Résumé
OBJECTIVE: One hundred thirty-one cases of postsurgical infections were reported in Southern Region of Brazil between August 2007 and January 2008. Thirty-nine (29.8 percent) cases were studied; this report describes epidemiological findings, species identification, antimicrobial susceptibility and clonal diversity of rapidly growing mycobacteria isolated in this outbreak. METHODS: All 39 isolates were analyzed by Ziehl-Nielsen stained smear, bacterial culture and submitted to rpoB partial gene sequencing for identification. The isolates were also evaluated for their susceptibility to amikacin, cefoxitin, clarithromycin, ciprofloxacin, doxycycline, tobramycin and sulfamethoxazole. RESULTS: Thirty-six isolates out of the confirmed cases were identified as Mycobacterium massilienseand the remaining three were identified as Mycobacterium abscessus, Mycobacterium chelonae and Mycobacterium fortuitum. All M. massiliense isolates were susceptible to amikacin (MIC90 = 8 µg/mL) and clarithromycin (MIC90 = 0.25 µg/mL) but resistant to cefoxitin, ciprofloxacin, doxycycline, tobramycin and sulfamethoxazole. Molecular analysis by pulsed-field gel electrophoresis clustered all 36 M. massiliense isolates and showed the same pattern (BRA 100) observed in three other outbreaks previously reported in Brazil. CONCLUSIONS: These findings suggest a common source of infection for all patients and reinforce the hypotheses of spread of M. massiliense BRA100 in Brazilian hospital surgical environment in recent years.
Sujets)
Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Antibactériens/pharmacologie , Infections à Mycobacterium/microbiologie , Mycobacterium/génétique , Infection de plaie opératoire/microbiologie , Techniques de typage bactérien/méthodes , ADN bactérien/analyse , ADN bactérien/génétique , Électrophorèse en champ pulsé , Tests de sensibilité microbienne , Mycobacterium/classification , Mycobacterium/isolement et purification , Analyse de séquence d'ADNRésumé
Apresentaçäo de um caso de dermatofitose por Microsporum nanum em rapaz de 19 anos, procedente de área rural, com lesöes eritemato-circinadas em regiäo inguino-crural e face interna da coxa esquerda. O exame micológico direto confirmou presença de filamentos micelianos, sendo que as características macro e micromorfológicas da colônia, associadas à positividade do teste de perfuraçäo do pêlo, foram compatíveis com Microsporum nanum. Foi tratado sistemicamente com ketoconazole 200mg/dia e topicamente com nitrato de isoconazol, havendo regressäo das lesöes após duas semanas de tratamento