Insertion sequences disrupting mgrB in carbapenem-resistant Klebsiella pneumoniae strains in Brazil.

OBJECTIVES: This study aimed to characterise insertional mutations disturbing themgrB gene in carbapenem-resistant Klebsiella pneumoniae (CRKp). METHODS: A total of 118 clinical CRKp isolates were surveyed for polymyxin resistance and insertion sequence (IS) elements disruptingmgrB. RESULTS: Of the 118 isolates, 78 (66.1%) displayed polymyxin resistance, of which 54% (42/78) hadmgrB::IS inserts. Sequencing analyses showed 13 insertion sites in mgrB. mgrB::ISSen4(IS3) was observed for the first time in CRKp. CONCLUSIONS: Ten different IS elements disruptedmgrB, with a predominance (76%) of IS5 sequences.

Identificação laboratorial de micobactérias em amostras respiratórias de pacientes com suspeita de tuberculose pulmonar no Laboratório Central de Saúde Pública do Distrito Federal (LACEN-DF) / Laboratory identification of mycobacteria from respiratory samples of patients with suspected pulmonary tuberculosis in samples isolated at the Central Laboratory of Public Health of the Federal District (LACEN-DF)

Introdução: O diagnóstico rápido e preciso da tuberculose (TB) e o início precoce do tratamento são fatores de grande importância para reduzir e minimizar o risco de contágio pelo Mycobacterium tuberculosis. Nesse contexto, as principais metodologias empregadas no Brasil para o diagnóstico da TB são os testes de baciloscopia e de cultura. Objetivo: O presente estudo tem como objetivo descrever os resultados de três técnicas laboratoriais para o diagnóstico da TB pulmonar. Métodos: Foram analisados dados de baciloscopias e culturas de 10.418 prontuários de pacientes de ambos os sexos, diferentes idades e locais de residência, no período de janeiro de 2011 a junho de 2014. Resultados: Foram analisados os prontuários de 284 pacientes com resultado positivo para o Complexo Mycobacterium Tuberculosis (CMTB). Dos 284 pacientes positivos para o CMTB, 210 apresentaram BAAR positivos (73,9%) e 74 negativos (26,1%). Nos cultivos em meio LJ, 255 amostras foram positivas (89,7%) e 29 negativas (10,3%), enquanto no meio de cultivo líquido Bactec MGIT® a positividade foi de 276 (97,1%) e 8 negativas (2,9 %). Conclusões: Observou-se que a identificação de BAAR em exame direto continua a ser de suma importância no diagnóstico precoce da TB. Os métodos de cultura, principalmente o sistema Bactec-MGIT®, mostraram neste estudo um incremento de 23,2% no diagnóstico da TB pulmonar. (AU)

Introduction: The rapid and accurate diagnosis of tuberculosis (TB) and early treatment are very important factors to reduce and minimize the risk of infection by Mycobacterium tuberculosis. In this context the main methodologies used in Brazil for the diagnosis of TB are smear tests and culture. Objective: This study aimed to describe the results of three laboratory techniques for the diagnosis of pulmonary TB. Methods: Sputum smear and culture data from 10,418 records of patients of both sexes, different ages and places of residence, from January 2011 to June 2014 were analyzed. Results: We analyzed the results of 284 patients with positive report for Mycobacterium tuberculosis Complex (CMTB). Of the 284 positive patients, 210 were positive AFB (73.9%) and 74 were negative (26.1%). In the culture medium LJ, 255 samples were positive (89.7%) and 29 negative (10.3%), while in the liquid Bactec MGIT® cultivation, 276 were positive (97.1%) and 8 were negative (2.9%). Conclusions: It was observed that the identification of acid-fast bacilli on direct examination continues to be of paramount importance in the early diagnosis of TB. The methods of culture, especially the Bactec-MGIT® system, showed in this study an increase of 23.2% in the diagnosis of pulmonary TB. (AU)