a patient on the TNF-alpha antagonist etanercept and without any prior soft tissue injury.

Topics: Anti-Bacterial Agents; Arthritis, Rheumatoid; Clarithromycin; Etanercept; Female; Humans; Immunoglobulin G; Immunosuppressive Agents; Middle Aged; Minocycline; Mycobacterium Infections; Opportunistic Infections; Receptors, Tumor Necrosis Factor; Skin Diseases, Bacterial; Tumor Necrosis Factor-alpha

Topics: Anti-Bacterial Agents; Axons; Humans; Male; Middle Aged; Minocycline; Mycobacterium Infections; Mycobacterium marinum; Peripheral Nervous System Diseases; Sensation Disorders

We compared the in vitro activity of the glycylcycline tigecycline (formerly GAR-936) with those of tetracycline, doxycycline, and minocycline by broth microdilution against 76 isolates belonging to seven species of rapidly growing mycobacteria (RGM) and 45 isolates belonging to five species of slowly growing nontuberculous mycobacteria (NTM). By using a resistance breakpoint of >4 micro g/ml for tigecycline and >8 micro g/ml for tetracycline, all RGM were highly susceptible to tigecycline, with inhibition of 50% of isolates at < or =0.12 micro g/ml and inhibition of 90% of isolates at 0.25 micro g/ml for Mycobacterium abscessus and inhibition of both 50 and 90% of isolates at < or =0.12 micro g/ml for M. chelonae and the M. fortuitum group. The MICs of tigecycline were the same for tetracycline-resistant and -susceptible strains, and RGM isolates were 4- to 11-fold more susceptible to tigecycline than to the tetracyclines. In contrast, no slowly growing NTM were susceptible to tigecycline, and isolates of M. marinum and M. kansasii were less susceptible to this agent than to minocycline. This new antimicrobial offers exciting therapeutic potential for the RGM, especially for isolates of the M. chelonae-M. abscessus group, against which the activities of the currently available drugs are limited.

Topics: Anti-Bacterial Agents; Doxycycline; Humans; Microbial Sensitivity Tests; Minocycline; Mycobacterium; Mycobacterium chelonae; Mycobacterium fortuitum; Mycobacterium Infections; Nontuberculous Mycobacteria; Tetracycline; Tigecycline

Mycobacterium vaccae is a rapidly growing mycobacterial species that was previously not considered a human pathogen. We report four cases of M. vaccae infection that occurred in the southern United States; one patient had cutaneous disease, and three patients had cavitary lung disease. Two of the three patients with pulmonary disease had a history of exposure to cattle. The conditions of all patients improved with therapy: the cutaneous infection responded to therapy with minocycline and trimethoprim-sulfamethoxazole, and the pulmonary infections responded to therapy with ciprofloxacin.

Topics: Aged; Animals; Anti-Bacterial Agents; Cattle; Ciprofloxacin; Humans; Male; Middle Aged; Minocycline; Mycobacterium; Mycobacterium Infections; Neoplasms; Pneumonia, Bacterial; Skin Diseases, Bacterial; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Anti-Bacterial Agents; Blood Glucose; Cefoxitin; Ciprofloxacin; Diabetes Mellitus, Type 1; Drug Therapy, Combination; Glycated Hemoglobin; Humans; Injections, Subcutaneous; Insulin; Minocycline; Mycobacterium Infections; Recurrence

A patient with systemic lupus erythematosus had a protracted skin infection with Mycobacterium marinum after a puffer fish sting. Disseminated cutaneous and synovial disease was associated with clinically active systemic lupus erythematosus two years after the initial infection. The infection was poorly responsive to multiple antituberculous regimens. Hematogenous spread of infection was the likely route of dissemination.

