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1.
Rev. epidemiol. controle infecç ; 10(3): 1-12, jul.-set. 2020. ilus
Article in English | LILACS | ID: biblio-1247650

ABSTRACT

Background and Objectives: Knowledge about species diversity of non-tuberculous mycobacteria (NTM) and the frequency of tuberculosis (TB) is an important issue in rural-urban regions such as Piauí (northeast of Brazil), of low incidence rate of TB , can help to improve diagnosis and prevention strategies. The aim of this study is to examine some epidemiological aspects and the frequency of Mycobacterium tuberculosis (Mtb) and NTM isolated at the central public health reference laboratory, Dr. Costa Alvarenga, Piauí (LACEN-PI). Methods: Data records of all mycobacterosis and tuberculosis cases from January 2014 to March 2015 were analyzed. Results : Of the 20% (142/706) positive growths, 70% (99) were Mtb and 10% NTM. The remainde was of inadequate clinical samples, not allowing the identification of even the suspected NTM. The most frequent clinical form was pulmonary with TB patients younger than those infected with NTM (p = 0.001), the majority living in Teresina (52%). NTMs identified were M. abscessus (36%), M. avium, M. intracellulare, Mycobacterium sp. (14% each) and M. asiaticum, M. szulgai, M. kansasii 7% (each). Mtb drug resistance (7.8%) and TB co-infection with the human immunodeficiency virus (HIV-TB) found to be high (49%, 19/39). Conclusion: The frequencies of Mtb infection, drug resistance and HIV-TB co-infection are still underestimated and failures in the identification of NTM may decrease the actual frequency of these infections. Therefore, there is a need for improvements in TB control and in the diagnosis of NTMs in Piauí.(AU)


Justificativa e Objetivos: O conhecimento da diversidade de espécies de micobactérias não tuberculosas (MNT ) e a frequência da tuberculose (TB) é uma questão importante em regiões rurais-urbanas como o Piauí (nordeste do Brasil), com baixa incidência de TB, pode ajudar a melhorar o diagnóstico e estratégias de prevenção. O objetivo deste estudo é examinar alguns aspectos epidemiológicos e a frequência de Mycobacterium tuberculosis (Mtb) e MNT isolados, no Laboratório Central de Referência em Saúde Pública, Dr. Costa Alvarenga, Piauí (LACEN-PI). Métodos: Dados de todo s os casos de micobacterioses e tuberculose de janeiro de 2014 a março de 2015 foram analisados. Resultados: Dos 20% (142/706), de amostras com crescimento positivo 70% (99) foram Mtb e 10% MNT . O restante era de amostras clínicas inadequadas, não permitindo a identificação inclusive de MNT suspeitos. A forma clínica mais frequente foi pulmonar com pacientes TB mais jovens do que os infectados com MNT (p = 0,001), a maioria morando em Teresina (52%). As MNT s identificadas foram M. abscessus (36%), M. avium , M. intracellulare , M. sp. (14%, cada) e M. asiaticum, M. szulgai , M. kansasii 7% (cada). A droga resistência de Mtb (7,8%) e a co-infecção TB e vírus da imunodeficiência humana (HIV-TB) mostraram-se altas (49%, 19/39).Conclusão: As frequências de infecção por Mtb, de resistência a medicamentos e co-infecção HIV-TB ainda são subestimadas e as falhas na identificação de MNT podem diminuir a real frequência destas infecções . Portanto, há necessidade de melhorias no controle da TB e no diagnóstico de MNT s no Piauí.(AU)


Justificacion y objetivos: Conocer la diversidad de especies de micobacterias no tuberculosas (MNT) y la frecuencia de tuberculosis (TB) es tema importante en regiones rurales-urbanas como Piauí (noreste de Brasil) con baja tasa de incidencia de TB, y puede ayudar a mejorar el diagnóstico y las estrategias de prevenció. El objetivo de este estudio es examinar algunos aspectos epidemiológicos y la frecuencia de Mycobacterium tuberculosis (Mtb) y MNT aislado, en el laboratorio central de referencia de salud pública, Dr. Costa Alvarenga, Piauí (LACEN-PI). Métodos: Se analizaron los datos de todos los casos de micobacteriosis de enero de 2014 a marzo de 2015. Resultados: Del 20% (142/706), de las muestras con crecimiento positivo el 70% (99) fueron Mtb y el 10% MNT. El resto fue de muestras clínicas inadecuadas, no permitiendo la identificación de MNT incluso sospechosas. La forma clínica más frecuente fue la pulmonar y los pacientes con TB eran más jóvenes que los infectados con MNT (p = 0.001), la mayoría viviendo en Teresina (52%).Los MNT identificados fueron M.abscessus (36%), M.avium, M.intracellulare, Mycobacterium sp. (14% cada) y M.asiaticum, M.szulgai, M.kansasii 7% (cada ). La resistencia a los medicamentos de Mtb (7,8%) y la coinfección de TB y el virus de la inmunodeficiencia humana (VIH-TB) fueron altas (49%, 19/39 )Conclusión: Las frecuencias aún subestimadas de resistencia a los medicamentos, coinfección por VIH-TB y fallas de identificaciónidentificación de MNT pueden disminuir la frecuencia real de estas infecciones. Consecuentemente, es necesario mejorar el control y diagnóstico de TB y MNT en Piauí.(AU)


