ABSTRACT
Múltiples infecciones oportunistas pueden manifestarse simultáneamente cuando la inmunosupresión es grave en pacientes infectados por el virus de la inmunodeficiencia humana. Se presenta un caso de coinfección de VIH, Bartonella spp y Mycobacterium kansasii, siendo escasos los reportes a la fecha de dicha asociación y aun más en pacientes que desconocen su condición de VIH
Multiple opportunistic infections can manifest simultaneously when immunosuppression is severe in patients infected with the human immunodeficiency virus. A case of co-infection with HIV, Bartonella spp and Mycobacterium kansasii is presented, with few reports to date of this association and even more so in patients who are unaware of their HIV status.
Subject(s)
Humans , Male , Adult , Bartonella Infections/diagnosis , HIV/immunology , MycobacteriumABSTRACT
Steroids are a class of medicines with important physiological and pharmacological effects. In pharmaceutical industry, steroidal intermediates are mainly prepared through Mycobacteria transformation, and then modified chemically or enzymatically into advanced steroidal compounds. Compared with the "diosgenin-dienolone" route, Mycobacteria transformation has the advantages of abundant raw materials, cost-effective, short reaction route, high yield and environmental friendliness. Based on genomics and metabolomics, the key enzymes in the phytosterol degradation pathway of Mycobacteria and their catalytic mechanisms are further revealed, which makes it possible for Mycobacteria to be used as chassis cells. This review summarizes the progress in the discovery of steroid-converting enzymes from different species, the modification of Mycobacteria genes and the overexpression of heterologous genes, and the optimization and modification of Mycobacteria as chassis cells.
Subject(s)
Mycobacterium/metabolism , Steroids/metabolism , Phytosterols/metabolism , GenomicsABSTRACT
La tuberculosis (TB) cutánea es una forma rara de tuberculosis extrapulmonar y puede tener diversas manifestaciones clínicas. La afectación cutánea puede producirse como resultado de inoculación exógena, diseminación contigua desde un foco de infección, o mediante la propagación hematógena desde un foco distante 1. Las formas multibacilares de localización cutánea siguen siendo, con mucho, las más comunes en los niños 2. La tuberculosis cutánea representa sólo el 1-2% de las formas extrapulmonares de TB. Se clasifica en varias variantes, y la escrofulodermia es una forma de tuberculosis endógena. Afecta a personas de todas las edades, sin embargo, los niños, los adolescentes y los ancianos se ven muy afectados, debido a la incapacidad inmunológica para contener la infección por micobacterias. La escrofulodermia puede presentarse de forma aislada o coexistir con formas pulmonares y diseminadas de TB. Se presenta como nódulos eritematosos que se fistulizan y descargan material caseoso y purulento 3. Los exámenes patológicos revelan abscesos, necrosis y granulomas de tipo tuberculoide (3). La correlación clínica, biológica, patológica y, a veces, la progresión con el tratamiento antibacilar son la clave del diagnóstico 2
Cutaneous tuberculosis (TB) is a rare form of extrapulmonary tuberculosis that can have diverse clinical manifestations. Cutaneous involvement may occur as a result of exogenous inoculation, contiguous dissemination from a focus of infection, or by hematogenous spread from a distant focus (1). Multibacillary forms of cutaneous localization remain by far the most common in children (2). Children and the elderly are greatly affected due to immunological inability to contain the mycobacterial infection. Scrofuloderma can occur in isolation or coexist with pulmonary and disseminated forms of TB. It presents with erythematous nodules that fistulize and discharge caseous and purulent material (3). Anatomopathological examinations reveal abscesses, necrosis and tuberculoid granulomas (3). Clinical, biological, pathological correlation and sometimes progression with antibacillary treatment are the key to diagnosis (2)
Subject(s)
Tuberculosis , Pediatrics , Tuberculosis, Cutaneous , Infections , MycobacteriumABSTRACT
Objective: The study aimed to evaluate molecular and immunological methods and to propose a workflow using them for tuberculosis (TB) diagnosis routine. Methods: A cross-sectional retrospective study was performed, including 121 liquid cultures from a TB laboratory located in the extreme south of Brazil. All cultures were positive for Mycobacterium tuberculosis complex (MTBC) by in-house Polymerase Chain Reaction (PCR) using DNA extracted by the CTAB method (PCR-CTAB) for IS6110 detection. These cultures were subjected to faster tests than this one, the immunological MPT64 assay and the PCR using DNA extracted by thermal lysis method (PCR-TL), and these were evaluated for MTBC identification using PCR-CTAB as a reference method. Results: The sensitivity of MPT64 assay and PCR-TL to identify MTBC in positive cultures by PCR-CTAB were 73.6% (89/121) and 98.3% (119/121), respectively. We proposed a workflow based on the use of MPT64 assay in liquid cultures suggestive of MTBC, and in case of a negative result, we suggest the performance of PCR-TL. The PCR-CTAB is suggested only if faster tests are negative. Conclusions: Methods capable of confirming MTBC in cultures should continue to be standardized, tested, and optimized to meet the ideal requirements of simplicity, quickness, and effectiveness. The molecular and immunological methods evaluated have differences in the execution and detection of MTBC in cultures, but they are rapid tools for laboratory TB diagnosi
Objetivos: O estudo objetivou avaliar métodos molecular e imunológico e propor um fluxo de trabalho utilizando-os para a rotina de diagnóstico da tuberculose (TB). Métodos: Foi realizado um estudo transversal retrospectivo, incluindo 121 culturas líquidas de um laboratório de TB localizado no extremo sul do Brasil. Todas as culturas foram positivas para o complexo Mycobacterium tuberculosis (CMTB) por Reação em Cadeia da Polimerase (PCR) in-house para detecção do IS6110, usando DNA extraído pelo método CTAB (PCR-CTAB). Essas culturas foram submetidas a testes mais rápidos que este, o ensaio imunológico MPT64 e a PCR com DNA extraído pelo método de lise térmica (PCR-LT), e estas foram avaliadas para identificação de CMTB usando PCR-CTAB como método de referência. Resultados: A sensibilidade do ensaio MPT64 e da PCR-LT para identificar o CMTB em culturas positivas pela PCRCTAB foi de 73,6% (89/121) e 98,3% (119/121), respectivamente. Propusemos um fluxo de trabalho baseado no uso do ensaio MPT64 em culturas líquidas sugestivas de CMTB e, em caso de resultado negativo, sugerimos a realização de PCR-LT. Sugere-se a PCR-CTAB apenas se os testes mais rápidos forem negativos. Conclusões: Os métodos capazes de confirmar o CMTB em culturas devem continuar sendo padronizados, testados e otimizados para atender aos requisitos ideais de simplicidade, rapidez e eficácia. Os métodos molecular e imunológico avaliados apresentam diferenças na execução e detecção do CMTB em culturas, mas são ferramentas rápidas para o diagnóstico laboratorial da TB.
