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Mycobacterium abscessus  complex consist of three rapidly growing subspecies:  M. abscessus, M. massiliense , and  M. bolletii . They are clinically important human pathogens responsible for opportunistic pulmonary and skin and soft tissue infections. Treatment of  M. abscessus  infections is difficult due to  in vitro  resistance to most antimicrobial agents. Tedizolid (TZD) is a next-generation oxazolidinone antimicrobial with a wide spectrum of activity even against multidrug resistant Gram-positive bacteria. In this study, the  in vitro  activity of TZD against the  M. abscessus  complex ( n  = 130) was investigated. Susceptibility testing by broth microdilution showed lower TZD minimum inhibitory concentrations (MICs) when compared to linezolid. The MIC 50  and MIC 90  was 1 mg/L and 4 mg/L, respectively across all  M. abscessus  complex members, reflecting no difference in subspecies response to TZD. Pre-exposure of  M. abscessus  complex to subinhibitory concentrations of TZD did not trigger any inducible drug resistance. Single-drug time kill assays and bactericidal activity assays demonstrated bacteriostatic activity of TZD in all three  M. abscessus  subspecies, even at high drug concentrations of 4 to 8x MIC. Combination testing of TZD with clarithromycin, doxycycline and amikacin using the checkerboard approach showed no antagonistic interactions. TZD may be an effective therapeutic antimicrobial agent for the treatment of  M. abscessus  infections.

Tedizolid Activity Against Clinical Mycobacterium abscessus Complex Isolates—An in vitro Characterization Study