BACKGROUND Mycobacterium chimaera, one of the Mycobacterium avium complex (MAC) members, was recently identified using modern gene sequencing analysis. Unlike M. avium and M. intracellulare, little is known about the clinical features, antimicrobial susceptibilities, and treatment outcomes of M. chimaera lung disease. METHODS This study was conducted in a medical center from December 2012 to July 2015. Patients who fulfilled the 2007 ATS/IDSA diagnostic criteria for nontuberculous mycobacterial lung disease were enrolled. M. chimaera isolates were identified based on the findings of sequencing of rpoB gene, the internal transcribed spacer (ITS) region of the 16S-23S rRNA gene, and the heat-shock protein 65 gene (hsp65). Minimum inhibitory concentrations (MICs) of 13 antimicrobial agents were determined. RESULTS During the study period, 247 patients with MAC lung disease were identified, and 11.3% (28/247) of the patients had lung disease caused by M. chimaera. Among these patients, 17 (60.7%) were female, and their median age was 72.5 (40-100) years. All M. chimaera isolates were susceptible to clarithromycin and rifabutin. All the isolates were resistant to moxifloxacin and only 10 (35.7%) and 2 (7.1%) were susceptible to amikacin and linezolid, respectively. Of the nine patients who received macrolide-based regimens, more achieved radiographic resolution than those treated with non-macrolide-based regimens (66.7% vs. 15.8%, P = 0.013), and they tended to have better survival (P = 0.10). CONCLUSIONS A substantial portion (11.3%) of MAC lung disease cases were caused by M. chimaera, and treatment with macrolide-based regimens resulted in better clinical outcomes for patients with M. chimaera lung disease.

中文翻译：

---

Chimaera chimaera肺部疾病的临床特征和治疗结果以及分枝杆菌分离株的抗菌药敏性。

背景技术近来使用现代基因测序分析鉴定了鸟分枝杆菌复合体（MAC）成员之一的嵌合分枝杆菌。与鸟分枝杆菌和胞内分枝杆菌不同，关于马氏支原体肺部疾病的临床特征，抗药性和治疗效果知之甚少。方法这项研究于2012年12月至2015年7月在医学中心进行。纳入符合2007年ATS / IDSA非结核分枝杆菌肺病诊断标准的患者。根据rpoB基因，16S-23S rRNA基因的内部转录间隔区（ITS）区域和热休克蛋白65基因（hsp65）的测序发现，鉴定了M. chimaera分离株。确定了13种抗菌剂的最小抑菌浓度（MICs）。结果在研究期间，确定了247例MAC肺部疾病患者，其中11.3％（28/247）的患者患有由M. chimaera引起的肺部疾病。在这些患者中，女性为17名（60.7％），中位年龄为72.5（40-100）岁。所有的嵌合体分枝杆菌均​​对克拉霉素和利福布汀敏感。所有分离株均对莫西沙星有抗药性，分别只有10（35.7％）和2（7.1％）对阿米卡星和利奈唑胺敏感。在接受大环内酯类方案的9例患者中，放射成像分辨率高于非大环内酯类方案（66.7％vs. 15.8％，P = 0.013），而且他们的生存率更高（P = 0.10）。 。结论MAC肺部疾病病例的很大一部分（11.3％）是由M. chimaera引起的，