Subject(s)
Mycobacterium tuberculosis , Tuberculosis , DNA , Polymerase Chain Reaction , Diagnostic Tests, Routine , Cetrimonium , MycobacteriumABSTRACT
En la Revista Colombiana de Neumología, número dos, volumen 34 del año 2022, está publicado el artículo original de los doctores Daniel Adolfo Suárez, Andrea Carolina Córdoba y Oscar Alberto Sáenz titulado "Factores de riesgo para complicaciones en pacientes con tuberculosis en una institución de tercer nivel de la ciudad de Bogotá". Es un estudio observacional retrospectivo de la cohorte de 130 pacientes con tuberculosis pulmonar diagnosticados entre los años 2017 y 2018, cuyo objetivo fue el de identificar posibles factores de riesgo asociados al desarrollo de complicaciones por la tuberculosis. Los autores presentan la revisión de la literatura con relación a las complicaciones de la tuberculosis. En general, las complicaciones de la tuberculosis se han dividido según el sitio anatómico comprometido, esto es, pulmonar o respiratorio, neurológico, cardiovascular, gastrointestinal u otros y han sido atribuidas al efecto patológico de la micobacteria o al efecto inflamatorio desencadenado por la respuesta inmune del huésped.
In the Colombian Journal of Pneumology, number two, volume 34 of the year 2022, the original article by doctors Daniel Adolfo Suárez, Andrea Carolina Córdoba and Oscar Alberto Sáenz entitled "Risk factors for complications in patients with tuberculosis in a hospital third level of the city of Bogotá". It is a retrospective observational study of the cohort of 130 patients with pulmonary tuberculosis diagnosed between 2017 and 2018, whose objective was to identify possible risk factors associated with the development of complications from tuberculosis. The authors present a review of the literature regarding the complications of tuberculosis. In general, the complications of tuberculosis have been divided according to the anatomical site involved, that is, pulmonary or respiratory, neurological, cardiovascular, gastrointestinal or others, and have been attributed to the pathological effect of the mycobacteria or to the inflammatory effect triggered by the immune response. of the host.
Subject(s)
Humans , Tuberculosis , Tuberculosis, Pulmonary , Pulmonary Medicine , Malnutrition , MycobacteriumABSTRACT
tuberculose é uma das doenças infectocontagiosas de maior importância no Brasil e no mundo. Afeta de forma importante populações em situação de vulnerabilidade social e econômica. O objetivo deste estudo foi realizar um levantamento do número de casos notificados de tuberculose no Brasil nos últimos 10 anos (2011 a 2021), avaliar os fatores que afetam a transmissão, bem como discutir o tratamento padrão e com fitoterápicos. O levantamento epidemiológico dos casos de tuberculose no Brasil de janeiro de 2011 a dezembro de 2021 foi realizado dentre os notificados pelo Sistema de Informação de Agravos de Notificação (SINAN). Os resultados indicaram um aumento linear de casos a partir de 2017 com 90.776 casos diagnosticados, em 2018 (94.720) e 2019 (96.655). Acredita-se que o aumento linear da tuberculose neste período pode estar relacionado principalmente com o aumento da pobreza, contudo o compartilhamento de utensílios durante o uso de narguilé podem representar fatores de risco para tuberculose. Seis plantas medicinais afetam diretamente as micobactérias (Chenopodium ambrosioides, Tetradenia riparia, Physalis angulata, Origanum vulgare, Eucalyptus globulus, Mikania glomerata) e cinco plantas com atividade antibacteriana auxiliam no trato respiratório (Nasturtium officinale, Allium sativum, Schinus terebinthifolius, Adiantum capillus-veneris, Allium cepa). Contudo, a tuberculose é uma doença reemergente sendo necessária a adoção de políticas públicas que intensifiquem e implementem medidas sócio-educativas para a implantação do uso de fitoterápicos como medida complementar.
