RESUMO
Tuberculosis is still a serious public health problem, with 10.8 million new cases and 1.8 million deaths worldwide in 2015. The diversity among members of the Mycobacterium tuberculosis complex, the causal agent of tuberculosis, is conducive to the design of different methods for rapid diagnosis. Mutations in the genes involved in resistance mechanisms enable the bacteria to elude the treatment. We have reviewed the methods for the rapid diagnosis of M. tuberculosis complex and the detection of susceptibility to drugs, both of which are necessary to prevent the onset of new resistance and to establish early, appropriate treatment.
Assuntos
Técnicas Bacteriológicas , Resistência Microbiana a Medicamentos , Farmacorresistência Bacteriana Múltipla , Mycobacterium tuberculosis/efeitos dos fármacos , Tuberculose/diagnóstico , Antituberculosos/farmacologia , Resistência Microbiana a Medicamentos/genética , Farmacorresistência Bacteriana Múltipla/genética , Genes Bacterianos , Humanos , Técnicas de Diagnóstico Molecular , Mycobacterium/classificação , Mycobacterium/genética , Mycobacterium tuberculosis/crescimento & desenvolvimento , Filogenia , Kit de Reagentes para Diagnóstico , Fatores de Tempo , Tuberculose/microbiologia , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/genética , Tuberculose Resistente a Múltiplos Medicamentos/microbiologiaRESUMO
OBJECTIVES: The aim of this study was to describe the evaluation of the use of MALDI-TOF MS for the identification of non-tuberculous mycobacteria (NTM) and Mycobacterium tuberculosis directly from liquid MGIT cultures from January 2017 to December 2017. MATERIAL/METHODS: A total of 155 isolates (mainly respiratory) were analyzed by MALDI-TOF MS (Bruker Daltonics) directly from MGIT liquid medium with a previous extraction procedure. RESULTS: MALDI-TOF MS generated acceptable scores for 152 isolates (98.06%). Fifty isolates were identified as M. tuberculosis complex and the remaining 105 as NTM (M. abscessus subsp. abscessus, M. avium, M. celatum, M chelonae, M. chimaera, M. fortuitum, M. gordonae, M. intracellulare, M. kansasii, M. lentiflavum, M. mageritense, M. mucogenicum and M. xenopi). CONCLUSIONS: These results indicate that MALDI-TOF MS can be useful to identify mycobacteria directly from MGIT cultures and is an accurate, rapid and cost-effective system to be used as a routine method.
Assuntos
Mycobacterium tuberculosis , Micobactérias não Tuberculosas , Meios de Cultura , Testes Diagnósticos de Rotina , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por MatrizAssuntos
Vacina BCG , Mycobacterium bovis , Humanos , Vacina BCG/efeitos adversos , Lactente , Masculino , Tuberculose/diagnósticoRESUMO
Objectives: The aim of this study was to describe the evaluation of the use of MALDI-TOF MS for the identification of non-tuberculous mycobacteria (NTM) and Mycobacterium tuberculosis directly from liquid MGIT cultures from January 2017 to December 2017. Material/methods: A total of 155 isolates (mainly respiratory) were analyzed by MALDI-TOF MS (Bruker Daltonics) directly from MGIT liquid medium with a previous extraction procedure. Results: MALDI-TOF MS generated acceptable scores for 152 isolates (98.06%). Fifty isolates were identified as M. tuberculosis complex and the remaining 105 as NTM (M. abscessus subsp. abscessus, M. avium, M. celatum, M chelonae, M. chimaera, M. fortuitum, M. gordonae, M. intracellulare, M. kansasii, M. lentiflavum, M. mageritense, M. mucogenicum and M. xenopi). Conclusions: These results indicate that MALDI-TOF MS can be useful to identify mycobacteria directly from MGIT cultures and is an accurate, rapid and cost-effective system to be used as a routine method.(AU)
Introducción: Evaluamos la espectrometría de masas (MALDI-TOF MS [Bruker Daltonics]) para la identificación de micobacterias no tuberculosas (MNT) y Mycobacterium tuberculosis a partir de cultivos líquidos (MGIT) desde enero del 2017 a diciembre del 2017. Métodos: Se analizaron mediante MALDI-TOF MS 155 cultivos MGIT positivos, principalmente de origen respiratorio. Previamente a la realización de MALDI-TOF se realizó un procedimiento de extracción directamente del MGIT. Resultados: Mediante MALDI-TOF MS se identificó correctamente a partir del MGIT el 98,06% (n=152) de los aislados. Cincuenta aislados se identificaron como M. tuberculosis complex y los 105 restantes como MNT (M. abscessus subsp. abscessus, M. avium, M. celatum, M chelonae, M. chimaera, M. fortuitum, M. gordonae, M. intracellulare, M. kansasii, M. lentiflavum, M. mageritense, M. mucogenicum y M. xenopi). Conclusiones: Estos resultados indican que MALDI-TOF es una técnica precisa, rápida y coste-efectiva para identificar micobacterias directamente a partir de medios de cultivo líquidos en la rutina diaria.(AU)
Assuntos
