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J Clin Microbiol ; 46(4): 1246-51, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18272714

RESUMO

Isolation of Mycobacterium avium complex (MAC) organisms from clinical samples may occur in patients without clinical disease, making the interpretation of results difficult. The clinical relevance of MAC isolates from different types of clinical samples (n = 47) from 39 patients in different sections of a hospital was assessed by comparison with environmental isolates (n = 17) from the hospital. Various methods for identification and typing (commercial probes, phenotypic characteristics, PCR for detection of IS1245 and IS901, sequencing of the hsp65 gene, and pulsed-field gel electrophoresis) were evaluated. The same strain was found in all the environmental isolates, 21 out of 23 (91.3%) of the isolates cultured from urine samples, and 5 out of 19 (26.3%) isolates from respiratory specimens. This strain did not cause disease in the patients. Testing best characterized the strain as M. avium subsp. hominissuis, with the unusual feature that 81.4% of these isolates lacked the IS1245 element. Contamination of certain clinical samples with an environmental strain was the most likely event; therefore, characterization of the environmental mycobacteria present in health care facilities should be performed to discard false-positive isolations in nonsterile samples, mainly urine samples. Molecular techniques applied in this study demonstrated their usefulness for this purpose.


Assuntos
Equipamentos e Provisões Hospitalares/microbiologia , Água Doce/microbiologia , Variação Genética , Complexo Mycobacterium avium , Infecção por Mycobacterium avium-intracellulare , Abastecimento de Água , Proteínas de Bactérias/genética , Técnicas de Tipagem Bacteriana , Chaperonina 60 , Chaperoninas/genética , Elementos de DNA Transponíveis , Eletroforese em Gel de Campo Pulsado , Hospitais , Humanos , Complexo Mycobacterium avium/classificação , Complexo Mycobacterium avium/genética , Complexo Mycobacterium avium/isolamento & purificação , Infecção por Mycobacterium avium-intracellulare/diagnóstico , Infecção por Mycobacterium avium-intracellulare/microbiologia , Reação em Cadeia da Polimerase/métodos , Escarro/microbiologia , Urina/microbiologia
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