Tuberculosis is one of the most important infectious diseases in Brazil and worldwide. It significantly affects populations in situations of social and economic vulnerability. This study aimed to survey the number of reported tuberculosis cases in Brazil in the last 10 years (2011 to 2021) to assess the factors that affect the transmission and discuss standard and herbal treatments. The epidemiological survey of tuberculosis cases in Brazil from January 2011 to December 2021 was carried out among those notified by the Notifiable Diseases Information System (SINAN). The results indicated a linear increase in cases from 2017, with 90,776 diagnosed cases, in 2018 (94,720) and 2019 (96,655). It is believed that the linear increase in tuberculosis in this period may be mainly related to the increase in poverty. However, the sharing of utensils during the use of hookah may represent risk factors for tuberculosis. Six medicinal plants directly affect mycobacteria (Chenopodium ambrosioides, Tetradenia riparia, Physalis angulata, Origanum vulgare, Eucalyptus globulus, Mikania glomerata), and five plants with antibacterial activity help in the respiratory tract (Nasturtium officinale, Allium sativum, Schinus terebinthifolius, Adiantum capillus-veneris, Allium cepa). However, tuberculosis is a re-emerging disease, and it is necessary to adopt public policies that intensify and implement socio-educational measures for using herbal medicines as a complementary measure.
La tuberculosis es una de las enfermedades infecciosas más importantes en Brasil y en el mundo. Afecta significativamente a las poblaciones en situación de vulnerabilidad social y económica. El objetivo de este estudio fue realizar una encuesta sobre el número de casos notificados de tuberculosis en Brasil en los últimos 10 años (2011 a 2021), para evaluar los factores que afectan a la transmisión, así como para discutir el tratamiento estándar y con fitoterapias. La encuesta epidemiológica de los casos de tuberculosis en Brasil desde enero de 2011 hasta diciembre de 2021 se realizó entre los notificados por el Sistema de Informação de Agravos de Notificação (SINAN). Los resultados indicaron un aumento lineal de casos desde 2017 con 90.776 casos diagnosticados, en 2018 (94.720) y 2019 (96.655). Se cree que el aumento lineal de la tuberculosis en este periodo puede estar relacionado principalmente con el aumento de la pobreza, aunque el hecho de compartir los utensilios durante el uso de la shisha puede representar factores de riesgo para la tuberculosis. Seis plantas medicinales afectan directamente a las micobacterias (Chenopodium ambrosioides, Tetradenia riparia, Physalis angulata, Origanum vulgare, Eucalyptus globulus, Mikania glomerata) y cinco plantas con actividad antibacteriana ayudan a las vías respiratorias (Nasturtium officinale, Allium sativum, Schinus terebinthifolius, Adiantum capillus-veneris, Allium cepa). Sin embargo, la tuberculosis es una enfermedad reemergente siendo necesaria la adopción de políticas públicas que intensifiquen e implementen medidas socioeducativas para la implementación del uso de fitoterápicos como medida complementaria.
Subject(s)
Tuberculosis/prevention & control , Tuberculosis/drug therapy , Tuberculosis/epidemiology , Epidemiology/statistics & numerical data , Communicable Diseases/drug therapy , Chenopodium ambrosioides , Phytotherapy , MycobacteriumABSTRACT
Abstract Erythema nodosum leprosum is a severe immune reaction that complicates the usual course of multibacillary leprosy. There is increased activation of T-cells in erythema nodosum leprosum. Treatment modalities available to date for the management are systemic steroids, thalidomide, methotrexate, cyclophosphamide, azathioprine, minocycline, and apremilast but none of them is promising and safe. Mycobacterium indicus pranii is an atypical mycobacterium possessing strong immunomodulatory properties. The vaccine for this mycobacterium has been shown to have both immunotherapeutic and immunoprophylactic effects in multibacillary leprosy patients. We report a case of chronic recalcitrant erythema nodosum Leprosum which responded to Mycobacterium indicus pranii vaccine without any adverse effects, thereby suggesting its role as a novel therapeutic option in this reaction.
