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Embargo date
2020-06-26
Sustainable Development Goals
03 Saúde e Bem-EstarCollections
- INI - Artigos de Periódicos [3645]
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EPIDEMIC OF POSTSURGICAL INFECTIONS CAUSED BY MYCOBACTERIUM MASSILIENSE
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Abstract
An epidemic of infections after video-assisted surgery (1,051 possible cases) caused by rapidly growing
mycobacteria (RGM) and involving 63 hospitals in the state of Rio de Janeiro, Brazil, occurred between August
2006 and July 2007. One hundred ninety-seven cases were confirmed by positive acid-fast staining and/or
culture techniques. Thirty-eight hospitals had cases confirmed by mycobacterial culture, with a total of 148
available isolates recovered from 146 patients. Most (n 144; 97.2%) isolates presented a PRA-hsp65
restriction pattern suggestive of Mycobacterium bolletii or Mycobacterium massiliense. Seventy-four of these
isolates were further identified by hsp65 or rpoB partial sequencing, confirming the species identification as M.
massiliense. Epidemic isolates showed susceptibility to amikacin (MIC at which 90% of the tested isolates are
inhibited [MIC90], 8 g/ml) and clarithromycin (MIC90, 0.25 g/ml) but resistance to ciprofloxacin (MIC90,
>32 g/ml), cefoxitin (MIC90, 128 g/ml), and doxycycline (MIC90, >64 g/ml). Representative epidemic M.
massiliense isolates that were randomly selected, including at least one isolate from each hospital where
confirmed cases were detected, belonged to a single clone, as indicated by the analysis of pulsed-field gel
electrophoresis (PFGE) patterns. They also had the same PFGE pattern as that previously observed in two
outbreaks that occurred in other Brazilian cities; we designated this clone BRA100. All five BRA100 M.
massiliense isolates tested presented consistent tolerance to 2% glutaraldehyde. This is the largest epidemic of
postsurgical infections caused by RGM reported in the literature to date in Brazil.
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