Molecular identification and typing of Mycobacterium massiliense isolated from postsurgical infections in Brazil.
OBJECTIVE
One hundred thirty-one cases of postsurgical infections were reported in Southern Region of Brazil between August 2007 and January 2008. Thirty-nine (29.8%) cases were studied; this report describes epidemiological findings, species identification, antimicrobial susceptibility and clonal diversity of rapidly growing mycobacteria isolated in this outbreak.


METHODS
All 39 isolates were analyzed by Ziehl-Nielsen stained smear, bacterial culture and submitted to rpoB partial gene sequencing for identification. The isolates were also evaluated for their susceptibility to amikacin, cefoxitin, clarithromycin, ciprofloxacin, doxycycline, tobramycin and sulfamethoxazole.


RESULTS
Thirty-six isolates out of the confirmed cases were identified as Mycobacterium massiliense and the remaining three were identified as Mycobacterium abscessus, Mycobacterium chelonae and Mycobacterium fortuitum. All M. massiliense isolates were susceptible to amikacin (MIC90 = 8 µg/mL) and clarithromycin (MIC90 = 0.25 µg/mL) but resistant to cefoxitin, ciprofloxacin, doxycycline, tobramycin and sulfamethoxazole. Molecular analysis by pulsed-field gel electrophoresis clustered all 36 M. massiliense isolates and showed the same pattern (BRA 100) observed in three other outbreaks previously reported in Brazil.


CONCLUSIONS
These findings suggest a common source of infection for all patients and reinforce the hypotheses of spread of M. massiliense BRA100 in Brazilian hospital surgical environment in recent years.
Universidade Federal do Paraná, PR, Brazil. fernandamonego@hotmail.com
Fernanda
F
Monego
Rafael Silva
RS
Duarte
Sueli Massumi
SM
Nakatani
Wildo Navegantes
WN
Araújo
Irina Nastassja
IN
Riediger
Sonia
S
Brockelt
Verena
V
Souza
Jamyra Iglesias
JI
Cataldo
Rubens Clayton da Silva
RC
Dias
Alexander Welker
AW
Biondo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015373:Bacterial Typing Techniques / Q000379:methods; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009161:Mycobacterium / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D009164:Mycobacterium Infections / Q000382:microbiology*; D017422:Sequence Analysis, DNA; D013530:Surgical Wound Infection / Q000382:microbiology*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial