       Document 0330
 DOCN  M94A0330
 TI    Rifampin-resistant Mycobacterium kansasii.
 DT    9412
 AU    Wallace RJ Jr; Dunbar D; Brown BA; Onyi G; Dunlap R; Ahn CH; Murphy DT;
       Department of Microbiology, University of Texas Health Center,; Tyler
       75710.
 SO    Clin Infect Dis. 1994 May;18(5):736-43. Unique Identifier : AIDSLINE
       MED/94355504
 AB    We identified 36 rifampin-resistant Mycobacterium kansasii isolates,
       including 17 (4%) of 464 isolates recovered in Texas between 1989 and
       1992. Of 29 patients infected with rifampin-resistant M. kansasii whose
       history of medication was known, 90% had previously received rifampin,
       and 58% of these patients had been treated with one or two effective
       drugs. Thirty-two percent of rifampin-resistant isolates recovered since
       1989 were from patients who were seropositive for human immunodeficiency
       virus (HIV) infection. Twenty courses of therapy with a four-drug
       regimen determined on the basis of in vitro susceptibilities were
       administered to 16 patients from whom rifampin-resistant isolates were
       recovered; the therapy did not include surgery. Sputum cultures
       converted to negative as the result of 90% of treatments (time to
       conversion: mean, 11 weeks; range, 4-20 weeks). Bacteriologic relapses
       occurred in four of five patients who withdrew from therapy after being
       culture negative for < or = 6 months of therapy and in one of 12
       patients who were culture negative for at least 12 months of therapy
       (mean, 16.3 months). This study suggests that the prognosis for cure of
       infection due to rifampin-resistant M. kansasii with chemotherapy alone
       is excellent, although the number of cases appears to be increasing, in
       part because of the HIV disease epidemic.
 DE    Adult  Aged  Aged, 80 and over  Amikacin/ADMINISTRATION & DOSAGE
       Antibiotics, Combined/*THERAPEUTIC USE  Antitubercular
       Agents/PHARMACOLOGY/*THERAPEUTIC USE  Ciprofloxacin/ADMINISTRATION &
       DOSAGE  Clinical Protocols  Drug Resistance, Microbial
       Ethambutol/ADMINISTRATION & DOSAGE  Female  Human
       Isoniazid/ADMINISTRATION & DOSAGE  Male  Middle Age  Mycobacterium
       Infections, Atypical/DRUG THERAPY/*EPIDEMIOLOGY/  MICROBIOLOGY
       Mycobacterium, Atypical/*DRUG EFFECTS  Pyrazinamide/ADMINISTRATION &
       DOSAGE  Pyridoxine/ADMINISTRATION & DOSAGE  Rifampin/ADMINISTRATION &
       DOSAGE/*PHARMACOLOGY  Streptomycin/ADMINISTRATION & DOSAGE  Support,
       Non-U.S. Gov't  Texas/EPIDEMIOLOGY  Treatment Outcome  Tuberculosis/DRUG
       THERAPY/*EPIDEMIOLOGY/MICROBIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