Subject(s)
Humans , Epidemiology , Mycobacterium , Nontuberculous Mycobacteria , Mycobacterium tuberculosis , Drug Resistance , AIDS Serodiagnosis , Health Services Research
2.
Salud(i)ciencia (Impresa) ; 24(1/2): 12-18, jun. 2020. graf.
Article in Spanish | LILACS, BINACIS | ID: biblio-1129948

ABSTRACT

El aumento de las infecciones por micobacterias ambientales u oportunistas (MAO) coincide mundialmente con el declive de la infección tuberculosa e incremento de la infección por el virus de inmunodeficiencia humana (VIH). El presente trabajo es un estudio retrospectivo realizado en el Laboratorio Nacional de Referencia-Investigaciones de Tuberculosis/Micobacterias/Lepra (LNRI-TB/Lepra/Micobacterias), del Instituto de Medicina Tropical Pedro Kourí (IPK), La Habana, Cuba, durante el período enero 2014-diciembre 2018. El objetivo de nuestro estudio fue conocer la variabilidad de especies aisladas para establecer un referente actualizado sobre las infecciones causadas por estas. En este trabajo se clasificaron-identificaron 413 cepas procedentes de pacientes sintomáticos; 162 (39.22%) eran aislamientos de pacientes con VIH/sida atendidos en nuestro Hospital Nacional de Referencia a Atención al paciente VIH/sida (IPK), y el resto (n = 251 [60.77%]), procedentes de pacientes inmunocompetentes, incluyendo aislamientos recibidos de los Centros Provinciales de Higiene, Epidemiología, y Microbiología (CPHEM). Las muestras fueron analizadas con las técnicas convencionales establecidas: las pulmonares fueron descontaminadas por el método de Petroff modificado; las extrapulmonares, por el método del ácido sulfúrico al 4%; el cultivo se realizó en medio de Löwenstein-Jensen modificado. Posteriormente se realizó la clasificación-identificación de especies según el esquema fenotípico-bioquímico establecido. Las especies con mayor porcentaje de aislamiento pertenecieron a los Grupos III y IV, complejo Mycobacterium avium-intracellulare (34.14%) y complejo M. fortuitum (20.82%), respectivamente. Estos resultados permitirán conocer la prevalencia de estas especies en nuestro país, reafirmando la importancia diagnóstica de estos microorganismos para aplicar tratamiento específico, sobre todo en pacientes con factores de riesgo, en quienes es más probable la diseminación de la infección.


The increase in infections by environmental or opportunistic mycobacteria (MAO) coincides worldwide with the decline in tuberculosis infection and an increase in infection by the human immunodeficiency virus (HIV). The present work is a retrospective study carried out at the National Reference Laboratory-Tuberculosis/Mycobacterial/Leprosy Research (LNRI-TB / Leprosy / Mycobacteria), of the Pedro Kourí Institute of Tropical Medicine (IPK), La Habana, Cuba, during the period January 2014-December 2018. The objective of our study was to know the variability of isolated species to establish an updated reference on the infections caused by MAO. In this study, 413 strains from symptomatic patients were classified and identified; 162 (39.22%) were isolates from patients with HIV/AIDS treated at our National Hospital of Reference for Attention to HIV/AIDS patients (IPK), and the remaining (n=251 [60.77%]), from immunocompetent patients, including isolates received from the Provincial Centers of Hygiene, Epidemiology, and Microbiology (CPHEM). The samples were analyzed with the established conventional techniques: the lung samples were decontaminated by the modified Petroff method; the extrapulmonary, by the 4% sulfuric acid method; the culture was carried out in modified Löwenstein-Jensen medium. Subsequently, the classification-identification of species was carried out according to the established phenotypic-biochemical scheme. The species with the highest percentage of isolation belonged to Groups III and IV, Mycobacterium avium-intracellulare complex (34.14%), and M. fortuitum complex (20.82%), respectively. These results will allow us to know the prevalence of these species in our country, emphasizing the diagnostic importance of these microorganisms and thus apply a specific treatment, especially in patients with risk factors, in whom the spread of the infection is more likely


Subject(s)
Tuberculosis , Mycobacterium avium Complex , Risk Factors , Acquired Immunodeficiency Syndrome , HIV , Mycobacterium , Mycobacterium avium
3.
Rev. chil. infectol ; 37(3): 252-256, jun. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1126117

