title: Phenotypic and molecular characterization of quinolone resistance in Mycobacterium abscessus subsp. bolletii recovered from postsurgical infections.
abstract: Several outbreaks of infections caused by rapidly growing mycobacteria (RGM) were reported in many Brazilian states (2032 notified cases) from 2004 to 2010. Most of the confirmed cases were mainly associated with Mycobacterium massiliense (recently renamed as Mycobacterium abscessus subsp. bolletii) BRA100 clone, recovered from patients who had undergone invasive procedures in which medical instruments had not been properly sterilized and/or disinfected. Since quinolones have been an option for the treatment of general RGM infections and have been suggested for therapeutic schemes for these outbreaks, we evaluated the in vitro activities of all generations of quinolones for clinical and reference RGM by broth microdilution, and analysed the peptide sequences of the quinolone resistance determining regions (QRDRs) of GyrA and GyrB after DNA sequencing followed by amino acid translation. Fifty-four isolates of M. abscessus subsp. bolletii, including clone BRA100, recovered in different states of Brazil, and 19 reference strains of RGM species were characterized. All 54 M. abscessus subsp. bolletii isolates were resistant to all generations of quinolones and showed the same amino acids in the QRDRs, including the Ala-83 in GyrA, and Arg-447 and Asp-464 in GyrB, described as being responsible for an intrinsic low level of resistance to quinolones in mycobacteria. However, other RGM species showed distinct susceptibilities to this class of antimicrobials and patterns of mutations contrary to what has been traditionally defined, suggesting that other mechanisms of resistance, different from gyrA or gyrB mutations, may also be involved in resistance to high levels of quinolones.
authors: Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Vinicius Calado Nogueira
authors: VCN
authors: de Moura
authors: Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Marlei Gomes
authors: MG
authors: da Silva
authors: Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Karen Machado
authors: KM
authors: Gomes
authors: Hospital Universitário Pedro Ernesto, Rio de Janeiro, Brazil.
authors: Fábrice Santana
authors: FS
authors: Coelho
authors: Instituto Fleury de Ensino e Pesquisa, São Paulo, Brazil.
authors: Jorge Luiz Mello
authors: JLM
authors: Sampaio
authors: Instituto de Doenças do Tórax, Rio de Janeiro, Brazil.
authors: Fernanda Carvalho de Queiroz
authors: FCQ
authors: Mello
authors: Instituto de Pesquisa Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
authors: Maria Cristina da Silva
authors: MCDS
authors: Lourenço
authors: Sérgio Franco Medicina Diagnóstica, Rio de Janeiro, Brazil.
authors: Efigênia de Lourdes Teixeira
authors: ELT
authors: Amorim
authors: Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Rafael Silva
authors: RS
authors: Duarte
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001483:Base Sequence; D001938:Brazil / Q000453:epidemiology; D027081:DNA Gyrase / Q000235:genetics; D024881:Drug Resistance, Bacterial / Q000235:genetics; D006801:Humans; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D009161:Mycobacterium / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D009164:Mycobacterium Infections / Q000453:epidemiology / Q000382:microbiology*; D010641:Phenotype; D015363:Quinolones / Q000494:pharmacology; D017422:Sequence Analysis, DNA; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D015363:Quinolones; D027081:DNA Gyrase