ABSTRACT
The objective of this study was to investigate the possible transmission of tuberculosis among 39 inmates with positive Mycobacterium tuberculosis smears in four correctional institutions located in Campinas City, SP, Brazil over a 19-month period. Fifty-one M. tuberculosis isolates from these inmates were characterized according to the number of IS6110 insertion elements present in their genomic DNA. The number of insertion elements in M. tuberculosis isolates varied from two to twelve. The dendrogram of similarity resulted in the grouping the isolates in six main clusters. These results, associated to epidemiological data, suggested the transmission of tuberculosis among inmates of the same and different institutions inmates. Univariate analysis of epidemiological data (total delay for beginning of treatment, previous treatment, and HIV status) and clustering occurrence showed that only "previous treatment" (OR = 7.65, p = 0.032) was associated with the possible transmission of tuberculosis in the studied prisons.
Subject(s)
Adult , Humans , Male , Middle Aged , Young Adult , DNA, Bacterial/analysis , Mycobacterium tuberculosis/genetics , Prisons/statistics & numerical data , Tuberculosis, Pulmonary/transmission , Brazil/epidemiology , Cluster Analysis , Mycobacterium tuberculosis/isolation & purification , Polymorphism, Restriction Fragment Length , Retrospective Studies , Tuberculosis, Pulmonary/epidemiology , Tuberculosis, Pulmonary/microbiology , Young AdultABSTRACT
The objective of this study was to investigate the possible transmission of tuberculosis among 39 inmates with positive Mycobacterium tuberculosis smears in four correctional institutions located in Campinas City, SP, Brazil over a 19-month period. Fifty-one M. tuberculosis isolates from these inmates were characterized according to the number of IS6110 insertion elements present in their genomic DNA. The number of insertion elements in M. tuberculosis isolates varied from two to twelve. The dendrogram of similarity resulted in the grouping the isolates in six main clusters. These results, associated to epidemiological data, suggested the transmission of tuberculosis among inmates of the same and different institutions inmates. Univariate analysis of epidemiological data (total delay for beginning of treatment, previous treatment, and HIV status) and clustering occurrence showed that only 'previous treatment' (OR = 7.65, p = 0.032) was associated with the possible transmission of tuberculosis in the studied prisons.
Subject(s)
DNA, Bacterial/analysis , Mycobacterium tuberculosis/genetics , Prisons/statistics & numerical data , Tuberculosis, Pulmonary/transmission , Adult , Brazil/epidemiology , Cluster Analysis , Humans , Male , Middle Aged , Mycobacterium tuberculosis/isolation & purification , Polymorphism, Restriction Fragment Length , Retrospective Studies , Tuberculosis, Pulmonary/epidemiology , Tuberculosis, Pulmonary/microbiology , Young AdultABSTRACT
SETTING: Four hundred and sixty-eight isoniazid (INH) resistant Mycobacterium tuberculosis isolates recovered from a selected Brazilian population. OBJECTIVE: To check for susceptibility to other chemotherapeutic drugs used in TB treatment, and to ascertain mutations involved in INH and rifampicin (RMP) resistance. DESIGN: Antimicrobial susceptibility to RMP, streptomycin and ethambutol (EMB) was evaluated by the resistance ratio method and pyrazinamide (PZA) by activity assay. Single strand conformation polymorphism (SSCP) and sequence analysis were performed in samples from this panel to confirm mutations in codon 315 of the katG and in a 69-bp region of the rpoB gene. RESULTS: Combined resistance to INH+RMP, INH+ PZA, INH+EMB, and INH+RMP+PZA was shown in respectively 272 (58.1%), 126 (26.9%), 47 (10%), 116 (24.8%) isolates. No katG mutation was found in 19 (39.6%) of 48 strains tested. Ser315Thr substitution was found in 29 (60.4%). All RMP-resistant strains tested (n = 25) showed rpoB mutations. S531L substitution was found in 15 (60%). CONCLUSION: INH-resistant strains isolated from selected Brazilian populations frequently show resistance to other first-line anti-tuberculosis drugs. rpoB mutation was responsible for RMP resistance in all strains. Among INHr strains, katG mutations were shown in only 60.4%. Genetic approaches targeting the rpoB gene but not the katG gene have a high sensitivity to detect resistance among Brazilian M. tuberculosis strains.