ABSTRACT

Resumen Introducción: Las enfermedades producidas por micobacterias son de gran importancia clínica y epidemiológica presentando el complejo Mycobacterium tuberculosis (MTBc) una morbi-mortalidad mayor que la producida por micobacterias no tuberculosas (MNTB). La identificación tradicional está basada en sus características fenotípicas mediante procesos laboriosos e incapaces en algunos casos de distinguir entre especies. Actualmente, la mayoría de las técnicas utilizadas se basan en métodos moleculares que tienen alta veracidad, pero son complejas y de alto costo. La espectrometría de masas con desorción/ionización láser asistida por una matriz asociada a tiempo de vuelo (MALDI-TOF MS) se basa en la comparación del espectro proteico producido con respecto al de una base de datos de referencia. Objetivo: Evaluar el rendimiento de MALDI-TOF MS en la identificación de micobacterias comparado con métodos moleculares: Material y Métodos: Se analizaron 28 aislados de nueve especies distintas mediante MALDI-TOF MS. Resultados: Se identificó correctamente 78,5% de las aislados (22/28), concordante en 100% (9/9) de MNTB de crecimiento rápido, 60% (9/15) en las MNTB de crecimiento lento y 100% (4/4) de MTBc. Todas las especies no identificadas (6/6) pertenecen al complejo M. avium/intracellulare. Conclusión: MALDI-TOD MS es una metodología rápida, fácil y de bajo costo, con adecuada veracidad respecto a los métodos moleculares.


Abstract Background: Mycobacterial diseases are very important both clinically and epidemiologically. Mycobacterium tuberculosis complex (MTBc) infections confer higher morbidity and mortality rate than non-tuberculous mycobacteria (NTM) infections. Traditional species identification techniques are based on phenotypic characteristics which take a long time by laborious processes and in occasions are no conclusive. Currently, most used techniques are based on molecular methods, which are accurate but are expensive and complex. Matrix Assisted Laser Desorption/Ionization Time-of-Flight mass spectrometry (MALDI-TOF MS) is a simple, cheap and fast identification method based on comparing protein spectra with a reference database. Aim: To assess the performance of MALDI-TOF MS in the identification of MTBc and NTM, compared with molecular methods. Methods: For that purpose, 28 isolates of 9 different species were analyzed through MALDI-TOF MS. Results: 78.5% (22/28) of isolates were correctly identified, 100% (9/9) of rapidly growers NTM, 60% (9/15) of slow growing NTM and 100% (4/4) of MTBc. Every unidentified isolate (6/6) corresponded to M. avium/intracellulare complex. Conclusion: MALDI-TOF MS is fast, simple and cheaper than molecular methods and also has adequate accuracy.


Subject(s)
Humans , Mycobacterium , Tuberculosis , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
4.
Rev. méd. hondur ; 88(1): 22-26, ene.- jun. 2020. tab
Article in Spanish | LILACS | ID: biblio-1128537

ABSTRACT

En 2015, la tasa global de incidencia de tuberculosis por 100,000 habitantes fue 43 en Honduras y 29 en el Municipio del Distrito Central. Objetivo: Caracterizar clínica y epidemiológicamente los casos de tuberculosis infantil, Región Sanitaria Metropolitana del Distrito Central (RSMDC), 2016. Métodos: Estudio descriptivo transversal. Se revisaron las Fichas de Notificación de Casos de Tuberculosis en pacientes menor o igual a18 años, registrados durante 2016. Se analizaron variables sociodemográficas y clínicas. Se diseñó una base de datos en EpiInfo 7.2.1. Se obtuvo autorización institucional. La información personal de los casos se manejó confidencialmente. Resultados: Del total de 400 fichas registradas, 13 (3.2%) contenían información completa. La caracterización se realizó a partir de estos 13 casos, 53.8% eran niñas, 46.2% entre 15 y 18 años. En 67% el diagnóstico fue clínico, 27% tenía tuberculosis pulmonar y 16.7% extrapulmonar. El método de diagnóstico más utilizado fue baciloscopía (38.5%). Todosrecibieron tratamiento básico primario, sin comorbilidades, no vivían en condición de riesgo o pertenecían a grupo de riesgo; no presentaron recaídas ni co-infección VIH. Discusión: El sistema de notificación de casos en RSMDC denota un déficit extraordinario e inaceptable en el registro de la información. Aunque la caracterización realizada puede estar sesgada por el número reducido de casos, sus características son similares a lo descrito para la tuberculosis infantil. Es imperativo fortalecer la vigilancia epidemiológica de la tuberculosis en Honduras con énfasis en la tuberculosis infantil y la detección y tratamiento de los contactos...(AU)


Subject(s)
Humans , Child , Adolescent , Tuberculosis/epidemiology , Mycobacterium , Tuberculosis, Lymph Node/complications , Tuberculosis, Pulmonary
6.
Article in Korean | WPRIM | ID: wpr-816605

ABSTRACT

BACKGROUND: Rapid and accurate detection of Mycobacterium tuberculosis (MTB) is of primary importance for infection control and selection of anti-tuberculosis drugs. However, most clinical laboratories report MTB complex (MTC) without reporting MTB because MTC comprising MTB, Mycobacterium bovis, Mycobacterium africanum, Mycobacterium microti, Mycobacterium caprae and Mycobacterium pinnipedii have 99.9% similarity at the nucleotide level and identical 16S rRNA sequences. This study was conducted to analyze the species frequency of MTC isolates obtained from clinical specimen.METHODS: Of 310 MTC isolates obtained from clinical samples in a tertiary care hospital from February 2017 to August 2018, MolecuTech Real TB-Taq (YD Diagnostics, Korea) real-time PCR was performed, specifically to detect MTB. For DNA showing MTB negative results by MTB-specific real-time PCR or pyrazinamide-resistant strains, PCR-based MTC typing, spoligotyping, and exact tandem repeat D gene sequencing were performed.RESULTS: All the 310 MTC isolates were identified to be MTB. Two MTB strains of East-African-Indian 4-Vietnam genotype, which have not been reported in Korea, were also found.CONCLUSION: There was no zoonotic tuberculosis in this study. Since we investigated only 310 MTC isolates detected in only one medical institution, multi-center study is needed to accurately know the prevalence of zoonotic tuberculosis in Korea.


Subject(s)
DNA , Genotype , Goats , Infection Control , Korea , Mycobacterium bovis , Mycobacterium tuberculosis , Mycobacterium , Prevalence , Real-Time Polymerase Chain Reaction , Sequence Analysis , Tandem Repeat Sequences , Tertiary Healthcare , Tuberculosis
7.
Article in English | WPRIM | ID: wpr-762469

ABSTRACT

The GENEDIA MTB/NTM Detection Kit (GENEDIA MTB/NTM; Green Cross Medical Science Corp., Chungbuk, Korea) is a multiplex real-time PCR assay used for differential identification of Mycobacterium tuberculosis complex (MTBC) and nontuberculous mycobacteria (NTM). While the importance of differential identification of MTB/NTM is recognized, there is limited data on the performance of GENEDIA MTB/NTM assay to date. A total of 687 consecutive sputum specimens were cultured and analyzed with the GENEDIA MTB/NTM and GENEDIA MTB assays. Nineteen specimens (2.8%) were MTBC-positive, and 69 (10.0%) were NTM-positive based on mycobacterial culture. All specimens showed concordant results for MTBC using both assays, with a kappa value of 1.00, overall sensitivity of 63.2% (12/19), and specificity of 100% (668/668). The overall NTM sensitivity and specificity were 23.2% (16/69) and 99.7% (616/618) for GENEDIA MTB/NTM. The association between NTM-positivity using GENEDIA MTB/NTM and the diagnosis of NTM pulmonary disease was not statistically significant. In conclusion, the two real-time PCR assays showed similar diagnostic performance for MTBC detection. However, the sensitivity for NTM detection was lower than that for MTBC detection.


Subject(s)
Diagnosis , Lung Diseases , Mycobacterium tuberculosis , Mycobacterium , Nontuberculous Mycobacteria , Real-Time Polymerase Chain Reaction , Sensitivity and Specificity , Sputum
9.
São Paulo; s.n; 2020. 125 p. ilus.
Thesis in Portuguese | LILACS, SES-SP, SESSP-CTDPROD, SES-SP, SESSP-TESESESSP, SES-SP | ID: biblio-1145869

ABSTRACT

O grupo Mycobacterium abscessus (MAG) é a principal causa de infecções pulmonares e extrapulmonares entre as micobactérias de crescimento rápido. Para determinar a resistência à claritromicina (CLA), o método de concentração inibitória mínima (CIM) é realizado, no entanto, as leituras são feitas após três e 14 dias de incubação para detectar a resistência induzida (RI). A suscetibilidade a CLA é detectada pela deleção ou polimorfismo no gene erm(41). Quando o genótipo é selvagem (T28), a RI à claritromicina é verificada, enquanto para C28 não é observada. O presente estudo tem como objetivo padronizar um ensaio Taqman de PCR em tempo real (qPCR) para detecção do polimorfismo T28C e compará-lo aos resultados obtidos do sequenciamento do gene erm(41). O total de 207 isolados de MAG que preencheram os critérios bacteriológicos da American Thoracic Society, foi recebido no IAL entre 2010 e 2012. Os isolados foram identificados pelo método PRA-hsp65 como M. abscessus tipo 1 (n=135, 65,2%) e M. abscessus tipo 2 (n=72, 34,8%) e submetidos ao CIM para CLA com leitura nos dias três e 14. A PCR convencional foi utilizada para detecção da deleção; o sequenciamento do gene erm(41) foi realizado para detectar a mutação T28C; o sequenciamento dos genes rpoB e hsp65 foram utilizados para identificação das subespécies e o sequenciamento do gene rrl foi feito para detecção da mutação A2058G (resistência adquirida). A sequência de MAG EU590129 foi submetida ao Centro de Treinamento da empresa Thermo Fisher Scientific, a qual customizou o ensaio e forneceu os parâmetros de corrida. Dos 207 isolados, 33 eram M. a. massiliense, 136 M. a. abscessus e 38 M. a. bolettii pelo sequenciamento do gene rpoB, que apresentou sete (3,38%) isolados discordantes em relação ao sequenciamento do gene hsp65. Nenhum isolado apresentou mutação no gene rrl. No sequenciamento de erm(41), 197 isolados foram T28 e 10 C28, assim como na qPCR. Na comparação dos perfis genéticos com o perfil de suscetibilidade foram encontrados 10 isolados com resultados discordantes (4,8%), sendo nove isolados sensíveis com gene erm(41) selvagem e um...(AU)


