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1.
Emerg Infect Dis ; 23(11): 1919-1922, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-29048290

RESUMO

Nontuberculous mycobacteria are human pathogens with increasing incidence and prevalence worldwide. Mycobacterium shimoidei is a rare cause of pulmonary disease, with only 15 cases previously reported. This series documents an additional 23 cases of M. shimoidei from Queensland, Australia, and highlights the pathogenicity and clinical role of this species.


Assuntos
Pneumopatias/microbiologia , Infecções por Mycobacterium não Tuberculosas/microbiologia , Micobactérias não Tuberculosas/isolamento & purificação , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Pneumopatias/tratamento farmacológico , Pneumopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Queensland/epidemiologia
2.
Emerg Infect Dis ; 20(10): 1612-9, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25279450

RESUMO

Laparoscopic gastric banding is a common bariatric procedure worldwide. Rapidly growing mycobacteria are environmental organisms increasingly seen as pathogens,often in infected prosthetic material. We report 18 cases of infection associated with laparoscopic gastric banding caused by Mycobacterium fortuitum and M. abscessus in Australia during 2005­2011. We identified cases by reviewing positive cultures at the Queensland state reference laboratory or through correspondence with clinicians, and we obtained clinical and epidemiologic data. Eleven cases of M. fortuitum and 7 cases of M. abscessus infection were identified. The port was thought to be the primary site of infection in 10 of these cases. Complications included peritonitis,band erosion, and chronic ulceration at the port site.Rapidly growing mycobacteria can infect both port and band and can occur as either an early perioperative or late infection.Combination antimicrobial therapy is used on the basis of in vitro susceptibilities. Device removal seems to be vital to successful therapy.


Assuntos
Cirurgia Bariátrica/efeitos adversos , Laparoscopia/efeitos adversos , Infecções por Mycobacterium/etiologia , Mycobacterium/classificação , Adulto , Austrália/epidemiologia , Cirurgia Bariátrica/métodos , Feminino , Humanos , Laparoscopia/métodos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium/epidemiologia , Infecções por Mycobacterium/microbiologia
3.
BMC Microbiol ; 14: 307, 2014 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-25476850

RESUMO

BACKGROUND: Papua New Guinea (PNG) is a high tuberculosis (TB) burden country of the WHO Western Pacific Region, but so far research on drug resistance (DR) and genotypes of Mycobacterium tuberculosis (M. tuberculosis) was only conducted in few provinces in the country. The aim of the present study was to obtain baseline data on the level of drug resistance and the genotypic diversity of circulating M. tuberculosis in additional provinces and to investigate the differences between three selected sites across PNG. RESULTS: Genotyping of 147 M. tuberculosis clinical isolates collected in Goroka, Eastern Highlands Province, in Alotau, Milne Bay Province and in Madang, Madang Province revealed three main lineages of M. tuberculosis: Lineage 4 (European-American lineage), Lineage 2 (East-Asian lineage) and Lineage 1 (Indo-Oceanic lineage). All three lineages were detected in all three sites, but the individual lineage compositions varied significantly between sites. In Madang Lineage 4 was the most prevalent lineage (76.6%), whereas in Goroka and Alotau Lineage 2 was dominating (60.5% and 84.4%, respectively) (p < 0.001). Overall, phenotypic drug susceptibility testing showed 10.8% resistance to at least one of the first-line drugs tested. Of all resistant strains (23/212) 30.4% were Streptomycin mono-resistant, 17.4% were Isoniazid mono-resistant and 13% were Rifampicin mono-resistant. Multi-drug resistant (MDR) TB was found in 2.8% of all tested cases (6/212). The highest amount of MDR TB was found in Alotau in Milne Bay Province (4.6%). CONCLUSION: A large number of drug resistant TB infections are present in the country and MDR TB has already been detected in all three surveyed regions of PNG, highlighting the importance of monitoring drug resistance and making it a high priority for the National Control Program. Due to the high prevalence of Lineage 2 in Milne Bay Province and given the frequent association of this lineage with drug resistance, monitoring of the latter should especially be scaled up in that province.