Subject(s)
Antitubercular Agents/pharmacology , Isoniazid/pharmacology , Mycobacterium tuberculosis/genetics , Rifampin/pharmacology , Bacterial Proteins/genetics , Brazil , Catalase/genetics , DNA Mutational Analysis , DNA-Directed RNA Polymerases/genetics , Drug Resistance, Microbial , Humans , Mycobacterium tuberculosis/pathogenicity , Polymorphism, Single-Stranded Conformational , Prevalence , Sequence Analysis, DNA , Tuberculosis, Multidrug-ResistantABSTRACT
Bacteremia due to mycobacteria can occur in AIDS patients in whom a rapid diagnosis is extremely important in order to plan a therapeutic conduct. Blood culture of mycobacteria using a biphasic system was set up in the Regional Laboratories of the Adolfo Lutz Institute, SP (Campinas, Ribeirão Preto, Santo André, Santos, São José do Rio Preto and Sorocaba). During a three year period (1994-97), 1521 blood samples were analyzed from 1336 AIDS patients, with CD4+ cell count < 100/ml, hematocrit < 30% and serum albumin concentration < 3.0 g/dl seen in regional outpatient clinics or as inpatients in hospitals. Of the blood samples examined, 9.9% were positive for mycobacteria. The predominant species was Mycobacterium avium complex (MAC) (53.8%) followed by Mycobacterium tuberculosis (28.0%). Mycobacterium xenopi was isolated in one case (0.8%) and in the remaining 17.4% the mycobacteria isolated were not identified. The implementation of blood culture for mycobacteria in our Institute has permitted the laboratory diagnosis of mycobacterial infections, in addition to providing data on the frequency of disseminated mycobacterial disease in AIDS patients in the region.
Subject(s)
AIDS-Related Opportunistic Infections/blood , Bacteremia/diagnosis , Mycobacterium Infections/blood , Mycobacterium/isolation & purification , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/microbiology , Bacteremia/microbiology , Bacteriological Techniques , Brazil/epidemiology , Culture Media , Humans , Mycobacterium Infections/diagnosis , Mycobacterium Infections/epidemiology , Mycobacterium Infections/microbiology , Mycobacterium Infections, Nontuberculous/blood , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium avium Complex , Mycobacterium avium-intracellulare Infection/blood , Mycobacterium avium-intracellulare Infection/diagnosis , Mycobacterium avium-intracellulare Infection/microbiology , Mycobacterium tuberculosis/isolation & purification , Nontuberculous Mycobacteria/isolation & purification , Tuberculosis/blood , Tuberculosis/diagnosis , Tuberculosis/microbiologyABSTRACT
Bacteremia due to mycobacteria can occur in AIDS patients in whom a rapid diagnosis is extremely important in order to plan a therapeutic conduct. Blood culture of mycobacteria using a biphasic system was set up in the Regional Laboratories of the Adolfo Lutz Institute, SP (Campinas, RibeirOo Preto, Santo AndrU, Santos, SOo JosU do Rio Preto and Sorocaba). During a three year period (1994-97), 1521 blood samples were analyzed from 1336 AIDS patients, with CD4+ cell count < 100/ml, hematocrit < 30 and serum albumin concentration < 3.0 g/dl seen in regional outpatient clinics or as inpatients in hospitals. Of the blood samples examined, 9.9 were positive for mycobacteria. The predominant species was Mycobacterium avium complex (MAC) (53.8) followed by Mycobacterium tuberculosis (28.0). Mycobacterium xenopi was isolated in one case (0.8) and in the remaining 17.4 the mycobacteria isolated were not identified. The implementation of blood culture for mycobacteria in our Institute has permitted the laboratory diagnosis of mycobacterial infections, in addition to providing data on the frequency of disseminated mycobacterial disease in AIDS patients in the region.(AU)
Subject(s)
