title: An outbreak of keratitis caused by Mycobacterium immunogenum.
abstract: From 8 October to 12 November 2003, 36 patients underwent surgical correction of myopia in a São Paulo, Brazil, clinic. Five patients had clinical signs of infectious keratitis, and a Mycobacterium species with previously unreported patterns determined by PCR restriction enzyme analysis of the hsp65 gene and PCR restriction enzyme analysis of the 16S-23S rRNA internal transcribed spacer (ITS) was isolated from corneal scrapings from four of these patients. Subsequent evaluation by phenotypic tests and partial sequencing of the hsp65, sodA, rpoB, and 16S rRNA genes and the ITS supported the species identification as a variant of Mycobacterium immunogenum. The source of infection was not determined. The outbreak was caused by a single clone, as evidenced by identical pulsed-field gel electrophoresis and enterobacterial repetitive intergenic consensus-PCR profiles. This is the first report of an outbreak where this species was isolated from infected tissues.
authors.affiliation: Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo--Escola Paulista de Medicina, Rua Botucatu, 862--3 degrees andar, 04023-062 São Paulo, Brazil. sampaio@ecb.epm.br
authors.forename: Jorge Luiz Mello
authors.initials: JL
authors.lastname: Sampaio
authors.forename: Doraldo Nassar
authors.initials: DN
authors.lastname: Junior
authors.forename: Denise
authors.initials: D
authors.lastname: de Freitas
authors.forename: Ana Luisa
authors.initials: AL
authors.lastname: Höfling-Lima
authors.forename: Kozue
authors.initials: K
authors.lastname: Miyashiro
authors.forename: Fernando Lopes
authors.initials: FL
authors.lastname: Alberto
authors.forename: Sylvia Cardoso
authors.initials: SC
authors.lastname: Leão
mesh_terms: D000328:Adult; D001426:Bacterial Proteins / Q000235:genetics; D001483:Base Sequence; D018834:Chaperonin 60; D018833:Chaperonins / Q000235:genetics; D003315:Cornea / Q000382:microbiology; D021903:DNA, Ribosomal Spacer / Q000032:analysis; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D007634:Keratitis / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008969:Molecular Sequence Data; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology* / Q000382:microbiology; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012338:RNA, Ribosomal, 23S / Q000235:genetics; D015183:Restriction Mapping; D017422:Sequence Analysis, DNA
chemical_list: D001426:Bacterial Proteins; D018834:Chaperonin 60; D021903:DNA, Ribosomal Spacer; D012336:RNA, Ribosomal, 16S; D012338:RNA, Ribosomal, 23S; C074119:heat-shock protein 65, Mycobacterium; D018833:Chaperonins