Assuntos
Farmacorresistência Bacteriana , Variação Genética , Mycobacterium tuberculosis/classificação , Mycobacterium tuberculosis/efeitos dos fármacos , Tuberculose/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antituberculosos/farmacologia , Feminino , Genótipo , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Tipagem Molecular , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/isolamento & purificação , Papua Nova Guiné/epidemiologia , Tuberculose/epidemiologia , Adulto Jovem
4.
BMC Infect Dis ; 14: 93, 2014 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-24555577

RESUMO

BACKGROUND: The incidence and characteristics of tuberculosis (TB) in remote areas of Papua New Guinea (PNG) are largely unknown. The purpose of our study was to determine the incidence of TB in the Gulf Province of PNG and describe disease characteristics, co-morbidities and drug resistance profiles that could impact on disease outcomes and transmission. METHODS: Between March 2012 and June 2012, we prospectively collected data on 274 patients presenting to Kikori Hospital with a presumptive diagnosis of TB, and on hospital inpatients receiving TB treatment during the study period. Sputum was collected for microscopy, GeneXpert analysis, culture and genotyping of isolates. RESULTS: We estimate the incidence of TB in Kikori to be 1290 per 100,000 people (95% CI 1140 to 1460) in 2012. The proportion of TB patients co-infected with HIV was 1.9%. Three of 32 TB cases tested were rifampicin resistant. Typing of nine isolates demonstrated allelic diversity and most were related to Beijing strains. CONCLUSIONS: The incidence of TB in Kikori is one of the highest in the world and it is not driven by HIV co-infection. The high incidence and the presence of rifampicin resistant warrant urgent attention to mitigate substantial morbidity in the region.


Assuntos
Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia , Tuberculose/microbiologia , Adolescente , Adulto , Alelos , Antituberculosos/uso terapêutico , Criança , Pré-Escolar , Coinfecção , Feminino , Genótipo , Infecções por HIV/complicações , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Papua Nova Guiné/epidemiologia , Estudos Prospectivos , Rifampina/uso terapêutico , Fatores de Risco , Escarro , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Adulto Jovem
5.
J Clin Microbiol ; 51(9): 3006-11, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23843489

RESUMO

It has been postulated that susceptible individuals may acquire infection with nontuberculous mycobacteria (NTM) from water and aerosol exposure. This study examined household water and shower aerosols of patients with NTM pulmonary disease. The mycobacteria isolated from clinical samples from 20 patients included M. avium (5 patients), M. intracellulare (12 patients), M. abscessus (7 patients), M. gordonae (1 patient), M. lentiflavum (1 patient), M. fortuitum (1 patient), M. peregrinum (1 patient), M. chelonae (1 patient), M. triplex (1 patient), and M. kansasii (1 patient). One-liter water samples and swabs were collected from all taps, and swimming pools or rainwater tanks. Shower aerosols were sampled using Andersen six-stage cascade impactors. For a subgroup of patients, real-time PCR was performed and high-resolution melt profiles were compared to those of ATCC control strains. Pathogenic mycobacteria were isolated from 19 homes. Species identified in the home matched that found in the patient in seven (35%) cases: M. abscessus (3 cases), M. avium (1 case), M. gordonae (1 case), M. lentiflavum (1 case), and M. kansasii (1 case). In an additional patient with M. abscessus infection, this species was isolated from potable water supplying her home. NTM grown from aerosols included M. abscessus (3 homes), M. gordonae (2 homes), M. kansasii (1 home), M. fortuitum complex (4 homes), M. mucogenicum (1 home), and M. wolinskyi (1 home). NTM causing human disease can be isolated from household water and aerosols. The evidence appears strongest for M. avium, M. kansasii, M. lentiflavum, and M. abscessus. Despite a predominance of disease due to M. intracellulare, we found no evidence for acquisition of infection from household water for this species.