Humans , AIDS-Related Opportunistic Infections/blood , Bacteremia/diagnosis , Mycobacterium/isolation & purification , Mycobacterium Infections/blood , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/microbiology , Bacteremia/microbiology , Bacteriological Techniques , Brazil/epidemiology , Culture Media , Nontuberculous Mycobacteria/isolation & purification , Mycobacterium Infections/diagnosis , Mycobacterium Infections/epidemiology , Mycobacterium Infections/microbiology , Mycobacterium Infections, Nontuberculous/blood , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium avium Complex , Mycobacterium avium-intracellulare Infection/blood , Mycobacterium avium-intracellulare Infection/diagnosis , Mycobacterium avium-intracellulare Infection/microbiology , Mycobacterium tuberculosis/isolation & purification , Tuberculosis/blood , Tuberculosis/diagnosis , Tuberculosis/microbiologyABSTRACT
Bacteremia due to mycobacteria can occur in AIDS patients in whom a rapid diagnosis is extremely important in order to plan a therapeutic conduct. Blood culture of mycobacteria using a biphasic system was set up in the Regional Laboratories of the Adolfo Lutz Institute, SP (Campinas, RibeirÒo Preto, Santo AndrÚ, Santos, SÒo JosÚ do Rio Preto and Sorocaba). During a three year period (1994-97), 1521 blood samples were analyzed from 1336 AIDS patients, with CD4+ cell count < 100/ml, hematocrit < 30 and serum albumin concentration < 3.0 g/dl seen in regional outpatient clinics or as inpatients in hospitals. Of the blood samples examined, 9.9 were positive for mycobacteria. The predominant species was Mycobacterium avium complex (MAC) (53.8) followed by Mycobacterium tuberculosis (28.0). Mycobacterium xenopi was isolated in one case (0.8) and in the remaining 17.4 the mycobacteria isolated were not identified. The implementation of blood culture for mycobacteria in our Institute has permitted the laboratory diagnosis of mycobacterial infections, in addition to providing data on the frequency of disseminated mycobacterial disease in AIDS patients in the region.
Subject(s)
Humans , Bacteremia , AIDS-Related Opportunistic Infections/blood , Mycobacterium , Mycobacterium Infections , Bacteremia , Bacteriological Techniques , Brazil , Culture Media , Mycobacterium avium-intracellulare Infection/blood , Mycobacterium avium-intracellulare Infection/diagnosis , Mycobacterium avium-intracellulare Infection/microbiology , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/microbiology , Nontuberculous Mycobacteria/isolation & purification , Mycobacterium avium Complex , Mycobacterium Infections , Mycobacterium Infections, Nontuberculous , Mycobacterium tuberculosis , TuberculosisABSTRACT
Bacteremia due to mycobacteria can occur in AIDS patients in whom a rapid diagnosis is extremely important in order to plan a therapeutic conduct. Blood culture of mycobacteria using a biphasic system was set up in the Regional Laboratories of the Adolfo Lutz Institute, SP (Campinas, RibeirÒo Preto, Santo André, Santos, SÒo José do Rio Preto and Sorocaba). During a three year period (1994-97), 1521 blood samples were analyzed from 1336 AIDS patients, with CD4+ cell count < 100/ml, hematocrit < 30
and serum albumin concentration < 3.0 g/dl seen in regional outpatient clinics or as inpatients in hospitals. Of the blood samples examined, 9.9
were positive for mycobacteria. The predominant species was Mycobacterium avium complex (MAC) (53.8
) followed by Mycobacterium tuberculosis (28.0
). Mycobacterium xenopi was isolated in one case (0.8
) and in the remaining 17.4
the mycobacteria isolated were not identified. The implementation of blood culture for mycobacteria in our Institute has permitted the laboratory diagnosis of mycobacterial infections, in addition to providing data on the frequency of disseminated mycobacterial disease in AIDS patients in the region.
