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Title: Epidemic of Postsurgical Infections Caused by Mycobacterium massiliense
Authors: Duarte, Rafael Silva
Silva Lourenco, Maria Cristina
Fonseca, Leila de Souza
Leao, Sylvia Cardoso [UNIFESP]
Amorim, Efigenia de Lourdes T.
Rocha, Ingrid L. L.
Coelho, Fabrice Santana
Viana-Niero, Cristina [UNIFESP]
Gomes, Karen Machado
Silva, Marlei Gomes da
Oliveira Lorena, Nadia Suely de
Pitombo, Marcos Bettini
Ferreira, Rosa M. C.
Oliveira Garcia, Marcio Henrique de
Oliveira, Gisele Pinto de
Lupi, Otilia
Vilaca, Bruno Rios
Serradas, Lucia Rodrigues
Chebabo, Alberto
Marques, Elizabeth Andrade
Teixeira, Lucia Martins
Dalcolmo, Margareth
Senna, Simone Goncalves
Mello Sampaio, Jorge Luiz
Universidade Federal do Rio de Janeiro (UFRJ)
Fundacao Oswaldo Cruz
Universidade Federal de São Paulo (UNIFESP)
Sergio Franco Med Diagnost
Universidade do Estado do Rio de Janeiro (UERJ)
Minist Saude
Secretaria Municipal Saude Rio de Janeiro
Hosp Clin Riomar
Hosp Univ Clementino Fraga Filho
Ctr Referencia Prof Helio Fraga
Inst Fleury Ensino & Pesquisa
Issue Date: 1-Jul-2009
Publisher: Amer Soc Microbiology
Citation: Journal of Clinical Microbiology. Washington: Amer Soc Microbiology, v. 47, n. 7, p. 2149-2155, 2009.
Abstract: An epidemic of infections after video-assisted surgery (1,051 possible cases) caused by rapidly growing mycobacteria (RGM) and involving 63 hospitals in the state of Rio de Janeiro, Brazil, occurred between August 2006 and July 2007. One hundred ninety-seven cases were confirmed by positive acid-fast staining and/or culture techniques. Thirty-eight hospitals had cases confirmed by mycobacterial culture, with a total of 148 available isolates recovered from 146 patients. Most (n = 144; 97.2%) isolates presented a PRA-hsp65 restriction pattern suggestive of Mycobacterium bolletii or Mycobacterium massiliense. Seventy-four of these isolates were further identified by hsp65 or rpoB partial sequencing, confirming the species identification as M. massiliense. Epidemic isolates showed susceptibility to amikacin (MIC at which 90% of the tested isolates are inhibited [MIC(90)], 8 mu g/ml) and clarithromycin (MIC(90), 0.25 mu g/ml) but resistance to ciprofloxacin (MIC(90), > 32 mu g/ml), cefoxitin (MIC(90), 128 mu g/ml), and doxycycline (MIC(90), >= 64 mu g/ml). Representative epidemic M. massiliense isolates that were randomly selected, including at least one isolate from each hospital where confirmed cases were detected, belonged to a single clone, as indicated by the analysis of pulsed-field gel electrophoresis (PFGE) patterns. They also had the same PFGE pattern as that previously observed in two outbreaks that occurred in other Brazilian cities; we designated this clone BRA100. All five BRA100 M. massiliense isolates tested presented consistent tolerance to 2% glutaraldehyde. This is the largest epidemic of postsurgical infections caused by RGM reported in the literature to date in Brazil.
ISSN: 0095-1137
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