Assuntos
Infecções por Mycobacterium não Tuberculosas/microbiologia , Micobactérias não Tuberculosas/isolamento & purificação , Pneumonia Bacteriana/microbiologia , Microbiologia da Água , Aerossóis , Características da Família , Humanos , Micobactérias não Tuberculosas/classificação
6.
BMC Microbiol ; 13: 89, 2013 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-23601969

RESUMO

BACKGROUND: Nontuberculous mycobacteria (NTM) are normal inhabitants of a variety of environmental reservoirs including natural and municipal water. The aim of this study was to document the variety of species of NTM in potable water in Brisbane, QLD, with a specific interest in the main pathogens responsible for disease in this region and to explore factors associated with the isolation of NTM. One-litre water samples were collected from 189 routine collection sites in summer and 195 sites in winter. Samples were split, with half decontaminated with CPC 0.005%, then concentrated by filtration and cultured on 7H11 plates in MGIT tubes (winter only). RESULTS: Mycobacteria were grown from 40.21% sites in Summer (76/189) and 82.05% sites in winter (160/195). The winter samples yielded the greatest number and variety of mycobacteria as there was a high degree of subculture overgrowth and contamination in summer. Of those samples that did yield mycobacteria in summer, the variety of species differed from those isolated in winter. The inclusion of liquid media increased the yield for some species of NTM. Species that have been documented to cause disease in humans residing in Brisbane that were also found in water include M. gordonae, M. kansasii, M. abscessus, M. chelonae, M. fortuitum complex, M. intracellulare, M. avium complex, M. flavescens, M. interjectum, M. lentiflavum, M. mucogenicum, M. simiae, M. szulgai, M. terrae. M. kansasii was frequently isolated, but M. avium and M. intracellulare (the main pathogens responsible for disease is QLD) were isolated infrequently. Distance of sampling site from treatment plant in summer was associated with isolation of NTM. Pathogenic NTM (defined as those known to cause disease in QLD) were more likely to be identified from sites with narrower diameter pipes, predominantly distribution sample points, and from sites with asbestos cement or modified PVC pipes. CONCLUSIONS: NTM responsible for human disease can be found in large urban water distribution systems in Australia. Based on our findings, additional point chlorination, maintenance of more constant pressure gradients in the system, and the utilisation of particular pipe materials should be considered.


Assuntos
Água Potável/microbiologia , Micobactérias não Tuberculosas/classificação , Micobactérias não Tuberculosas/isolamento & purificação , Austrália , Biodiversidade , Desinfecção/métodos , Humanos , Estações do Ano
7.
Commun Dis Intell Q Rep ; 37(1): E40-6, 2013 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-23692157

RESUMO

The Australian Mycobacterium Reference Laboratory Network collects and analyses laboratory data on new cases of disease caused by the Mycobacterium tuberculosis complex. In 2010, a total of 1,051 cases were identified by bacteriology; an annual reporting rate of 4.7 cases per 100,000 population. Twelve children aged less than 10 years had bacteriologically-confirmed tuberculosis. Results of in vitro drug susceptibility testing were available for 1,050 isolates for isoniazid (INH), rifampicin (RIF), ethambutol (EMB), and pyrazinamide (PYZ). A total of 126 (12%) isolates of M. tuberculosis were resistant to at least one of these anti-tuberculosis agents. Resistance to at least INH and RIF (defined as multi-drug resistance, MDR) was detected in 37 (3.5%) isolates, including three Australians with extensive travel in high burden TB countries; 33 were from the respiratory tract (sputum n=28, bronchoscopy n=5). Nineteen (65.5%) of the MDR-TB-positive sputum specimens were smear-positive, as were single samples from bronchoscopy and urine. Sixteen patients with MDR-TB were from the Torres Strait Protected Zone. If these Papa New Guinea nationals are excluded from the analysis, the underlying MDR-TB rate in Australian isolates was 2.0%. One case of extensively drug-resistant TB (defined as MDR-TB with additional resistance to a fluoroquinolone and an injectable agent) was detected in 2010.


