title: Outbreaks due to Mycobacterium abscessus subsp. bolletii in southern Brazil: persistence of a single clone from 2007 to 2011.
abstract: Outbreaks associated with rapidly growing mycobacteria (RGM) have been increasingly reported worldwide, including in Brazil. Among the RGM, the Mycobacterium abscessus complex is the most pathogenic and related to multidrug resistance. The aim of this study was to evaluate the antimicrobial susceptibility and molecular profile of RGM isolates involved in new postsurgical infection outbreaks in Brazil since 2007. Of the 109 cases reported in the state of Rio Grande do Sul between 2007 and 2011, 43 (39 %) had confirmed mycobacterial growth in culture. Clinical isolates were obtained from biopsy specimens or abscess aspirates. PRA-hsp65 restriction pattern identified the isolates as M. abscessus type 2, and partial rpoB sequencing confirmed the identification as M. abscessus subsp. bolletii. All isolates were susceptible to amikacin and resistant to ciprofloxacin, doxycycline, sulfamethoxazole, moxifloxacin and tobramycin. Most isolates (72 %) were fully susceptible to cefoxitin but six isolates (14 %) were fully resistant to clarithromycin. The latter differed from the susceptibility profiles of the previously described BRA100 clone from other Brazilian regions. Nevertheless, pulsed-field gel electrophoresis analysis revealed that these isolates belonged to a single BRA100 clone. In conclusion, our study reports the persistence of an emergent single and highly resistant clone of M. abscessus subsp. bolletii for several years even after national implementation of infection control measures.
authors.affiliation: Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.|Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Luciana de S
authors.initials: LS
authors.lastname: Nunes
authors.affiliation: Laboratório Central de Saúde Pública, Porto Alegre, Brazil.
authors.forename: Ludmila F
authors.initials: LF
authors.lastname: Baethgen
authors.affiliation: Laboratório Central de Saúde Pública, Porto Alegre, Brazil.
authors.forename: Marta O
authors.initials: MO
authors.lastname: Ribeiro
authors.affiliation: Laboratório Central de Saúde Pública, Porto Alegre, Brazil.
authors.forename: Cássia M
authors.initials: CM
authors.lastname: Cardoso
authors.affiliation: Unidade de Pesquisa Biomédica, Serviço de Patologia Clínica, Hospital de Clínicas de Porto Alegre (HCPA), Brazil.
authors.forename: Fernanda
authors.initials: F
authors.lastname: de Paris
authors.affiliation: Laboratório Central de Saúde Pública, Porto Alegre, Brazil.
authors.forename: Simone M M
authors.initials: SMM
authors.lastname: De David
authors.affiliation: Instituto de Microbiologia, Universidade Federal do Rio de Janeiro (UFRJ), Brazil.
authors.forename: Marlei G
authors.initials: MG
authors.lastname: da Silva
authors.affiliation: Instituto de Microbiologia, Universidade Federal do Rio de Janeiro (UFRJ), Brazil.
authors.forename: Rafael S
authors.initials: RS
authors.lastname: Duarte
authors.affiliation: Laboratório de Pesquisa em Resistência Bacteriana (LABRESIS), Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.|Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Afonso L
authors.initials: AL
authors.lastname: Barth
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D001938:Brazil / Q000453:epidemiology; D018834:Chaperonin 60 / Q000235:genetics; D012321:DNA-Directed RNA Polymerases / Q000235:genetics; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006801:Humans; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058889:Molecular Typing; D009161:Mycobacterium / Q000145:classification* / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology* / Q000382:microbiology; D012150:Polymorphism, Restriction Fragment Length; D017422:Sequence Analysis, DNA; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D018834:Chaperonin 60; C074119:heat-shock protein 65, Mycobacterium; D012321:DNA-Directed RNA Polymerases; C105078:RNA polymerase beta subunit