Use of MALDI-TOF MS (Bruker Daltonics) for identification of Mycobacterium species isolated directly from liquid medium / Utilización de MALDI-TOF MS (Bruker Daltonics) para la identificación de micobacterias aisladas directamente en medio líquido

Objectives: The aim of this study was to describe the evaluation of the use of MALDI-TOF MS for the identification of non-tuberculous mycobacteria (NTM) and Mycobacterium tuberculosis directly from liquid MGIT cultures from January 2017 to December 2017. Material/methods: A total of 155 isolates (mainly respiratory) were analyzed by MALDI-TOF MS (Bruker Daltonics) directly from MGIT liquid medium with a previous extraction procedure. Results: MALDI-TOF MS generated acceptable scores for 152 isolates (98.06%). Fifty isolates were identified as M. tuberculosis complex and the remaining 105 as NTM (M. abscessus subsp. abscessus, M. avium, M. celatum, M chelonae, M. chimaera, M. fortuitum, M. gordonae, M. intracellulare, M. kansasii, M. lentiflavum, M. mageritense, M. mucogenicum and M. xenopi). Conclusions: These results indicate that MALDI-TOF MS can be useful to identify mycobacteria directly from MGIT cultures and is an accurate, rapid and cost-effective system to be used as a routine method.(AU)

Introducción: Evaluamos la espectrometría de masas (MALDI-TOF MS [Bruker Daltonics]) para la identificación de micobacterias no tuberculosas (MNT) y Mycobacterium tuberculosis a partir de cultivos líquidos (MGIT) desde enero del 2017 a diciembre del 2017. Métodos: Se analizaron mediante MALDI-TOF MS 155 cultivos MGIT positivos, principalmente de origen respiratorio. Previamente a la realización de MALDI-TOF se realizó un procedimiento de extracción directamente del MGIT. Resultados: Mediante MALDI-TOF MS se identificó correctamente a partir del MGIT el 98,06% (n=152) de los aislados. Cincuenta aislados se identificaron como M. tuberculosis complex y los 105 restantes como MNT (M. abscessus subsp. abscessus, M. avium, M. celatum, M chelonae, M. chimaera, M. fortuitum, M. gordonae, M. intracellulare, M. kansasii, M. lentiflavum, M. mageritense, M. mucogenicum y M. xenopi). Conclusiones: Estos resultados indican que MALDI-TOF es una técnica precisa, rápida y coste-efectiva para identificar micobacterias directamente a partir de medios de cultivo líquidos en la rutina diaria.(AU)

Use of MALDI-TOF MS (Bruker Daltonics) for identification of Mycobacterium species isolated directly from liquid medium.

OBJECTIVES: The aim of this study was to describe the evaluation of the use of MALDI-TOF MS for the identification of non-tuberculous mycobacteria (NTM) and Mycobacterium tuberculosis directly from liquid MGIT cultures from January 2017 to December 2017. MATERIAL/METHODS: A total of 155 isolates (mainly respiratory) were analyzed by MALDI-TOF MS (Bruker Daltonics) directly from MGIT liquid medium with a previous extraction procedure. RESULTS: MALDI-TOF MS generated acceptable scores for 152 isolates (98.06%). Fifty isolates were identified as M. tuberculosis complex and the remaining 105 as NTM (M. abscessus subsp. abscessus, M. avium, M. celatum, M chelonae, M. chimaera, M. fortuitum, M. gordonae, M. intracellulare, M. kansasii, M. lentiflavum, M. mageritense, M. mucogenicum and M. xenopi). CONCLUSIONS: These results indicate that MALDI-TOF MS can be useful to identify mycobacteria directly from MGIT cultures and is an accurate, rapid and cost-effective system to be used as a routine method.

Bacteriemia por L. monocytogenes: descripción de casos y revisión de la bibliografía / Bacteraemia due to L. monocytogenes: description of cases and review of literature

La bacteriemia por L. monocytogenes es una entidad poco frecuente que se relaciona con edad avanzada o neoplasias; su mortalidad es elevada. El objetivo de este trabajo es describir las características epidemiológicas, clínicas y terapéuticas de esta bacteriemia, mediante un análisis descriptivo retrospectivo de los casos con hemocultivos positivos del Hospital de Calatayud, entre 2008 y 2018. De los 4 casos identificados, todos se produjeron en los últimos 3 años analizados, la edad era superior a la de otros trabajos y los factores de riesgo y la mortalidad fueron similares a los de estos. La prevención y la detección precoz son fundamentales para controlar el aumento de esta entidad

Bacteraemia due to L. monocytogenes is a sporadic disease related to advanced age or neoplasms, and mortality associated with this disease is high. This study aims to describe the epidemiological, clinical, and therapeutics characteristics of this specific disease, through a retrospective descriptive analysis of cases with positive blood cultures from Calatayud Hospital, from 2008 to 2018. Four cases were detected, all of them occurred in the last 3 years analysed, and the age was greater than the age published in other papers. However, risk factors and mortality were similar. Prevention and early detection are essential to control the increase in this pathology

[Bacteraemia due to L. monocytogenes: Description of cases and review of literature]. / Bacteriemia por L. monocytogenes: descripción de casos y revisión de la bibliografía.

Bacteraemia due to L. monocytogenes is a sporadic disease related to advanced age or neoplasms, and mortality associated with this disease is high. This study aims to describe the epidemiological, clinical, and therapeutics characteristics of this specific disease, through a retrospective descriptive analysis of cases with positive blood cultures from Calatayud Hospital, from 2008 to 2018. Four cases were detected, all of them occurred in the last 3 years analysed, and the age was greater than the age published in other papers. However, risk factors and mortality were similar. Prevention and early detection are essential to control the increase in this pathology.

Linfadenitis por micobacterias no tuberculosas: experiencia de 15 años / Lymphadenitis due to non-tuberculous mycobacteria: experience over 15 years

OBJETIVO: Estudiar la epidemiología, las manifestaciones clínicas, el manejo diagnóstico-terapéutico y la evolución de las linfadenitis por micobacterias no tuberculosas en la población pediátrica de Aragón. MATERIAL Y MÉTODOS: Estudio retrospectivo de pacientes menores de 15 años diagnosticados de linfadenitis por micobacteria no tuberculosa entre 2000 y 2015. CRITERIOS DE INCLUSIÓN: pacientes con linfadenitis y cultivo positivo. Los resultados se expresan como medias, rango y desviación típica para las variables cuantitativas, y porcentajes para las cualitativas. RESULTADOS: Se detectan 27 casos, edad media de presentación 39,9 meses (rango 10 meses-8 años). El tiempo desde inicio de los síntomas hasta la primera consulta especializada es 1,7 ± 1,1 meses. La localización más frecuente es submaxilar en 17/27 casos (63%), lado derecho en el 59,3%, con tamaño de 2,96 ± 1,26 cm. Solo 16/27 presentan fistulización. Prueba de tuberculina superior a 10 mm en 7/24 (29,1%). El cultivo es positivo para Mycobacterium avium en 14/27 (51,9%), Mycobacterium intracellulare 3/27 (11,1%), Mycobacterium lentiflavum 3/27 (11,1%). El 92,6% (23/27) es tratado inicialmente con amoxicilina-clavulánico. La combinación de antibióticos y cirugía se aplica en 16/27 casos (59,3%), solo antibioterapia 7/27 (25,9%) y únicamente exéresis 4/27 (14,8%). Dos pacientes precisan reintervención y un caso desarrolla neutropenia grave secundaria a rifabutina. Solo un caso (3,7%) presenta parálisis facial transitoria como secuela. CONCLUSIONES: La combinación de antibioterapia y cirugía es el tratamiento más frecuente. El retraso en el diagnóstico hace que la exéresis como primera opción terapéutica se realice únicamente en uno de cada 7 pacientes