Subject(s)
Humans , Vaccines , Leprosy, Lepromatous/drug therapy , Erythema Nodosum/drug therapy , Leprosy, Multibacillary , MycobacteriumABSTRACT
Por las particularidades de los hospitales, su entorno contiene un gran número de microorganismos proporcionando condiciones muy favorables para la reproducción y la propagación de microorganismos patógenos. Por otro lado, como un sitio importante del uso de antibióticos, las infecciones asociadas a hospitales y la resistencia a los antimicrobianos promueven mutuamente la formación de un círculo vicioso. Existen fuertes evidencias de que la transmisión por aire y aerosoles de los microorganismos patógenos están muy extendidos en los entornos hospitalarios. En ese sentido, las partículas transportadas por el aire se caracterizan por su baja densidad, invisibilidad y susceptibilidad a la turbulencia. El asentamiento de partículas infecciosas en el aire sobre la herida de un paciente puede causar infecciones en cirugía o en caso más graves, infectar a pacientes con sistemas inmunológicos comprometidos, o puede conducir, si las condiciones de ventilación no son apropiadas, a la diseminación de bacterias y hongos (bioaerosoles) desde pacientes infecciosos a toda la comunidad hospitalaria. Para mejorar el estado de estas infecciones asociadas a los hospitales, los sistemas tradicionales se han centrado en estrategias para eliminar patógenos presentes en pacientes, superficies clínicas y trabajadores de la salud, que ha impulsado la implementación de varios protocolos de control y desinfección de infecciones que también han tenido éxito en la reducción de la incidencia de este tipo de infecciones hospitalarias. Dentro de estos procedimientos, está el uso de sistema de ventilación con presión de aire positiva o negativa El objetivo de este trabajo es determinar la capacidad de control microbiano de los sistemas de ventilación en dos centros de asistencia médica del Perú en habitaciones con pacientes inmunosuprimidos (VIH/Sida) aislados o en habitaciones de pacientes infecciosos(AU)
Due to the particularities of hospitals, their environment contains a large number of microorganisms, providing very favorable conditions for the reproduction and spread of pathogenic microorganisms. On the other hand, as an important site of antibiotic use, hospital-associated infections and antimicrobial resistance mutually promote the formation of a vicious circle. There is strong evidence that airborne and aerosol transmission of pathogenic microorganisms is widespread in hospital settings. In that sense, airborne particles are characterized by their low density, invisibility, and susceptibility to turbulence. The settling of airborne infectious particles on a patient's wound can cause infections in surgery or, in more serious cases, infect patients with compromised immune systems, or can lead, if ventilation conditions are not appropriate, to the spread of pathogens. bacteria and fungi (bioaerosols) from infectious patients to the entire hospital community. To improve the status of these hospital-associated infections, traditional systems have focused on strategies to eliminate pathogens present in patients, clinical surfaces, and healthcare workers, which has prompted the implementation of various infection control and disinfection protocols that they have also been successful in reducing the incidence of this type of hospital infection. Within these procedures, there is the use of a ventilation system with positive or negative air pressure. The objective of this work is to determine the microbial control capacity of the ventilation systems in two medical care centers in Peru in rooms with immunosuppressed patients (HIV/AIDS) isolated or in infectious patient rooms(AU)
Subject(s)
Sterilization , Cross Infection , Anti-Bacterial Agents , Noxae , Ventilation , Disinfection , MycobacteriumABSTRACT
In recent years, two novel proteins in the ribosomes of mycobacteria have been discovered by cryo-electron microscopy. The protein bS22 is located near the decoding center of the 30S subunit, and the protein bL37 is located near the peptidyl transferase center of the 50S subunit. Since these two proteins bind to conserved regions of the ribosome targeted by antibiotics, it is speculated that they might affect the binding of related drugs to these targets. Therefore, we knocked out the genes encoding these two proteins in wild-type Mycolicibacterium smegmatis mc2155 through homologous recombination, and then determined the growth curves of these mutants and their sensitivity to related antibiotics. The results showed that compared with the wild-type strain, the growth rate of these two mutants did not change significantly. However, mutant ΔbS22 showed increased sensitivity to capreomycin, kanamycin, amikacin, streptomycin, gentamicin, paromomycin, and hygromycin B, while mutant ΔbL37 showed increased sensitivity to linezolid. These changes in antibiotics sensitivity were restored by gene complementation. This study hints at the possibility of using ribosomal proteins bS22 and bL37 as targets for drug design.
Subject(s)
Anti-Bacterial Agents/pharmacology , Cryoelectron Microscopy , Mycobacterium/genetics , Ribosomal Proteins/genetics , Ribosomes/metabolismABSTRACT
Introduction: tuberculosis is a bacteriosis caused by the etiological agent Mycobacterium tuberculosis, which initially affects the lungs, however it can become extrapulmonary. Although this infection is an important public health problem in Brazil, epidemiological studies on this disease are scarce. Objective: thus, the present study aimed to elucidate the epidemiological profile of people affected by tuberculosis in Campina Grande PB, between the years 2014 to 2018. Methodology: this is an epidemiological, retrospective, analytical and documentary study, in which data were collected from the Department of Informatics of the "Sistema Único de Saúde". Results: Between 2014 and 2018, 795 cases of tuberculosis were reported in Campina Grande-PB, with 2018 having the highest number of cases (24.6%). The epidemiological profile of those affected was predominantly male, aged 20 to 39 years, with low schooling, mixed race and residents of the urban area. When associating sex with immunosuppressive factors, a statistically significant association was observed between, HIV, the state of acquired immunodeficiency syndrome (AIDS) and alcoholism (p <0.05). Conclusion: in this way, the data of this research can guide the development of indicators and public policies for the most susceptible population.
Introdução: a tuberculose é uma bacteriose causada pelo agente etiológico Mycobacterium tuberculosis, que inicialmente acomete os pulmões, entretanto pode tornar-se extrapulmonar. Mesmo esta infecção tratando-se de um importante problema de saúde pública no Brasil, há grande escassez de estudos epidemiológicos referentes a essa doença. Objetivo: o presente estudo teve como objetivo elucidar o perfil epidemiológico de acometidos por tuberculose em Campina Grande, PB, entre os anos de 2014 a 2018. Metodologia: trata-se de um estudo epidemiológico, retrospectivo, analítico e documental, em que os dados foram coletados a partir do Departamento de Informática do Sistema Único de Saúde. Resultados: entre 2014 a 2018, foram notificados 795 casos de tuberculose em Campina Grande, PB, sendo que o ano de 2018 foi aquele com o maior número de casos 24,6%. O perfil epidemiológico de acometidos foi, predominantemente, de indivíduos do gênero masculino, com 20 a 39 anos de idade, baixa escolaridade, etnia parda e residentes da zona urbana. Ao associar o gênero com os fatores imunossupressores, observouse associação estatisticamente significativa entre VIH, estado de SIDA e alcoolismo (p<0,05). Conclusão: assim, os dados desta pesquisa podem nortear o desenvolvimento de indicadores e políticas públicas para a população mais susceptível.
Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Tuberculosis , Epidemiology , Mycobacterium , Ethnicity , Epidemiologic Studies , Laboratory and Fieldwork Analytical Methods , Retrospective Studies , Educational StatusABSTRACT
The diagnosis of bovine tuberculosis (TB) by molecular techniques has been broadly studied. These methods allow accelerating the diagnosis, in addition to presenting high specificity and sensitivity in the identification of the pathogen, critical characteristic for public health, especially when it comes to the direct diagnosis of the biologic samples, which has been little explored. This paper has evaluated a multiplex polymerase chain reaction (mPCR) as a tool to diagnose TB, which was performed directly on the granulomatous material of suspicious lesions collected in a cold chamber under state inspection in the state of Bahia, Brazil. Of the 74 samples evaluated, 14.86% were positive, with 10.81% positive for mPCR and culture, 4.05% negative for cultivation and positive for mPCR. The correlation between the cultivation and the mPCR presented agreeance higher than 61.54% of the cases. The results have indicated that the protocol proved itself effective, fast and very promising in the surveillance in slaughterhouses for the diagnosis of tuberculosis directly from the granuloma.(AU)
Subject(s)
Animals , Cattle , Tuberculosis, Bovine/diagnosis , Diagnosis , Multiplex Polymerase Chain Reaction , Mycobacterium , Abattoirs , Molecular Diagnostic Techniques , Granuloma , NoxaeABSTRACT
El lavado broncoalveolar (LBA) se describió hace aproximadamente 50 años, y desde ese momento se ha venido empleando cada vez con más frecuencia, llegando a ser uno de los métodos de elección para hacer el diagnóstico microbiológico de las infecciones respiratorias bajas, pues facilita la identificación de patógenos oportunistas y no oportunistas. Su uso se incrementó paralelamente con el número de pacientes inmunocomprometidos, sobre todo a causa del SIDA y los trasplantes, situaciones en las que con frecuencia los pacientes padecen infecciones pulmonares por gérmenes oportunistas. El LBA es un procedimiento seguro que permite obtener muestras que aportan información amplia de las características celulares y microbiológicas del tracto respiratorio inferior. Para garantizar su utilidad es fundamental que la recolección, transporte, almacenamiento y procesamiento de las muestras sean óptimos. El análisis de las muestras se hace por técnicas convencionales para identificación de microorganismos, como son las tinciones y el aislamiento en medios de cultivo, y por otros métodos tales como la inmunofluorescencia, pruebas inmunológicas para la detección de antígenos y anticuerpos, y pruebas de biología molecular. En la presente revisión, se hace una actualización sobre el procedimiento de obtención, almacenamiento y transporte de las muestras de LBA, así como de las técnicas de diagnóstico microbiológico más utilizadas para identificar los principales agentes infecciosos asociados con enfermedades del tracto respiratorio inferior
Bronchoalveolar lavage (BAL) was described approximately 50 years ago and since then it has been used with increasing frequency, becoming one of the methods of choice for making the microbiological diagnosis of lower respiratory infections, as it facilitates the identification of opportunistic and non-opportunistic pathogens. Its use increased in parallel with the number of immunocompromised patients, especially due to AIDS and transplantation, situations in which patients frequently suffer from lung infections due to opportunistic germs. BAL is a safe procedure that allows obtaining samples that provide comprehensive information on the cellular and microbiological characteristics of the lower respiratory tract. Optimal collection, transport, storage and processing of samples is essential to guarantee its usefulness. Analysis of the samples is done both by conventional techniques for the identification of microorganisms, such as staining and isolation in culture media, as well as by other methods such as immunofluorescence, immunological tests for the detection of antigens and antibodies, and molecular biology assays. In this review, an update in presented on the procedure for obtaining, storing and transporting BAL samples, as well as on the most widely used microbiological diagnostic techniques to identify the main infectious agents associated with lower respiratory tract diseases
Subject(s)
Humans , Bronchoalveolar Lavage , Respiratory Tract Infections , Staining and Labeling , Bacterial Infections and Mycoses , Diagnosis , MycobacteriumABSTRACT
Descrevem-se os aspectos clínicos, anatomopatológicos, imuno-histoquímicos, microbiológicos e moleculares de um caso de adenocarcinoma pulmonar associado à infecção por Mycobacterium sp. em uma vaca. O animal apresentou hiporexia, emagrecimento, vocalizações, postura ortopneica, ingurgitamento da jugular, estase venosa positiva, gemido expiratório e morte. Na necropsia, os pulmões estavam aumentados e apresentavam, na superfície pleural, nódulos branco-amarelados, firmes, multifocais a coalescentes, interpostos por áreas avermelhadas. Ao corte, os nódulos aprofundavam-se ao parênquima e possuíam múltiplos focos de aspecto caseoso e friável e áreas de mineralização. O saco pericárdico e os linfonodos traqueobrônquicos, ilíacos, lombares aórticos e mamários apresentavam lesões semelhantes. Histologicamente, observou-se neoformação carcinomatosa associada a áreas multifocais de necrose e mineralização. As células neoplásicas foram fortemente imunomarcadas pelo anticorpo antipancitoqueratina AE1/AE3. Na cultura microbiológica de fragmentos dos pulmões, houve crescimento de colônias bacterianas compatíveis com micobactérias atípicas. O sequenciamento molecular submetido ao BLASTn identificou o Mycobacterium sp. WCM 7299 (ID: gb|KJ873243.1|).(AU)