Topics: Adult; Animals; Cellulitis; Female; Fish Venoms; Fishes, Poisonous; Humans; Lupus Erythematosus, Systemic; Minocycline; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Skin Diseases, Infectious; Synovitis; Tendinopathy; Wrist

Topics: Adult; Corneal Transplantation; Ethambutol; Eye Injuries; Humans; Keratitis; Male; Minocycline; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Rifampin; Scleral Diseases; Skin Tests

Topics: Female; Humans; Middle Aged; Minocycline; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Skin Diseases, Infectious; Tetracyclines

Topics: Diagnosis, Differential; Humans; Male; Middle Aged; Minocycline; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Skin Diseases, Infectious; Sporotrichosis

Topics: Humans; Minocycline; Mycobacterium; Mycobacterium Infections; Nontuberculous Mycobacteria; Rifampin; Skin Diseases; Tuberculin Test

Induration of the lower parts of the legs with abscess and ulcer formation occurred in a 60-year-old woman. Mycobacterium chelonei, a ubiquitous, saprophytic pathogen that uncommonly causes human disease, was cultured from biopsy material. Although spontaneous healing usually occurs in a few months with such infections, our patient's disease persisted for more than two years until control was achieved with minocycline hydrochloride.

Topics: Abscess; Female; Humans; Leg Ulcer; Middle Aged; Minocycline; Mycobacterium; Mycobacterium Infections; Skin Diseases, Infectious

Topics: Adult; Humans; Male; Minocycline; Mycobacterium Infections; Skin Diseases, Infectious; Tetracyclines

Topics: Female; Humans; Middle Aged; Minocycline; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Skin Diseases, Infectious; Tetracyclines

Two patients with Mycobacterium marinum infections from home tropical fish aquariums are presented herein. Both patients showed dramatic improvement with minocycline therapy. In vitro susceptibility results also confirmed minocycline, doxycycline, and tetracycline efficacy using disc diffusion and dilution methods.

Topics: Adult; Arm; Female; Granuloma; Hand; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Minocycline; Mycobacterium; Mycobacterium Infections; Tetracyclines

A sporotrichoid-like Mycobacterium kansasii infection of the skin is reported. This is the fifth reported case in the English literature of dermatological manifestations of a M. kansasii infection and the first reported case of a response to minocycline hydrochloride therapy.

Topics: Female; Humans; Middle Aged; Minocycline; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Skin Diseases, Infectious

Topics: Humans; Male; Middle Aged; Minocycline; Mycobacterium Infections; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Skin Diseases, Infectious; Tetracyclines

Using a Steers replicator technique the in vitro sensitivities of 32 clinical isolates of Mycobacterium marinum to doxycycline and minocycline were tested. Of 32 strains, sensitivity to doxycycline ranged from 3 strains (9%) with a drug concentration of 2 microgram/ml to 11 strains (34%) at a concentration of 6 microgram/ml. Sensitivity to minocycline ranged from 2 strains (6%) at the 2microgram/ml concentration to 23 strains (72%) at the 8 microgram/ml concentration. Our data suggest that a significant percentage of M. marinum strains are sensitive to therapeutically achievable levels of doxycycline and minocycline. These drugs may prove clinically useful in treating infections caused by sensitive strains of M. marinum.

Topics: Doxycycline; Humans; Microbial Sensitivity Tests; Minocycline; Mycobacterium; Mycobacterium Infections; Skin Diseases, Infectious; Tetracyclines

Topics: Female; Humans; Male; Middle Aged; Minocycline; Mycobacterium Infections; Tetracyclines

Atypical acid-fast infections are not infrequent in the Gulf Coastal region. The development of erythematous papules within three or four weeks after aquatic exposure deserves such consideration. Deeper tissues may also become involved. This should signal a caution when considering the use of corticosteroid injections in such a suspicious lesion. Inasmuch as hypertrophic scar formation at a site of trauma must be considered in the differential diagnosis, it is important to secure histopathologic examination prior to treatment. While a surgical approach has been required for the most part, oral administration of minocycline hydrochloride has brought about healing in the patients reported herein. This article deals with only three cases. However, response was complete and without recurrence in each. Such therapy is recommended prior to the use of more drastic procedures.

Topics: Adult; Fingers; Granuloma; Hand; Humans; Male; Middle Aged; Minocycline; Mycobacterium Infections; Skin Diseases, Infectious; Swimming; Tetracyclines