OBJECTIVE: To study the epidemiology, clinical features, diagnosis, therapeutic management, and outcome of non-tuberculous mycobacterial lymphadenitis in a paediatric population of Aragón (Spain). MATERIAL AND METHODS: A retrospective study was conducted on patients under 15 years-old diagnosed with non-tuberculous mycobacterial lymphadenitis between the years 2000 and 2015. Inclusion criteria: patients with lymphadenitis and positive culture. Quantitative values are shown as mean, rank, and standard deviation, and qualitative data as frequencies. RESULTS: Twenty-seven cases were registered, with a mean age of presentation of 39.9 months (range 10 months-8 years). The mean time between the symptoms onset and first consultation was 1.7 ± 1.1 months. The most frequent location was sub-maxilar in 17/27 cases (63%), on the right side in 59.3%, and size 2.96 ± 1.26 cm. Fistulae were observed in 16/27 cases. Tuberculin test was greater than 10 mm in 7/24 (29.1%). Microbiological cultures were positive for Mycobacterium avium in 14/27 (51.9%), Mycobacterium intracellulare 3/27 (11.1%), and Mycobacterium lentiflavum 3/27 (11.1%). Combined treatment of antibiotics and surgery was given in 16/27 cases (59.8%), medical treatment only in7/27 (25.9%), and surgical exeresis alone in 4/27 (14.8%). Two patients required a new surgery, and one showed severe neutropenia secondary to rifabutin. Only one case (3.7%) suffered from temporary facial palsy as sequel. CONCLUSIONS: The most frequent treatment was the combination of antibiotics and surgery. Delay in diagnosis seemed to be responsible for the limited number of exeresis as first option, only one for every seven patients

[Lymphadenitis due to non-tuberculous mycobacteria: Experience over 15 years]. / Linfadenitis por micobacterias no tuberculosas: experiencia de 15 años.

OBJECTIVE: To study the epidemiology, clinical features, diagnosis, therapeutic management, and outcome of non-tuberculous mycobacterial lymphadenitis in a paediatric population of Aragón (Spain). MATERIAL AND METHODS: A retrospective study was conducted on patients under 15 years-old diagnosed with non-tuberculous mycobacterial lymphadenitis between the years 2000 and 2015. INCLUSION CRITERIA: patients with lymphadenitis and positive culture. Quantitative values are shown as mean, rank, and standard deviation, and qualitative data as frequencies. RESULTS: Twenty-seven cases were registered, with a mean age of presentation of 39.9 months (range 10 months-8 years). The mean time between the symptoms onset and first consultation was 1.7±1.1 months. The most frequent location was sub-maxilar in 17/27 cases (63%), on the right side in 59.3%, and size 2.96±1.26cm. Fistulae were observed in 16/27 cases. Tuberculin test was greater than 10mm in 7/24 (29.1%). Microbiological cultures were positive for Mycobacterium avium in 14/27 (51.9%), Mycobacterium intracellulare 3/27 (11.1%), and Mycobacterium lentiflavum 3/27 (11.1%). Combined treatment of antibiotics and surgery was given in 16/27 cases (59.8%), medical treatment only in7/27 (25.9%), and surgical exeresis alone in 4/27 (14.8%). Two patients required a new surgery, and one showed severe neutropenia secondary to rifabutin. Only one case (3.7%) suffered from temporary facial palsy as sequel. CONCLUSIONS: The most frequent treatment was the combination of antibiotics and surgery. Delay in diagnosis seemed to be responsible for the limited number of exeresis as first option, only one for every seven patients.

Réplica a "Emergencia de aislados de Mycobacterium tuberculosis complex resistentes a rifampicina y sensibles a isoniazida" / Reply to "Emergent strains of rifampicin-resistant Mycobacterium tuberculosis complex and susceptibility to isoniazid"

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