The clinical, anatomopathological, immunohistochemical, microbiological and molecular aspects of a case of pulmonary adenocarcinoma associated with infection by Mycobacterium sp. in a cow are described. The animal presented hyporexia, weight loss, vocalizations, orthopneic posture, jugular engorgement, positive venous stasis, expiratory groaning and death. At necropsy, the lungs were enlarged and presented firm, multifocal to coalescent yellowish nodules, interposed by reddish areas on the pleural surface. At cut, the nodules deepened to the parenchyma and had multiple foci of caseous and friable appearance and areas of mineralization. The pericardial sac and tracheobronchial, iliac, aortic lumbar and mammary lymph nodes showed similar lesions. Histologically, a carcinomatous neoformation, associated with multifocal areas of necrosis and mineralization, was observed. Neoplastic cells were strongly immunolabelled by anti-PanCytokeratin antibody AE1/AE3. Microbiological culture of lung fragments showed growth of bacterial colonies compatible with atypical mycobacteria. Molecular sequencing submitted to BLASTn identified the Mycobacterium sp. WCM 7299 (ID: gb|KJ873243.1|).(AU)
Subject(s)
Animals , Female , Cattle , Adenocarcinoma of Lung/veterinary , Mycobacterium/isolation & purification , Immunohistochemistry/veterinary , Lung Neoplasms/veterinaryABSTRACT
Background and Objectives: Knowledge about species diversity of non-tuberculous mycobacteria (NTM) and the frequency of tuberculosis (TB) is an important issue in rural-urban regions such as Piauí (northeast of Brazil), of low incidence rate of TB , can help to improve diagnosis and prevention strategies. The aim of this study is to examine some epidemiological aspects and the frequency of Mycobacterium tuberculosis (Mtb) and NTM isolated at the central public health reference laboratory, Dr. Costa Alvarenga, Piauí (LACEN-PI). Methods: Data records of all mycobacterosis and tuberculosis cases from January 2014 to March 2015 were analyzed. Results : Of the 20% (142/706) positive growths, 70% (99) were Mtb and 10% NTM. The remainde was of inadequate clinical samples, not allowing the identification of even the suspected NTM. The most frequent clinical form was pulmonary with TB patients younger than those infected with NTM (p = 0.001), the majority living in Teresina (52%). NTMs identified were M. abscessus (36%), M. avium, M. intracellulare, Mycobacterium sp. (14% each) and M. asiaticum, M. szulgai, M. kansasii 7% (each). Mtb drug resistance (7.8%) and TB co-infection with the human immunodeficiency virus (HIV-TB) found to be high (49%, 19/39). Conclusion: The frequencies of Mtb infection, drug resistance and HIV-TB co-infection are still underestimated and failures in the identification of NTM may decrease the actual frequency of these infections. Therefore, there is a need for improvements in TB control and in the diagnosis of NTMs in Piauí.(AU)
Justificativa e Objetivos: O conhecimento da diversidade de espécies de micobactérias não tuberculosas (MNT ) e a frequência da tuberculose (TB) é uma questão importante em regiões rurais-urbanas como o Piauí (nordeste do Brasil), com baixa incidência de TB, pode ajudar a melhorar o diagnóstico e estratégias de prevenção. O objetivo deste estudo é examinar alguns aspectos epidemiológicos e a frequência de Mycobacterium tuberculosis (Mtb) e MNT isolados, no Laboratório Central de Referência em Saúde Pública, Dr. Costa Alvarenga, Piauí (LACEN-PI). Métodos: Dados de todo s os casos de micobacterioses e tuberculose de janeiro de 2014 a março de 2015 foram analisados. Resultados: Dos 20% (142/706), de amostras com crescimento positivo 70% (99) foram Mtb e 10% MNT . O restante era de amostras clínicas inadequadas, não permitindo a identificação inclusive de MNT suspeitos. A forma clínica mais frequente foi pulmonar com pacientes TB mais jovens do que os infectados com MNT (p = 0,001), a maioria morando em Teresina (52%). As MNT s identificadas foram M. abscessus (36%), M. avium , M. intracellulare , M. sp. (14%, cada) e M. asiaticum, M. szulgai , M. kansasii 7% (cada). A droga resistência de Mtb (7,8%) e a co-infecção TB e vírus da imunodeficiência humana (HIV-TB) mostraram-se altas (49%, 19/39).Conclusão: As frequências de infecção por Mtb, de resistência a medicamentos e co-infecção HIV-TB ainda são subestimadas e as falhas na identificação de MNT podem diminuir a real frequência destas infecções . Portanto, há necessidade de melhorias no controle da TB e no diagnóstico de MNT s no Piauí.(AU)
