RESUMO
Systematic molecular/genomic epidemiology studies for tuberculosis surveillance cannot be implemented in many countries. We selected Panama as a model for an alternative strategy. Mycobacterial interspersed repetitive unit-variable-number tandem-repeat (MIRU-VNTR) analysis revealed a high proportion (50%) of Mycobacterium tuberculosis isolates included in 6 clusters (A-F) in 2 provinces (Panama and Colon). Cluster A corresponded to the Beijing sublineage. Whole-genome sequencing (WGS) differentiated clusters due to active recent transmission, with low single-nucleotide polymorphism-based diversity (cluster C), from clusters involving long-term prevalent strains with higher diversity (clusters A, B). Prospective application in Panama of 3 tailored strain-specific PCRs targeting marker single-nucleotide polymorphisms identified from WGS data revealed that 31.4% of incident cases involved strains A-C and that the Beijing strain was highly represented and restricted mainly to Colon. Rational integration of MIRU-VNTR, WGS, and tailored strain-specific PCRs could be a new model for tuberculosis surveillance in countries without molecular/genomic epidemiology programs.
Assuntos
Modelos Teóricos , Mycobacterium tuberculosis , Tuberculose/epidemiologia , Tuberculose/transmissão , Humanos , Repetições Minissatélites , Epidemiologia Molecular , Tipagem Molecular , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/genética , Filogenia , Polimorfismo de Nucleotídeo Único , Vigilância da População , Tuberculose/genética , Tuberculose/microbiologia , Sequenciamento Completo do GenomaRESUMO
BACKGROUND: The genus Mycobacterium includes well-known bacteria such as M. tuberculosis causing tuberculosis and M. leprae causing leprosy. Additionally, various species collectively termed non-tuberculous mycobacteria (NTM) can cause infections in humans and animals, affecting individuals across all age groups and health conditions. However, information on NTM infection prevalence in Panama is limited. METHODS: This study conducted a retrospective analysis of clinical records from 2017 to 2021, specifically focusing on patients with NTM isolates. Data were categorized by variables like sex, age, HIV status, and sample source. RESULTS: Among the 4430 clinical records analyzed, 698 were linked to patients with NTM isolates. Of these patients, 397 were male, and 301 were female. Most female patients with NTM isolates (n = 190) were aged >45 to 85 years, while most male patients (n = 334) fell in the >25 to 75 years age group. A noteworthy proportion of male patients (n = 65) were aged 25-35 years. A significant age difference between male (median [min-max] = 53 years [3-90]) and female (median [61 years [6-94]) patients was observed (p < 0.001). Regarding HIV status, 77 positive individuals were male, and 19 were female (p < 0.001). Most samples (n = 566) were sputum samples, with additional pulmonary-associated samples such as broncho-alveolar lavage, tracheal secretions, and pleural fluid samples. Among extrapulmonary isolates (n = 48), sources included catheter secretions, intracellular fluids, peritoneal fluid, blood cultures, cerebrospinal fluid, bone marrow samples, and capillary transplant lesions. Specifically, the analysis identified the pathogenic microorganisms responsible for mycobacteriosis in Panama during the specific period 2017-2021, as M. fortuitum (34.4%), M. intracellulare (20.06%), and M. abscessus (13.75%), respectively. CONCLUSIONS: This study highlights the growing public health concern of NTM infections in Panama. The research provides valuable insights into the prevalence and distribution of NTM species in the country, offering a foundation for the development and implementation of effective prevention and control strategies for NTM infections in Panama.
Assuntos
Infecções por HIV , Infecções por Mycobacterium não Tuberculosas , Mycobacterium tuberculosis , Tuberculose , Animais , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Micobactérias não Tuberculosas , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Infecções por Mycobacterium não Tuberculosas/microbiologia , Estudos Retrospectivos , Mycobacterium leprae , Panamá/epidemiologia , Tuberculose/complicações , Infecções por HIV/complicaçõesRESUMO
El trabajo presenta los resultados alcanzados en el marco del proyecto "Optimización de la Red de Agua Potable" puesto en marcha a mediados de 2001 por O.S.S.E (Obras Sanitarias Sociedad del Estado) en la provincia de San Juan (Argentina). El objetivo general del proyecto es el diseño, desarrollo e implementación SIGRAP, un sistemas de gestión que integra la información técnica, administrativa y comercial de la red de agua potable. El proyecto incorpora nuevas tecnologías basadas en las Bases de Datos, los Sistemas de Información Geográfica y los Sistemas de Cálculos Avanzado para redes de agua junto con un plan de capacitación de recursos humanos dirigidos a aumentar la productividad de la empresa, mejorar el nivel del servicio de agua potable, atender los requerimientos cada vez más exigentes y aumentar la cantidad de vida de los habitantes
Assuntos
Distribuição da Água , Redes de Distribuição de Água , Otimização de Processos , Modelos HidráulicosRESUMO
El trabajo presenta los resultados alcanzados en el marco del proyecto "Optimización de la Red de Agua Potable" puesto en marcha a mediados de 2001 por O.S.S.E (Obras Sanitarias Sociedad del Estado) en la provincia de San Juan (Argentina). El objetivo general del proyecto es el diseño, desarrollo e implementación SIGRAP, un sistemas de gestión que integra la información técnica, administrativa y comercial de la red de agua potable. El proyecto incorpora nuevas tecnologías basadas en las Bases de Datos, los Sistemas de Información Geográfica y los Sistemas de Cálculos Avanzado para redes de agua junto con un plan de capacitación de recursos humanos dirigidos a aumentar la productividad de la empresa, mejorar el nivel del servicio de agua potable, atender los requerimientos cada vez más exigentes y aumentar la cantidad de vida de los habitantes