Assuntos
Tuberculose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Relatórios Anuais como Assunto , Austrália/epidemiologia , Criança , Pré-Escolar , Coinfecção , Notificação de Doenças , Farmacorresistência Bacteriana , Farmacorresistência Bacteriana Múltipla , Feminino , Soropositividade para HIV , História do Século XXI , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Mycobacterium/classificação , Mycobacterium/efeitos dos fármacos , Tuberculose/tratamento farmacológico , Tuberculose/história , Tuberculose/microbiologia , Adulto Jovem
8.
J Subst Use Addict Treat ; 154: 209151, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37652209

RESUMO

INTRODUCTION: As telehealth models for treatment of opioid use disorder (OUD) are expanding, the field does not know the reliability of urine drug screening (UDS) in this setting. The objective of this study is to determine the rate of falsification of UDS testing among patients with OUD in active treatment with buprenorphine via a telehealth provider. METHODS: This is a prospective cohort study of 899 randomly selected eligible patients, of which 392 participated in the final cohort that the study team used for analysis. The study mailed patients a UDS cup and asked them to return the sample by mail. After the UDS sample was received, a buccal swab was mailed, and the study asked patients to schedule a virtual meeting in which consent was sought and an observed buccal swab was obtained. We evaluated urine for evidence of falsification, and used buccal swabs to genetically match individuals to urine samples. RESULTS: After exclusion criteria, 395 (52.3 %) of 755 patients who received a UDS kit returned it for analysis prior to knowledge of the study. Of that, 392 samples had sufficient quantity for testing. We determined 383 (97.7 %) to be human urine containing buprenorphine without indication of exogenous buprenorphine addition and with evidence of compliance. A total of 374 patients received a buccal swab kit and 139 (37.2 %) attended the consent/observed buccal swab session. One hundred and thirty-two patients consented and completed the swab under video observation, and 120 successfully sent the swab back to the external laboratory. Of the 120 buccal swabs received, 109 (90.8 %) were a genetic match, 10 (8.3 %) were indeterminate, and 1 (0.8 %) was a genetic mismatch. CONCLUSIONS: This study of patients treated by a telehealth OUD provider demonstrated a low rate of urine test falsification.


Assuntos
Buprenorfina , Transtornos Relacionados ao Uso de Opioides , Telemedicina , Humanos , Estudos Prospectivos , Reprodutibilidade dos Testes , Buprenorfina/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico
9.
Int J Antimicrob Agents ; 62(4): 106938, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37517624

RESUMO

OBJECTIVES: Mycobacterium abscessus is an emerging infection in people living with lung diseases, including cystic fibrosis (CF) and bronchiectasis, and it has limited treatment options and low cure rates. The off-label use of novel antibiotics developed for other bacterial pathogens offers potential new therapeutic options. We aimed to describe the in vitro activity of imipenem, imipenem-relebactam and tedizolid against comparator antibiotics in M. abscessus isolates from Australian patients with and without CF. METHODS: We performed susceptibility testing for imipenem-relebactam, tedizolid and comparator antibiotics by Clinical and Laboratory Standards Institute (CLSI) criteria against 102 clinical M. abscessus isolates, including 46 from people with CF. RESULTS: In this study, the minimum inhibitory concentration (MICs) of imipenem-relebactam was one-fold dilution less than of imipenem alone. The MIC50 and MIC90 of imipenem-relebactam were 8 and 16 mg/L, respectively, whereas for imipenem they were 16 and 32 mg/L. Tedizolid had an MIC50 and MIC90 of 2 and 4 mg/L, respectively. Forty non-CF isolates had linezolid susceptibility performed, with MIC50 and MIC90 values of 16 and 32 mg/L, respectively, measured. CONCLUSIONS: This study shows lower MICs for imipenem-relebactam and tedizolid compared to other more commonly used antibiotics and supports their consideration in clinical trials for M. abscessus treatment.


Assuntos
Mycobacterium abscessus , Humanos , Austrália , Antibacterianos/farmacologia , Imipenem/farmacologia , Testes de Sensibilidade Microbiana
10.
Water Res X ; 21: 100201, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38098883

RESUMO

The regrowth and subsequent exposure of opportunistic pathogens (OPs) whilst reopening buildings that have been locked down due to the stay-at-home restrictions to limit the spread of COVID-19, is a public health concern. To better understand such microbiological risks due to lowered occupancy and water demand in buildings, first and post-flush water samples (n = 48) were sampled from 24 drinking water outlets from eight university buildings in two campuses (urban and rural), with various end-user occupancies. Both campuses were served with chlorinated water originating from a single drinking water distribution system in South-East Queensland, situated 14 km apart, where the rural campus had lower chlorine residuals. Culture-dependent and culture-independent methods (such as flow cytometry, qPCR and 16S rRNA gene amplicon sequencing) were used concurrently to comprehensively characterise the OPs of interest (Legionella spp., Pseudomonas aeruginosa, and nontuberculous mycobacteria (NTM)) and the premise plumbing microbiome. Results showed that buildings with extended levels of stagnation had higher and diverse levels of microbial growth, as observed in taxonomic structure and composition of the microbial communities. NTM were ubiquitous in all the outlets sampled, regardless of campus or end-user occupancy of the buildings. qPCR and culture demonstrated prevalent and higher concentrations of NTM in buildings (averaging 3.25 log10[estimated genomic copies/mL]) with extended stagnation in the urban campus. Furthermore, flushing the outlets for 30 minutes restored residual and total chlorine, and subsequently decreased the levels of Legionella by a reduction of 1 log. However, this approach was insufficient to restore total and residual chlorine levels for the outlets in the rural campus, where both Legionella and NTM levels detected by qPCR remained unchanged, regardless of building occupancy. Our findings highlight that regular monitoring of operational parameters such as residual chlorine levels, and the implementation of water risk management plans are important for non-healthcare public buildings, as the levels of OPs in these environments are typically not assessed.

11.
BMC Microbiol ; 12: 191, 2012 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-22943573

RESUMO

BACKGROUND: Monitoring drug resistance in Mycobacterium tuberculosis is essential to curb the spread of tuberculosis (TB). Unfortunately, drug susceptibility testing is currently not available in Papua New Guinea (PNG) and that impairs TB control in this country. We report for the first time M. tuberculosis mutations associated with resistance to first and second-line anti-TB drugs in Madang, PNG. A molecular cluster analysis was performed to identify M. tuberculosis transmission in that region. RESULTS: Phenotypic drug susceptibility tests showed 15.7% resistance to at least one drug and 5.2% multidrug resistant (MDR) TB. Rifampicin resistant strains had the rpoB mutations D516F, D516Y or S531L; Isoniazid resistant strains had the mutations katG S315T or inhA promoter C15T; Streptomycin resistant strains had the mutations rpsL K43R, K88Q, K88R), rrs A514C or gidB V77G. The molecular cluster analysis indicated evidence for transmission of resistant strain. CONCLUSIONS: We observed a substantial rate of MDR-TB in the Madang area of PNG associated with mutations in specific genes. A close monitoring of drug resistance is therefore urgently required, particularly in the presence of drug-resistant M. tuberculosis transmission. In the absence of phenotypic drug susceptibility testing in PNG, molecular assays for drug resistance monitoring would be of advantage.


Assuntos
Antituberculosos/farmacologia , Farmacorresistência Bacteriana , Mutação de Sentido Incorreto , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/genética , Tuberculose/microbiologia , Proteínas de Bactérias/genética , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis/isolamento & purificação , Papua Nova Guiné , Projetos Piloto
12.
Artigo em Inglês | MEDLINE | ID: mdl-36294279

RESUMO

Pseudomonas aeruginosa (Pa) is the predominant bacterial pathogen in people with cystic fibrosis (CF) and can be transmitted by airborne droplet nuclei. Little is known about the ability of ultraviolet band C (UV-C) irradiation to inactivate Pa at doses and conditions relevant to implementation in indoor clinical settings. We assessed the effectiveness of UV-C (265 nm) at up to seven doses on the decay of nebulized Pa aerosols (clonal Pa strain) under a range of experimental conditions. Experiments were done in a 400 L rotating sampling drum. A six-stage Andersen cascade impactor was used to collect aerosols inside the drum and the particle size distribution was characterized by an optical particle counter. UV-C effectiveness was characterized relative to control tests (no UV-C) of the natural decay of Pa. We performed 112 tests in total across all experimental conditions. The addition of UV-C significantly increased the inactivation of Pa compared with natural decay alone at all but one of the UV-C doses assessed. UV-C doses from 246-1968 µW s/cm2 had an estimated effectiveness of approximately 50-90% for airborne Pa. The effectiveness of doses ≥984 µW s/cm2 were not significantly different from each other (p-values: 0.365 to ~1), consistent with a flattening of effectiveness at higher doses. Modelling showed that delivering the highest dose associated with significant improvement in effectiveness (984 µW s/cm2) to the upper air of three clinical rooms would lead to lower room doses from 37-49% of the 8 h occupational limit. Our results suggest that UV-C can expedite the inactivation of nebulized airborne Pa under controlled conditions, at levels that can be delivered safely in occupied settings. These findings need corroboration, but UV-C may have potential applications in locations where people with CF congregate, coupled with other indoor and administrative infection control measures.


Assuntos
Fibrose Cística , Pseudomonas aeruginosa , Humanos , Desinfecção/métodos , Aerossóis e Gotículas Respiratórios , Raios Ultravioleta , Fibrose Cística/microbiologia
13.
Emerg Infect Dis ; 17(3): 395-402, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21392429

RESUMO

Mycobacterium lentiflavum, a slow-growing nontuberculous mycobacterium, is a rare cause of human disease. It has been isolated from environmental samples worldwide. To assess the clinical significance of M. lentiflavum isolates reported to the Queensland Tuberculosis Control Centre, Australia, during 2001-2008, we explored the genotypic similarity and geographic relationship between isolates from humans and potable water in the Brisbane metropolitan area. A total of 47 isolates from 36 patients were reported; 4 patients had clinically significant disease. M. lentiflavum was cultured from 13 of 206 drinking water sites. These sites overlapped geographically with home addresses of the patients who had clinically significant disease. Automated repetitive sequence-based PCR genotyping showed a dominant environmental clone closely related to clinical strains. This finding suggests potable water as a possible source of M. lentiflavum infection in humans.


Assuntos
Ingestão de Líquidos , Água Doce/microbiologia , Mycobacterium/classificação , Mycobacterium/isolamento & purificação , Abastecimento de Água , Adulto , Idoso de 80 Anos ou mais , Feminino , Genótipo , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Mycobacterium/genética , Infecções por Mycobacterium/epidemiologia , Infecções por Mycobacterium/microbiologia , Reação em Cadeia da Polimerase , Queensland/epidemiologia , Sequências Repetitivas de Ácido Nucleico
14.
J Clin Microbiol ; 48(1): 162-7, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19864478

RESUMO

Mycobacterium asiaticum was first reported as a cause of human disease in 1982, with only a few cases in the literature to date. This study aims to review the clinical significance of M. asiaticum isolates in Queensland, Australia. A retrospective review (1989 to 2008) of patients with M. asiaticum isolates was conducted. Data were collected through the Queensland TB Control Centre database. Disease was defined in accordance with the American Thoracic Society criteria. Twenty-four patients (13 female) had a positive culture of M. asiaticum, many residing around the Tropic of Capricorn. M. asiaticum was responsible for pulmonary disease (n = 2), childhood lymphadenitis (n = 1), olecranon bursitis (n = 1), 6 cases of possible pulmonary disease, and 2 possible wound infections. Chronic lung disease was a risk factor for pulmonary infection, and wounds/lacerations were a risk factor for extrapulmonary disease. Extrapulmonary disease responded to local measures. Pulmonary disease responded to ethambutol-isoniazid-rifampin plus pyrazinamide for the first 2 months in one patient, and amikacin-azithromycin-minocycline in another patient. While M. asiaticum is rare in Queensland, there appears to be an environmental niche. Although often a colonizer, it can be a cause of pulmonary and extrapulmonary disease. Treatment of pulmonary disease remains challenging. Extrapulmonary disease does not mandate specific nontuberculous mycobacterium (NTM) treatment.