Justificacion y objetivos: Conocer la diversidad de especies de micobacterias no tuberculosas (MNT) y la frecuencia de tuberculosis (TB) es tema importante en regiones rurales-urbanas como Piauí (noreste de Brasil) con baja tasa de incidencia de TB, y puede ayudar a mejorar el diagnóstico y las estrategias de prevenció. El objetivo de este estudio es examinar algunos aspectos epidemiológicos y la frecuencia de Mycobacterium tuberculosis (Mtb) y MNT aislado, en el laboratorio central de referencia de salud pública, Dr. Costa Alvarenga, Piauí (LACEN-PI). Métodos: Se analizaron los datos de todos los casos de micobacteriosis de enero de 2014 a marzo de 2015. Resultados: Del 20% (142/706), de las muestras con crecimiento positivo el 70% (99) fueron Mtb y el 10% MNT. El resto fue de muestras clínicas inadecuadas, no permitiendo la identificación de MNT incluso sospechosas. La forma clínica más frecuente fue la pulmonar y los pacientes con TB eran más jóvenes que los infectados con MNT (p = 0.001), la mayoría viviendo en Teresina (52%).Los MNT identificados fueron M.abscessus (36%), M.avium, M.intracellulare, Mycobacterium sp. (14% cada) y M.asiaticum, M.szulgai, M.kansasii 7% (cada ). La resistencia a los medicamentos de Mtb (7,8%) y la coinfección de TB y el virus de la inmunodeficiencia humana (VIH-TB) fueron altas (49%, 19/39 )Conclusión: Las frecuencias aún subestimadas de resistencia a los medicamentos, coinfección por VIH-TB y fallas de identificaciónidentificación de MNT pueden disminuir la frecuencia real de estas infecciones. Consecuentemente, es necesario mejorar el control y diagnóstico de TB y MNT en Piauí.(AU)
Subject(s)
Humans , Epidemiology , Mycobacterium , Nontuberculous Mycobacteria , Mycobacterium tuberculosis , Drug Resistance , AIDS Serodiagnosis , Health Services ResearchABSTRACT
Abstract The incidence of nontuberculous mycobacterial infections is increasing worldwide; by 2017, more than 190 species and subspecies have been documented. Although classically associated with immunosuppression, the recognition of these etiological agents in diseases affecting immunocompetent individuals and in healthcare-associated infections, such as after surgical and cosmetic procedures, makes the study of the epidemiology and pathogenesis of these microorganisms relevant in medical practice. Mycobacterium lentiflavum is slow-growing and rarely affects the skin. A case of cutaneous mycobacteriosis caused by M. lentiflavum is reported in an immunocompetent patient after subcutaneous injection of a lipolytic compound, treated with clarithromycin and levofloxacin.
Subject(s)
Humans , Bacterial Infections , Mycobacterium , Mycobacterium Infections, Nontuberculous , Injections, Subcutaneous , Anti-Bacterial Agents , Nontuberculous MycobacteriaABSTRACT
En 2015, la tasa global de incidencia de tuberculosis por 100,000 habitantes fue 43 en Honduras y 29 en el Municipio del Distrito Central. Objetivo: Caracterizar clínica y epidemiológicamente los casos de tuberculosis infantil, Región Sanitaria Metropolitana del Distrito Central (RSMDC), 2016. Métodos: Estudio descriptivo transversal. Se revisaron las Fichas de Notificación de Casos de Tuberculosis en pacientes menor o igual a18 años, registrados durante 2016. Se analizaron variables sociodemográficas y clínicas. Se diseñó una base de datos en EpiInfo 7.2.1. Se obtuvo autorización institucional. La información personal de los casos se manejó confidencialmente. Resultados: Del total de 400 fichas registradas, 13 (3.2%) contenían información completa. La caracterización se realizó a partir de estos 13 casos, 53.8% eran niñas, 46.2% entre 15 y 18 años. En 67% el diagnóstico fue clínico, 27% tenía tuberculosis pulmonar y 16.7% extrapulmonar. El método de diagnóstico más utilizado fue baciloscopía (38.5%). Todosrecibieron tratamiento básico primario, sin comorbilidades, no vivían en condición de riesgo o pertenecían a grupo de riesgo; no presentaron recaídas ni co-infección VIH. Discusión: El sistema de notificación de casos en RSMDC denota un déficit extraordinario e inaceptable en el registro de la información. Aunque la caracterización realizada puede estar sesgada por el número reducido de casos, sus características son similares a lo descrito para la tuberculosis infantil. Es imperativo fortalecer la vigilancia epidemiológica de la tuberculosis en Honduras con énfasis en la tuberculosis infantil y la detección y tratamiento de los contactos...(AU)
Subject(s)
Humans , Child , Adolescent , Tuberculosis/epidemiology , Mycobacterium , Tuberculosis, Lymph Node/complications , Tuberculosis, PulmonaryABSTRACT
Resumen Introducción: Las enfermedades producidas por micobacterias son de gran importancia clínica y epidemiológica presentando el complejo Mycobacterium tuberculosis (MTBc) una morbi-mortalidad mayor que la producida por micobacterias no tuberculosas (MNTB). La identificación tradicional está basada en sus características fenotípicas mediante procesos laboriosos e incapaces en algunos casos de distinguir entre especies. Actualmente, la mayoría de las técnicas utilizadas se basan en métodos moleculares que tienen alta veracidad, pero son complejas y de alto costo. La espectrometría de masas con desorción/ionización láser asistida por una matriz asociada a tiempo de vuelo (MALDI-TOF MS) se basa en la comparación del espectro proteico producido con respecto al de una base de datos de referencia. Objetivo: Evaluar el rendimiento de MALDI-TOF MS en la identificación de micobacterias comparado con métodos moleculares: Material y Métodos: Se analizaron 28 aislados de nueve especies distintas mediante MALDI-TOF MS. Resultados: Se identificó correctamente 78,5% de las aislados (22/28), concordante en 100% (9/9) de MNTB de crecimiento rápido, 60% (9/15) en las MNTB de crecimiento lento y 100% (4/4) de MTBc. Todas las especies no identificadas (6/6) pertenecen al complejo M. avium/intracellulare. Conclusión: MALDI-TOD MS es una metodología rápida, fácil y de bajo costo, con adecuada veracidad respecto a los métodos moleculares.
