This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Google Scholar Articles by Duarte, R. S. Articles by Sampaio, J. L. M. PubMed PubMed Citation Articles by Duarte, R. S. Articles by Sampaio, J. L. M.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, July 2009, p. 2149-2155, Vol. 47, No. 7
0095-1137/09/$08.00+0     doi:10.1128/JCM.00027-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Epidemic of Postsurgical Infections Caused by Mycobacterium massiliense

Rafael Silva Duarte,^1* Maria Cristina Silva Lourenço,² Leila de Souza Fonseca,¹ Sylvia Cardoso Leão,³ Efigenia de Lourdes T. Amorim,⁴ Ingrid L. L. Rocha,⁴ Fabrice Santana Coelho,⁵ Cristina Viana-Niero,³ Karen Machado Gomes,¹ Marlei Gomes da Silva,¹ Nádia Suely de Oliveira Lorena,⁶ Marcos Bettini Pitombo,⁶ Rosa M. C. Ferreira,² Márcio Henrique de Oliveira Garcia,⁷ Gisele Pinto de Oliveira,⁸ Otilia Lupi,⁹ Bruno Rios Vilaça,¹ Lúcia Rodrigues Serradas,¹⁰ Alberto Chebabo,¹¹ Elizabeth Andrade Marques,⁶ Lúcia Martins Teixeira,¹ Margareth Dalcolmo,¹² Simone Gonçalves Senna,¹ and Jorge Luiz Mello Sampaio¹³

Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil,¹ Instituto de Pesquisa Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil,² Departamento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, Brazil,³ Sérgio Franco Medicina Diagnóstica, Rio de Janeiro, Brazil,⁴ Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil,⁵ Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil,⁶ Secretaria de Vigilância em Saúde do Ministério da Saúde, Brasília, Brazil,⁷ Instituto de Estudos de Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil,⁸ Secretaria Municipal de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil,⁹ Hospital de Clínicas Riomar, Rio de Janeiro, Brazi1,¹⁰ Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazi1,¹¹ Centro de Referência Professor Hélio Fraga, Rio de Janeiro, Brazil,¹² Instituto Fleury de Ensino e Pesquisa, São Paulo, Brazil,¹³

Received 6 January 2009/ Returned for modification 19 February 2009/ Accepted 4 April 2009

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 µg/ml) and clarithromycin (MIC₉₀, 0.25 µg/ml) but resistance to ciprofloxacin (MIC₉₀, 32 µg/ml), cefoxitin (MIC₉₀, 128 µg/ml), and doxycycline (MIC₉₀, 64 µg/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.

---

* Corresponding author. Mailing address: Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, CCS, Bloco I, Cidade Universitária, Rio de Janeiro, RJ 21941-590, Brazil. Phone: 55 21 2560-8344, ext. 134. Fax: 55 21 2560-8344, ext. 108. E-mail: rsduarte{at}ufrj.br

Published ahead of print on 29 April 2009.

---

Journal of Clinical Microbiology, July 2009, p. 2149-2155, Vol. 47, No. 7
0095-1137/09/$08.00+0     doi:10.1128/JCM.00027-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

This article has been cited by other articles:

• Jeon, K., Kwon, O J., Lee, N. Y., Kim, B.-J., Kook, Y.-H., Lee, S.-H., Park, Y. K., Kim, C. K., Koh, W.-J. (2009). Antibiotic Treatment of Mycobacterium abscessus Lung Disease: A Retrospective Analysis of 65 Patients. Am. J. Respir. Crit. Care Med. 180: 896-902 [Abstract] [Full Text]  
• Svetlikova, Z., Skovierova, H., Niederweis, M., Gaillard, J.-L., McDonnell, G., Jackson, M. (2009). Role of Porins in the Susceptibility of Mycobacterium smegmatis and Mycobacterium chelonae to Aldehyde-Based Disinfectants and Drugs. Antimicrob. Agents Chemother. 53: 4015-4018 [Abstract] [Full Text]  
• Leao, S. C., Tortoli, E., Viana-Niero, C., Ueki, S. Y. M., Lima, K. V. B., Lopes, M. L., Yubero, J., Menendez, M. C., Garcia, M. J. (2009). Characterization of Mycobacteria from a Major Brazilian Outbreak Suggests that Revision of the Taxonomic Status of Members of the Mycobacterium chelonae-M. abscessus Group Is Needed. J. Clin. Microbiol. 47: 2691-2698 [Abstract] [Full Text]