Assuntos
Infecções por Mycobacterium/epidemiologia , Infecções por Mycobacterium/microbiologia , Mycobacterium/classificação , Mycobacterium/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Infecciosos Locais/uso terapêutico , Antituberculosos/uso terapêutico , Bursite/tratamento farmacológico , Bursite/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium/tratamento farmacológico , Infecções por Mycobacterium/patologia , Queensland/epidemiologia , Estudos Retrospectivos , Resultado do Tratamento , Tuberculose dos Linfonodos/tratamento farmacológico , Tuberculose dos Linfonodos/microbiologia , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/microbiologia , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia
15.
Appl Environ Microbiol ; 74(10): 3094-8, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18359837

RESUMO

Several protocols for isolation of mycobacteria from water exist, but there is no established standard method. This study compared methods of processing potable water samples for the isolation of Mycobacterium avium and Mycobacterium intracellulare using spiked sterilized water and tap water decontaminated using 0.005% cetylpyridinium chloride (CPC). Samples were concentrated by centrifugation or filtration and inoculated onto Middlebrook 7H10 and 7H11 plates and Lowenstein-Jensen slants and into mycobacterial growth indicator tubes with or without polymyxin, azlocillin, nalidixic acid, trimethoprim, and amphotericin B. The solid media were incubated at 32 degrees C, at 35 degrees C, and at 35 degrees C with CO(2) and read weekly. The results suggest that filtration of water for the isolation of mycobacteria is a more sensitive method for concentration than centrifugation. The addition of sodium thiosulfate may not be necessary and may reduce the yield. Middlebrook M7H10 and 7H11 were equally sensitive culture media. CPC decontamination, while effective for reducing growth of contaminants, also significantly reduces mycobacterial numbers. There was no difference at 3 weeks between the different incubation temperatures.


Assuntos
Técnicas Bacteriológicas/métodos , Complexo Mycobacterium avium/isolamento & purificação , Mycobacterium avium/isolamento & purificação , Microbiologia da Água , Antibacterianos/farmacologia , Centrifugação , Contagem de Colônia Microbiana , Meios de Cultura/química , Filtração , Temperatura , Tiossulfatos/farmacologia
16.
Artigo em Inglês | MEDLINE | ID: mdl-26798558

RESUMO

OBJECTIVE: To determine the proportion of non-tuberculous mycobacteria (NTM) in samples of pulmonary tuberculosis (TB) cases from Papua New Guinea who were diagnosed using acid-fast microscopy. METHODS: As part of a case detection study for TB, conducted in three provincial hospitals in Papua New Guinea, sputum samples of suspected tuberculous cases aged 15 years or older were collected from November 2010 to July 2012. Mycobacterial species isolated from sputum and grown in culture were examined to distinguish between NTM and the Mycobacterium tuberculosis complex (MTBC). RESULTS: NTM were detected in 4% (9/225) of sputum samples grown in culture. Five (2.2%) of them were identified as NTM only and four (1.8%) were identified as mixed cultures containing both MTBC and NTM. Four different NTM species were identified; M. fortuitum, M. intracellulare, M. terrae and M. avium. DISCUSSION: This is the first report from Papua New Guinea identifying NTM in three different locations. As NTM cannot be distinguished from M. tuberculosis through smear microscopy, the presence of NTM can lead to a false-positive diagnosis of tuberculosis. The prevalence of NTM should be determined and a diagnostic algorithm developed to confirm acid-fast bacilli in a smear as M. tuberculosis.


Assuntos
Infecções por Mycobacterium não Tuberculosas/epidemiologia , Micobactérias não Tuberculosas/isolamento & purificação , Tuberculose Pulmonar/microbiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Microscopia/métodos , Pessoa de Meia-Idade , Papua Nova Guiné/epidemiologia , Prevalência , Tuberculose Pulmonar/epidemiologia , Adulto Jovem
17.
Commun Dis Intell Q Rep ; 35(2): 154-61, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22010508