Subject(s)
Disease Susceptibility , Mutation , Mycobacterium
10.
Braz. j. med. biol. res ; 53(11): e9551, 2020. graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1132485

ABSTRACT

The objective of this study was to investigate the effect of Mycobacterium vaccae on Jagged 1 and gamma delta T17 (γδT17) cells in asthmatic mice. An asthma mouse model was established through immunization with ovalbumin (OVA). Gamma-secretase inhibitor (DAPT) was used to block the Notch signaling pathway. M. vaccae was used to treat asthma, and related indicators were measured. Blocking Notch signaling inhibited the production of γδT17 cells and secretion of cytokine interleukin (IL)-17, which was accompanied by a decrease in Jagged1 mRNA and protein expression in the treated asthma group compared with the untreated asthma group. Similarly, treatment with M. vaccae inhibited Jagged1 expression and γδT17 cell production, which was associated with decreased airway inflammation and reactivity. The Notch signaling pathway may play a role in the pathogenesis of asthma through the induction of Jagged1 receptor. On the other hand, the inhibitory effect of M. vaccae on Jagged1 receptor in γδT17 cells could be used for the prevention and treatment of asthma.


Subject(s)
Animals , Rabbits , Signal Transduction , Mycobacterium , Ovalbumin , Receptors, Notch , Jagged-1 Protein
11.
Article in English | WPRIM | ID: wpr-829019

ABSTRACT

Objective@#Our objective was to investigate the occurrence of opportunistic pathogens and characterize the bacterial community structures in the water system of a pulmonary hospital.@*Methods@#The water samples were collected from automatic and manual faucets in the consulting room, treatment room, dressing room, respiratory ward, and other non-medical rooms in three buildings of the hospital. Quantitative polymerase chain reaction was used to quantify the load of several waterborne opportunistic pathogens and related microorganisms, including spp., spp., and . Illumina sequencing targeting 16S rRNA genes was performed to profile bacterial communities.@*Results@#The occurrence rates of spp., spp., and were 100%, 100%, and 76%, respectively in all samples. Higher occurrence rates of were observed in the outpatient service building (building 1, 91.7%) and respiration department and wards (building 2, 80%) than in the office building (building 3), where no was found. were more abundant in automatic faucets (average 2.21 × 10 gene copies/L) than in manual faucets (average 1.03 × 10 gene copies/mL) ( < 0.01). , , , , , and were the dominant bacterial phyla. Disinfectant residuals, nitrate, and temperature were found to be the key environmental factors driving microbial community structure shifts in water systems.@*Conclusion@#This study revealed a high level of colonization of water faucets by opportunistic pathogens and provided insight into the characteristics of microbial communities in a hospital water system and approaches to reduce risks of microbial contamination.


Subject(s)
China , Drinking Water , Microbiology , Genes, Bacterial , Hospitals , Legionella , Microbiota , Mycobacterium , Mycobacterium avium , RNA, Bacterial , RNA, Ribosomal, 16S , Water Quality , Water Supply
13.
Article in English | WPRIM | ID: wpr-810969

ABSTRACT

BACKGROUND: Long-term administration of ethambutol (EMB) for Mycobacterium avium complex lung disease (MAC-LD) sometimes leads to permanent discontinuation of EMB due to various adverse events. This study aimed to investigate treatment outcomes after discontinuation of EMB.METHODS: Among patients diagnosed with MAC-LD between January 2001 and December 2014, 508 patients whose treatment was initiated with standard regimen until May 2018 were enrolled at a tertiary referral center in Korea. Of these 508 patients, 60 (11.8%) discontinued EMB due to various adverse effects. Among these 60 patients, treatment outcomes were analyzed for 44 patients by comparing their outcomes with those of matched subjects who received the standard treatment regimen without EMB discontinuation.RESULTS: The mean age of the 60 patients who discontinued EMB was 64.4 years. Ocular toxicity was the most common cause of discontinuation of EMB (75.0%, 45/60). The mean duration of EMB administration before its discontinuation was 7.0 ± 4.6 months. The treatment failure rate of the 44 patients with EMB discontinuation analyzed for treatment outcome was 29.6%, which was higher than that of the matched patients who received the standard regimen (18.3%), although the difference was not significant (P = 0.095). Of these 44 patients, EMB was substituted with later-generation fluoroquinolone in 23 patients, and the treatment failure rate of these 23 patients was significantly higher than that of the matched patients who received the standard regimen (39.1% vs. 19.3%, P = 0.045).CONCLUSION: These findings suggest that treatment outcomes are unsatisfactory in patients with MAC-LD who discontinue EMB owing to adverse events. Notably, there was a statistically significant high failure rate in patients who were prescribed fluoroquinolone to replace EMB.


Subject(s)
Ethambutol , Fluoroquinolones , Humans , Korea , Lung Diseases , Mycobacterium avium Complex , Mycobacterium avium , Mycobacterium , Tertiary Care Centers , Treatment Failure , Treatment Outcome
14.
Int. j. odontostomatol. (Print) ; 13(3): 357-362, set. 2019. tab
Article in English | LILACS | ID: biblio-1012436

ABSTRACT

ABSTRACT: The contamination of the dental units' waterlines is a reality, which can develop individual and collective disorders. The aim of this study was to evaluate the prevalence and resistance profile of bacteria on the internal surfaces of waterlines in a dental clinic from a Dentistry school of a Brazilian university. The design was an exploratory, descriptive study with quantitative and qualitative approach. Samples (n=4) were collected for analysis at different points: the portion closest to the water reservoir of the chair, and the portion closest to the triple syringe. After collection the samples were cultured in BHI medium in an oven for 24-48 h at 37 °C. For the quantitative analysis 1 ml of each sample was used for serial dilution up to the dilution value seven. The colonies were counted after pour plate and the results expressed in UFC/cm2. The qualitative analysis was initiated with the cultivation of Agar Blood, EMB-Levine and Cetrimide Agar for 24 h, and the identification of bacteria was performed by microscopic analyses. The resistance profile was verified by classical antibiogram. The internal surfaces of unit waterlines units exhibited a mean of 2.44 x 109 CFU / cm2. Bacillus subtilis and Pseudomonas aeruginosa were identified. The resistance profile of Pseudomonas aeruginosa indicated sensitivity to all tested antibiotics. A large number of microorganisms was quantified from biofilm accumulated in the dental units' waterlines. However, they were not resistant to classic antibiogram. Better management and application of decontamination protocols for waterlines need to be applied since opportunistic infections may be associated with Pseudomonas aeruginosa.


RESUMEN: La contaminación de líneas de agua en las unidades dentarias es una realidad, generando enfermedades individuales y colectivas. El objetivo de este estudio fue evaluar la prevalencia y resistencia de las bacterias en las zonas internas de las líneas de agua de la Facultad de Odontología de una universidad brasileña. El diseño del estudio fue exploratorio, descriptivo con enfoques cuantitativos y cualitativos. Las muestras para análisis (n=4) fueron selecionadas de distintos lugares: el punto más cercano al sistema de agua del sillón odontológico y el punto más cercano a la jeringa tríplice. Las muestras obtenidas fueron cultivadas en un médio BHI por 24-48 h, en un horno a 37 ºC. Para el análisis cuantitativo, se utilizó 1 ml de cada muestra para dilución hasta el valor siete. Las colonias fueran contadas y los resultados fueron expresados en UFC/cm2. El análisis cualitativo fue iniciado con el cultivo de Agar Sangre, EBM-Levine y Agar Cetrimide por 24 h y la identificación de la bacteria fue realizada por análisis microscópicos. El perfil de resistencia fue verificado por el antibiograma clásico. Las zonas internas de las unidades de líneas de agua mostraron un promédio de 2,44 x 109 UFC/cm2. Bacillus subtilis y Pseudomonas aeruginosa fueron encontrados. El perfil de resistencia de Pseudomonas aeruginosa indicó sensibilidad a todos los antibióticos testados. Un gran número de microorganismos fue cuantificado desde la biopelícula acumulada en las líneas de agua de unidades dentales. Sin embargo, no resistieron al antibiograma clásico. Se requiere una mejor gestión y aplicación de protocolos de decontaminación en las líneas de agua debido a que las infecciones oportunistas puedan estar asociadas a Pseudomonas aeruginosa.


Subject(s)
Humans , Water/adverse effects , Biofilms , Infection Control, Dental/methods , Water Microbiology , Brazil , Colony Count, Microbial , Equipment Contamination/prevention & control , Prospective Studies , Dental Equipment/microbiology , Mycobacterium/growth & development
15.
Rev. argent. microbiol ; 51(1): 22-25, mar. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1041815

ABSTRACT

Las micobacterias de crecimiento rápido son una rara causa de endocarditis bacteriana. Durante las últimas décadas han aumentado las infecciones debido a este tipo de micobacterias, en especial las postraumáticas y las posquirúrgicas. Estas infecciones pueden ser localizadas o diseminadas, y también pueden producir brotes nosocomiales debido a la contaminación del equipamiento médico. Por lo general, las tinciones para bacterias ácido-alcohol resistentes no se emplean de rutina en el procesamiento de hemocultivos positivos. Sin embargo, el microbiólogo debe estar atento al ver un bacilo gram positivo, ya que podría tratarse de una micobacteria de crecimiento rápido. Describimos un caso de endocarditis por de Mycobacterium mageritense en una paciente con parche pericárdico autógeno y un catéter para medir la presión en la aurícula izquierda. La bacteria fue identificada por espectrometría de masas (MALDI-TOF MS), score 2,3, y luego confirmada por secuenciación y análisis del gen ARNr 16s con las bases de datos del NCBI y EzTaxon, con una concordancia del 99,8 y el 100%, respectivamente.


Rapidly growing non-tuberculosis mycobacteria are a rare cause of bacterial endocarditis. During the last decades, there has been an increase in infections due to rapidly growing mycobacteria, mainly after trauma and post-surgical procedures, both localized and disseminated, as well as nosocomial outbreaks due to contamination of medical equipment. Routine acid-fast staining for blood culture bottles is not always performed; however, the microbiologist should be aware of potential RGM infections especially when gram positive bacilli are observed. We describe a case of endocarditis caused by Mycobacterium mageritense in a patient with an autologous pericardial patch and a pressure catheter in the left auricle. The bacterial species was identified as Mycobacterium mageritense by mass spectrometry (MALDI-TOF MS), score 2.3, and confirmed by 16S rRNA analysis with 99.8 and 100% agreement, respectively.