Abstract Background: Mycobacterial diseases are very important both clinically and epidemiologically. Mycobacterium tuberculosis complex (MTBc) infections confer higher morbidity and mortality rate than non-tuberculous mycobacteria (NTM) infections. Traditional species identification techniques are based on phenotypic characteristics which take a long time by laborious processes and in occasions are no conclusive. Currently, most used techniques are based on molecular methods, which are accurate but are expensive and complex. Matrix Assisted Laser Desorption/Ionization Time-of-Flight mass spectrometry (MALDI-TOF MS) is a simple, cheap and fast identification method based on comparing protein spectra with a reference database. Aim: To assess the performance of MALDI-TOF MS in the identification of MTBc and NTM, compared with molecular methods. Methods: For that purpose, 28 isolates of 9 different species were analyzed through MALDI-TOF MS. Results: 78.5% (22/28) of isolates were correctly identified, 100% (9/9) of rapidly growers NTM, 60% (9/15) of slow growing NTM and 100% (4/4) of MTBc. Every unidentified isolate (6/6) corresponded to M. avium/intracellulare complex. Conclusion: MALDI-TOF MS is fast, simple and cheaper than molecular methods and also has adequate accuracy.
Subject(s)
Humans , Mycobacterium , Tuberculosis , Spectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationABSTRACT
El aumento de las infecciones por micobacterias ambientales u oportunistas (MAO) coincide mundialmente con el declive de la infección tuberculosa e incremento de la infección por el virus de inmunodeficiencia humana (VIH). El presente trabajo es un estudio retrospectivo realizado en el Laboratorio Nacional de Referencia-Investigaciones de Tuberculosis/Micobacterias/Lepra (LNRI-TB/Lepra/Micobacterias), del Instituto de Medicina Tropical Pedro Kourí (IPK), La Habana, Cuba, durante el período enero 2014-diciembre 2018. El objetivo de nuestro estudio fue conocer la variabilidad de especies aisladas para establecer un referente actualizado sobre las infecciones causadas por estas. En este trabajo se clasificaron-identificaron 413 cepas procedentes de pacientes sintomáticos; 162 (39.22%) eran aislamientos de pacientes con VIH/sida atendidos en nuestro Hospital Nacional de Referencia a Atención al paciente VIH/sida (IPK), y el resto (n = 251 [60.77%]), procedentes de pacientes inmunocompetentes, incluyendo aislamientos recibidos de los Centros Provinciales de Higiene, Epidemiología, y Microbiología (CPHEM). Las muestras fueron analizadas con las técnicas convencionales establecidas: las pulmonares fueron descontaminadas por el método de Petroff modificado; las extrapulmonares, por el método del ácido sulfúrico al 4%; el cultivo se realizó en medio de Löwenstein-Jensen modificado. Posteriormente se realizó la clasificación-identificación de especies según el esquema fenotípico-bioquímico establecido. Las especies con mayor porcentaje de aislamiento pertenecieron a los Grupos III y IV, complejo Mycobacterium avium-intracellulare (34.14%) y complejo M. fortuitum (20.82%), respectivamente. Estos resultados permitirán conocer la prevalencia de estas especies en nuestro país, reafirmando la importancia diagnóstica de estos microorganismos para aplicar tratamiento específico, sobre todo en pacientes con factores de riesgo, en quienes es más probable la diseminación de la infección.
The increase in infections by environmental or opportunistic mycobacteria (MAO) coincides worldwide with the decline in tuberculosis infection and an increase in infection by the human immunodeficiency virus (HIV). The present work is a retrospective study carried out at the National Reference Laboratory-Tuberculosis/Mycobacterial/Leprosy Research (LNRI-TB / Leprosy / Mycobacteria), of the Pedro Kourí Institute of Tropical Medicine (IPK), La Habana, Cuba, during the period January 2014-December 2018. The objective of our study was to know the variability of isolated species to establish an updated reference on the infections caused by MAO. In this study, 413 strains from symptomatic patients were classified and identified; 162 (39.22%) were isolates from patients with HIV/AIDS treated at our National Hospital of Reference for Attention to HIV/AIDS patients (IPK), and the remaining (n=251 [60.77%]), from immunocompetent patients, including isolates received from the Provincial Centers of Hygiene, Epidemiology, and Microbiology (CPHEM). The samples were analyzed with the established conventional techniques: the lung samples were decontaminated by the modified Petroff method; the extrapulmonary, by the 4% sulfuric acid method; the culture was carried out in modified Löwenstein-Jensen medium. Subsequently, the classification-identification of species was carried out according to the established phenotypic-biochemical scheme. The species with the highest percentage of isolation belonged to Groups III and IV, Mycobacterium avium-intracellulare complex (34.14%), and M. fortuitum complex (20.82%), respectively. These results will allow us to know the prevalence of these species in our country, emphasizing the diagnostic importance of these microorganisms and thus apply a specific treatment, especially in patients with risk factors, in whom the spread of the infection is more likely