Humanos , Masculino , Feminino , Mycobacterium , Micobactérias não Tuberculosas , Espectrometria de Massas/métodos , Mycobacterium tuberculosis , Meios de Cultura , Testes Diagnósticos de Rotina , Doenças Transmissíveis , MicrobiologiaAssuntos
Tuberculoma/diagnóstico , Tuberculose Cutânea/diagnóstico , Idoso de 80 Anos ou mais , Cicatriz/etiologia , Diagnóstico Tardio , Feminino , Células Gigantes/ultraestrutura , Histiócitos/ultraestrutura , Humanos , Linfócitos/ultraestrutura , Coxa da Perna , Recusa do Paciente ao Tratamento , Tuberculoma/microbiologia , Tuberculoma/patologia , Tuberculose Cutânea/microbiologia , Tuberculose Cutânea/patologiaRESUMO
No disponible
Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Tuberculoma/diagnóstico , Tuberculose Cutânea/diagnóstico , Cicatriz/etiologia , Diagnóstico Tardio , Células Gigantes/ultraestrutura , Histiócitos/ultraestrutura , Tuberculoma/microbiologia , Tuberculoma/patologia , Tuberculose Cutânea/microbiologia , Tuberculose Cutânea/patologia , Recusa do Paciente ao TratamentoRESUMO
Objectives: Our objective was to evaluate the in vitro activity of ceftolozane-tazobactam against multidrug resistant (MDR) and extensively drug-resistant (XDR) non metallo-ß-lactamase producing Pseudomonas aeruginosa clinical isolates at Hospital Universitario Miguel Servet (Zaragoza, Spain) from February 2016 to October 2017. Material and methods: We evaluated the in vitro activity of ceftolozane-tazobactam and other antipseudomonal antibiotics against 12 MDR and 117 XDR non metallo-ß-lactamase producing P. aeruginosa isolates. Ceftolozane-tazobactam minimal inhibitory concentrations (MICs) were determined by MIC gradient diffusion test strip. Results: Among the 129 MDR/XDR isolates included, 119 (92.2%) were susceptible to ceftolozane-tazobactam, and ten (7.8%) were resistant. MIC50 was 2 mg/L, and MIC90 4 mg/L. Ceftolozane-tazobactam was the second most active antibiotic after colistin, overtaking amikacin. Conclusions: Ceftolozane-tazobactam is a valuable treatment option for MDR and XDR P. aeruginosa infections in our setting
Objetivos: Nuestro objetivo fue evaluar la sensibilidad in vitro de ceftolozano-tazobactam en aislados clínicos de P. aeruginosa multirresistente (MDR) y extremadamente resistente (XDR) desde Febrero de 2016 a Octubre de 2017 en el Hospital Universitario Miguel Servet, Zaragoza (España). Material y métodos: Evaluamos la actividad in vitro de ceftolozano-tazobactam y otros antibióticos anti-pseudomónicos en 12 aislados de P. aeruginosa MDR y en 117 aislados XDR, no productores de metalo-ß-lactamasas. Se determinó la concentración mínima inhibitoria (CMI) de ceftolozano-tazobactam mediante tiras de difusión en gradiente. Resultados: Entre los 129 aislados MDR/XDR incluidos, 119 (92,2%) fueron sensibles a ceftolozano-tazobactam, y diez (7,8%) presentaron resistencia. La CMI50 fue de 2 mg/L, y la CMI90 de 4 mg/L. Ceftolozano-tazobactam fue el segundo antibiótico más activo después de colistina, superando a amikacina. Conclusiones: Ceftolozano-tazobactam es una opción de tratamiento válida para infecciones causadas por P. aeruginosa MDR y XDR en nuestro entorno
Assuntos
Humanos , Tazobactam/farmacocinética , Cefalosporinas/farmacocinética , Pseudomonas aeruginosa/patogenicidade , Infecções por Pseudomonas/tratamento farmacológico , Técnicas In Vitro/métodos , Resistência a Múltiplos Medicamentos , Quimioterapia Combinada/métodos , Resultado do TratamentoRESUMO
La tuberculosis continúa siendo hoy en día un grave problema de salud pública con 10,8 millones de casos nuevos y 1,8 millones de muertes a nivel mundial en el año 2015. La diversidad existente entre los miembros del complejo Mycobacterium tuberculosis que producen la tuberculosis permiten el diseño de métodos para su rápido diagnóstico. Así mismo, las mutaciones en los genes implicados en los mecanismos de resistencia permiten escapar a la bacteria del tratamiento. Hemos revisado los métodos de diagnóstico rápido de M. tuberculosis complex y de la detección de la sensibilidad/resistencia a los fármacos; ambas cosas son necesarias para detener la aparición de nuevas resistencias e instaurar un tratamiento precoz y correcto (AU)
Tuberculosis is still a serious public health problem, with 10.8 million new cases and 1.8 million deaths worldwide in 2015. The diversity among members of the Mycobacterium tuberculosiscomplex, the causal agent of tuberculosis, is conducive to the design of different methods for rapid diagnosis. Mutations in the genes involved in resistance mechanisms enable the bacteria to elude the treatment. We have reviewed the methods for the rapid diagnosis of M. tuberculosis complex and the detection of susceptibility to drugs, both of which are necessary to prevent the onset of new resistance and to establish early, appropriate treatment (AU)