The Journal of Practical Medicine ›› 2026, Vol. 42 ›› Issue (7): 1134-1141.doi: 10.3969/j.issn.1006-5725.2026.07.003

• Feature Reports:Tuberculosis • Previous Articles    

Mechanisms of drug resistance, clinical drug susceptibility testing, and advances in treatment of Mycobacterium abscessus

Xiaoyu LAI,Xunxun CHEN,Qinghua LIAO,Meiling YU,Huixin GUO,Jiawen WANG,Yuhui CHEN,Wenpei WEN()   

  1. Department of the Outpatient,Center for Tuberculosis Control of Guangdong Province,Guangzhou 510630,Guangdong,China
  • Received:2025-08-18 Revised:2025-09-12 Accepted:2025-09-30 Online:2026-04-10 Published:2026-04-13
  • Contact: Wenpei WEN E-mail:wwp_yb@126.com

Abstract:

The Mycobacterium abscessus complex (MABC) stands as the most prevalent clinically pathogenic rapidly-growing nontuberculous mycobacterium, with a distinct preference for the respiratory tract. Its rapid growth and substantial disparities in drug resistance among subspecies make the treatment of drug-resistant infections arduous. This article conducts a comprehensive review of the molecular mechanisms of drug resistance in MABC. These mechanisms include erm(41)-mediated inducible macrolide resistance, acquired macrolide resistance resulting from rrl gene mutations, and the mechanisms behind aminoglycoside resistance, such as target mutations, inactivation by modifying enzymes, and efflux pumps. It further details the subspecies-specific differences in drug resistance and the characteristics of geographical distribution. Moreover, it summarizes the principles of clinical drug susceptibility testing, highlighting the integrated application of subspecies identification, phenotypic detection, and molecular typing. Integrating the latest research advances, it presents multidrug combination therapy strategies and experimental therapeutic approaches for drug-resistant MABC infections. The aim is to offer references for clinical precision diagnosis and individualized treatment, and to contribute to enhancing the level of diagnosis and treatment of drug-resistant MABC infections.

Key words: Mycobacterium abscessus complex, rapidly growing mycobacteria, nontuberculous mycobacteria, drug resistance, anti-infective therapy

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