Subject(s)
Humans , Female , Adult , Endocarditis, Bacterial/microbiology , Catheter-Related Infections/diagnosis , Mycobacterium/isolation & purification , Mass Spectrometry/methods , RNA, Ribosomal, 16S/analysis , Catheter-Related Infections/therapy , Blood Culture/methods
16.
J. health med. sci. (Print) ; 5(1): 29-33, Ene-Mar. 2019. tab
Article in Spanish | LILACS | ID: biblio-1151837

ABSTRACT

El género Mycobacterium se encuentra asociado a una cantidad importante de patologías, donde la tuberculosis destaca dentro de los principales problemas de salud pública a nivel mundial y nacional. Esta se agudiza con el incremento en la resistencia antimicrobiana y, por ello, la pesquisa de micobacterias contempla un pilar fundamental en el diagnóstico de patologías infecciosas de importancia clínica. Por lo tanto, el objetivo fue describir las principales especies de micobacterias aisladas y su patrón de susceptibilidad a partir de muestras clínicas procesadas en el Hospital Dr. Hernán Henríquez Aravena durante el año 2012. Se realizó un estudio descriptivo retrospectivo, en donde se utilizaron los resultados de 7023 baciloscopías procesadas en el Laboratorio Clínico del Hospital Dr. Hernán Henríquez Aravena de Temuco el año 2012. Todas las baciloscopías fueron analizadas y solicitadas según criterios establecidos por el Instituto de Salud Pública de Chile, comprendiendo muestras de expectoración y no expectoración. De las 7023 baciloscopías realizadas, 100 resultaron ser positivas para Mycobacterium. De 21 cepas enviadas al Instituto de Salud Pública de Chile para identificación, 19 cepas corresponden al complejo Mycobacterium tuberculosis y dos a Mycobacterium avium intracelular. En el estudio de sensibilidad, se encontró resistencia a estreptomicina e isoniazida en 13,3 % de las expectoraciones. De acuerdo a lo establecido por la literatura, más del 90 % pertenecen a Mycobacterium tuberculosis, mientras que, de las micobacterias no tuberculosas sólo se aislaron Mycobacterium avium intracelular. Los antimicrobianos con mayores niveles de resistencia son estreptomicina e isoniazida.


The genus Mycobacterium is associated with a significant number of pathologies, where tuberculosis stands out among the main public health problems worldwide and nationally. This is exacerbated by the increase in antimicrobial resistance and, therefore, the research of mycobacteria contemplates a fundamental pillar in the diagnosis of infectious pathologies of clinical importance. Therefore, the aim was to describe the main species of isolated mycobacteria and their susceptibility pattern from clinical samples processed at the Dr. Hernán Henríquez Aravena Hospital during 2012. A retrospective descriptive study was carried out, where the results of 7023 sputum microscopy processed in the Clinical Laboratory of the Dr. Hernán Henríquez Aravena Hospital in Temuco in 2012. All sputum microscopy was analyzed and requested according to criteria established by the Instituto de Salud Pública of Chile, including expectoration and non-sputum samples. Of the 7023-sputum microscopy performed, 100 were positive for Mycobacterium. Of 21 strains sent to the Instituto de Salud Pública of Chile for identification, 19 strains correspond to the Mycobacterium tuberculosis complex and two to intracellular Mycobacterium avium. In the sensitivity study, resistance to streptomycin and isoniazid was found in 13.3 % of the expectorations. According to what is established by the literature, more than 90 % belong to Mycobacterium tuberculosis, while only intracellular Mycobacterium avium was isolated from non-tuberculous mycobacteria. Antimicrobials with higher levels of resistance are streptomycin and isoniazid.


Subject(s)
Humans , Animals , Tuberculosis/epidemiology , Mycobacterium avium , Mycobacterium tuberculosis/pathogenicity , Sputum/microbiology , Tuberculosis/diagnosis , Health Centers , Chile/epidemiology , Epidemiology, Descriptive , Clinical Laboratory Services , Microscopy/methods , Mycobacterium/classification
17.
Article in English | WPRIM | ID: wpr-719497

