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- ItemAcesso aberto (Open Access)Application of four molecular typing methods for analysis of Mycobacterium fortuitum group strains causing post-mammaplasty infections(Blackwell Publishing, 2006-02-01) Sampaio, JLM [UNIFESP]; Chimara, Erica; Ferrazoli, Lucilaine; Telles, Maria Alice da Silva; Del Guercio, VMF; Jerico, ZVN; Miyashiro, Kozue [UNIFESP]; Fortaleza, CMCB; Padoveze, M. C.; Leao, S. C. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fleury Ctr Med Diagnost; Inst Adolfo Lutz Registro; Inst Vozza Med & Diagnose LTDA; Ctr Vigilancia Epidemiol Prof Alexandre VranjacA cluster of cases of post-augmentation mammaplasty surgical site infections occurred between 2002 and 2004 in Campinas, in the southern region of Brazil. Rapidly growing mycobacteria were isolated from samples from 12 patients. Eleven isolates were identified as Mycobacterium fortuitum and one as Mycobacterium porcinum by PCR-restriction digestion of the hsp65 gene. These 12 isolates, plus six additional M. fortuitum isolates from non-related patients, were typed by pulsed-field gel electrophoresis (PFGE) and three PCR-based techniques: 16S-23S rRNA internal transcribed spacer (ITS) genotyping; randomly amplified polymorphic DNA (RAPD) PCR; and enterobacterial repetitive intergenic consensus (ERIC) PCR. Four novel M. fortuitum allelic variants were identified by restriction analysis of the ITS fragment. One major cluster, comprising six M. fortuitum isolates, and a second cluster of two isolates, were identified by the four methods. RAPD-PCR and ITS genotyping were less discriminative than ERIC-PCR. ERIC-PCR was comparable to PFGE as a valuable complementary tool for investigation of this type of outbreak.
- ItemAcesso aberto (Open Access)Deep stromal mycobacterial keratitis: viable bacteria after six months of treatment: case report and literature review(Conselho Brasileiro de Oftalmologia, 2005-08-01) Gusmão, Filipe Brandão Accioly de [UNIFESP]; Alvarenga, Lênio [UNIFESP]; Barbosa, Luciene [UNIFESP]; Sampaio, Jorge; Leao, Sylvia Cardoso [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Freitas, Denise de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Laboratório FleuryTo report the presence of viable mycobacteria in a patient with keratitis treated for 6 months. Species identification was performed using the PRA method (polymerase chain reaction followed by restriction endonuclease analysis). Clonality was evaluated with RAPD (randomly amplified polymorphic DNA) and ERIC-PCR (enterobacterial repetitive intergenic consensus - polymerase chain reaction) methods. The patient reported trauma due to a metallic foreign body 3 weeks prior to presentation. Initial corneal scraping cultures revealed Mycobacterium abscessus. After 6 months of topical and systemic treatment the patient presented with no active inflammation and was considered clinically cured. An optic penetrating keratoplasty was performed. Culture of the excised cornea revealed Mycobacterium abscessus. Both isolates had the same clonal origin. The most interesting finding of this case report was the positive culture of the excised cornea after 6 months of intensive specific topical therapy. To our knowledge, this is the first report in the literature showing this possibility in the treatment of Mycobacterial keratitis. Thus, Mycobacterium abscessus may present viable bacteria after long-term treatment and should be followed carefully for a long period of time after tapering the medication.