RESUMO

There were 886 and 1,062 bacteriologically-confirmed cases of tuberculosis (TB) in 2008 and 2009, representing an annual rate of 4.1 and 4.9 cases per 100,000 population respectively. Over the 2 years, a total of 23 children aged under 10 years (male n = 13, female n = 10) had bacteriologically confirmed tuberculosis, including 3 children with TB meningitis. Results of in vitro drug susceptibility testing were available for 885 of 886 and 1,060 of 1,062 isolates for isoniazid (INH), rifampicin (RIF), ethambutol (EMB), and pyrazinamide (PYZ) in 2008 and 2009 respectively. In 2008, a total of 94 (10.7%) isolates of Mycobacterium tuberculosis complex were resistant to at least one of the anti-tuberculosis agents. Any resistance to INH was noted for 76 (8.7%), 23 (2.6%) for RIF, 10 (1.1%) for EMB and 9 (1.0%) for PYZ. Resistance to at least INH and RIF (defined as multidrug-resistant TB (MDR-TB) was detected in 21 (2.4%) isolates. None of the 21 MDR-TB isolates had resistance to either ofloxacin or the injectable agents. In 2009, a total of 168 (15.9%) were resistant to at least one of the anti-TB agents. Any resistance to INH was noted for 150 (14.2%) isolates, 37 (3.5%) for RIF, 5 (0.5%) for EMB and 13 (1.2%) for PYZ. A total of 31 (2.9%) isolates were MDR-TB. In 2009, there were 2 cases of quinolone resistance in MDR-TB from persons born overseas. Mono-resistance to INH was the most commonly detected resistance with 33 and 80 isolates in 2008 and 2009, respectively. Mono-resistance to RIF was infrequently encountered with 2 and 5 isolates in 2008 and 2009 respectively. There were six and 11 MDR-TB patients from the Papua New Guinea (PNG) - Torres Strait Islands (TSI) cross-border region in 2008 and 2009 respectively. The PNG-TSI zone now contributes a substantial proportion of MDR-TB cases to the database. In addition, there were 24 isolates of Mycobacterium bovis bacille Calmette Guérin (BCG), 15 were cultured from males (4 aged < or = 5 years) and from 9 females (5 aged < or = 5 years). The predominant site of isolation was from vaccination abscess. Eight males (range: 57-87 years) had M. bovis BCG isolated from urine or blood culture.


Assuntos
Antituberculosos/farmacologia , Antituberculosos/uso terapêutico , Mycobacterium/efeitos dos fármacos , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia , Adulto , Austrália/epidemiologia , Feminino , Infecções por HIV/complicações , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Mycobacterium/isolamento & purificação , Tuberculose/complicações , Tuberculose Resistente a Múltiplos Medicamentos/complicações , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Adulto Jovem
19.
Commun Dis Intell Q Rep ; 33(3): 298-303, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20043600

RESUMO

The Australian Mycobacterium Reference Laboratory Network collects and analyses laboratory data on new cases of disease caused by the Mycobacterium tuberculosis complex. In 2007, a total of 872 cases were identified by bacteriology; an annual reporting rate of 4.1 cases per 100,000 population. Isolates were identified as M. tuberculosis (n=867), M. africanum (n=4) and M. bovis (n=1). Fifteen children aged under 10 years had bacteriologically-confirmed tuberculosis. Results of in vitro drug susceptibility testing were available for 871 of 872 isolates for isoniazid (H), rifampicin (R), ethambutol (E), and pyrazinamide (Z). A total of 98 (11.3%) isolates of M. tuberculosis were resistant to at least one of these anti-tuberculosis agents. Resistance to at least H and R (defined as multi-drug resistance, MDR) was detected in 24 (2.8%) isolates, all from overseas-born patients; 17 were from the respiratory tract (sputum n=16, endotracheal aspirate n=1). Thirteen patients with MDR-TB were from the Papua New Guinea-Torres Strait Islands zone. Of the 98 M. tuberculosis isolates resistant to at least one of the standard drugs, 54 (55.1%) were from new cases, 9 (9.2%) from previously treated cases, and no information was available on the remaining 35 cases. Seven were Australian-born, 90 were overseas- born, and the country of birth of 1 was unknown. Of the 90 overseas-born persons with drug resistant disease, 66 (73.3%) were from 5 countries: India (n=16); Papua New Guinea (n=15); the Philippines (n=12); Vietnam (n=12); and China (n=11). No XDR-TB was detected in 2007.


Assuntos
Antituberculosos/farmacologia , Farmacorresistência Bacteriana Múltipla , Tuberculose/epidemiologia , Adulto , Idoso , Austrália/epidemiologia , Feminino , Humanos , Laboratórios , Masculino
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