ABSTRACT

BACKGROUND: Mycobacterium bovis Bacille Calmette-Guérin (BCG) osteitis, a rare complication of BCG vaccination, has not been well investigated in Korea. This study aimed to evaluate the clinical characteristics of BCG osteitis during the recent 10 years in Korea. METHODS: Children diagnosed with BCG osteitis at the Seoul National University Children's Hospital from January 2007 to March 2018 were included. M. bovis BCG was confirmed by multiplex polymerase chain reaction (PCR) in the affected bone. BCG immunization status and clinical information were reviewed retrospectively. RESULTS: Twenty-one patients were diagnosed with BCG osteitis and their median symptom onset from BCG vaccination was 13.8 months (range, 6.0–32.5). Sixteen children (76.2%) received Tokyo-172 vaccine by percutaneous multiple puncture method, while four (19.0%) and one (4.8%) received intradermal Tokyo-172 and Danish strain, respectively. Common presenting symptoms were swelling (76.2%), limited movement of the affected site (63.2%), and pain (61.9%) while fever was only accompanied in 19.0%. Femur (33.3%) and the tarsal bones (23.8%) were the most frequently involved sites; and demarcated osteolytic lesions (63.1%) and cortical breakages (42.1%) were observed on plain radiographs. Surgical drainage was performed in 90.5%, and 33.3% of them required repeated surgical interventions due to persistent symptoms. Antituberculosis medications were administered for a median duration of 12 months (range, 12–31). Most patients recovered without evident sequelae. CONCLUSION: Highly suspecting BCG osteitis based on clinical manifestations is important for prompt management. A comprehensive national surveillance system is needed to understand the exact incidence of serious adverse reactions following BCG vaccination and establish safe vaccination policy in Korea.


Subject(s)
Child , Drainage , Femur , Fever , Humans , Immunization , Incidence , Korea , Methods , Multiplex Polymerase Chain Reaction , Mycobacterium bovis , Mycobacterium , Osteitis , Punctures , Retrospective Studies , Seoul , Tarsal Bones , Vaccination
19.
Article in English | WPRIM | ID: wpr-719621

ABSTRACT

The pathogen Mycobacterium avium complex (MAC) is the most common cause of nontuberculous mycobacterial pulmonary disease worldwide. The decision to initiate long-term antibiotic treatment is difficult for the physician due to inconsistent disease progression and adverse effects associated with the antibiotic treatment. The prognostic factors for the progression of MAC pulmonary disease are low body mass index, poor nutritional status, presence of cavitary lesion(s), extensive disease, and a positive acid-fast bacilli smear. A regimen consisting of macrolides (clarithromycin or azithromycin) with rifampin and ethambutol has been recommended; this regimen significantly improves the treatment of MAC pulmonary disease and should be maintained for at least 12 months after negative sputum culture conversion. However, the rates of default and disease recurrence after treatment completion are still high. Moreover, treatment failure or macrolide resistance can occur, although in some refractory cases, surgical lung resection can improve treatment outcomes. However, surgical resection should be carefully performed in a well-equipped center and be based on a rigorous risk-benefit analysis in a multidisciplinary setting. New therapies, including clofazimine, inhaled amikacin, and bedaquiline, have shown promising results for the treatment of MAC pulmonary disease, especially in patients with treatment failure or macrolide-resistant MAC pulmonary disease. However, further evidence of the efficacy and safety of these new treatment regimens is needed. Also, a new consensus is needed for treatment outcome definitions as widespread use of these definitions could increase the quality of evidence for the treatment of MAC pulmonary disease.


Subject(s)
Amikacin , Body Mass Index , Clofazimine , Consensus , Disease Progression , Ethambutol , Humans , Lung , Lung Diseases , Macrolides , Mycobacterium avium Complex , Mycobacterium avium , Mycobacterium , Nontuberculous Mycobacteria , Nutritional Status , Recurrence , Rifampin , Sputum , Treatment Failure , Treatment Outcome
20.
Article in English | WPRIM | ID: wpr-765157

ABSTRACT

BACKGROUND: In-hospital detection of newly diagnosed active pulmonary tuberculosis (TB) is important for prevention of potential outbreaks. Here, we report our experience of the aggressive contact investigation strategy in a university hospital in the Republic of Korea after healthcare workers (HCWs), patients, and visitors experience an in-hospital exposure to active pulmonary TB. METHODS: A contact investigation after the unexpected detection of newly diagnosed active pulmonary TB (index patients) was performed in a university hospital from August 2016 to April 2017. Initial and 3-month-post-exposure chest radiographs were advised for all patients, visitors, and HCWs in close contact with the index patients. An additional tuberculous skin test or interferon gamma releasing assay was performed at the time of exposure and 3 months post-exposure in HCWs in close contact with the index patients. RESULTS: Twenty-four index patients were unexpectedly diagnosed with active pulmonary TB after admission to the hospital with unassociated diseases. The median time from admission to TB diagnosis was 5 days (range, 1–22 days). In total, 1,057 people were investigated because of contact with the index patients, 528 of which had close contact (206 events in 157 HCWs, 322 patients or visitors). Three months post exposure, 9 (9.2%) among 98 TB-naïve close contact HCWs developed latent tuberculosis infections (LTBIs). Among the 65 close contact patients or visitors, there was no radiological or clinical evidence of active pulmonary TB. CONCLUSION: An aggressive contact investigation after an unexpected in-hospital diagnosis of active pulmonary TB revealed a high incidence of LTBI among TB-naïve HCWs who had contact with the index patients.


Subject(s)
Delivery of Health Care , Diagnosis , Disease Outbreaks , Humans , Incidence , Infection Control , Interferons , Latent Tuberculosis , Mycobacterium , Radiography, Thoracic , Republic of Korea , Skin Tests , Tuberculosis, Pulmonary
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