RESUMO
Fifteen episodes of Mycobacterium tuberculosis laboratory cross-contamination suspected between 1996 and 2001 at 6 laboratories in Buenos Aires City and suburbs were investigated by IS6110 RFLP. Thirteen episodes were confirmed. Even though BACTEC 460 produced the highest number of confirmed episodes in a single laboratory, the most extended one occurred while employing conventional culture procedures in solid medium. The double repetitive element-polymerase chain reaction (DRE-PCR) was applied to 8 of these episodes and produced concordant results with those of the RFLP. The DRE-PCR appears to be a valuable tool for the prompt identification of false positive cultures. The timely rectification of defects in laboratory protocols can avert false diagnoses of tuberculosis and unnecessary prolonged treatments.
Assuntos
Técnicas Bacteriológicas , DNA Bacteriano/análise , Contaminação de Equipamentos , Laboratórios Hospitalares , Mycobacterium tuberculosis/isolamento & purificação , Reação em Cadeia da Polimerase/métodos , Polimorfismo de Fragmento de Restrição , Tuberculose/diagnóstico , Aerossóis , Argentina , Técnicas Bacteriológicas/instrumentação , Meios de Cultura , Reações Falso-Positivas , Humanos , Radiometria/instrumentação , Manejo de Espécimes , Esterilização/métodosRESUMO
Fifteen episodes of Mycobacterium tuberculosis laboratory cross-contamination suspected between 1996 and 2001 at 6 laboratories in Buenos Aires City and suburbs were investigated by IS6110 RFLP. Thirteen episodes were confirmed. Even though BACTEC 460 produced the highest number of confirmed episodes in a single laboratory, the most extended one occurred while employing conventional culture procedures in solid medium. The double repetitive element-polymerase chain reaction (DRE-PCR) was applied to 8 of these episodes and produced concordant results with those of the RFLP. The DRE-PCR appears to be a valuable tool for the prompt identification of false positive cultures. The timely rectification of defects in laboratory protocols can avert false diagnoses of tuberculosis and unnecessary prolonged treatments.
Assuntos
Humanos , Técnicas Bacteriológicas , DNA Bacteriano , Contaminação de Equipamentos , Laboratórios Hospitalares , Mycobacterium tuberculosis , Polimorfismo de Fragmento de Restrição , Reação em Cadeia da Polimerase/métodos , Tuberculose , Aerossóis , Argentina , Meios de Cultura , Esterilização/métodos , Reações Falso-Positivas , Radiometria , Manejo de Espécimes , Técnicas Bacteriológicas/instrumentaçãoRESUMO
Fifteen episodes of Mycobacterium tuberculosis laboratory cross-contamination suspected between 1996 and 2001 at 6 laboratories in Buenos Aires City and suburbs were investigated by IS6110 RFLP. Thirteen episodes were confirmed. Even though BACTEC 460 produced the highest number of confirmed episodes in a single laboratory, the most extended one occurred while employing conventional culture procedures in solid medium. The double repetitive element-polymerase chain reaction (DRE-PCR) was applied to 8 of these episodes and produced concordant results with those of the RFLP. The DRE-PCR appears to be a valuable tool for the prompt identification of false positive cultures. The timely rectification of defects in laboratory protocols can avert false diagnoses of tuberculosis and unnecessary prolonged treatments.(AU)
Assuntos
Humanos , Técnicas Bacteriológicas , DNA Bacteriano/análise , Contaminação de Equipamentos , Laboratórios Hospitalares , Mycobacterium tuberculosis/isolamento & purificação , Reação em Cadeia da Polimerase/métodos , Polimorfismo de Fragmento de Restrição , Tuberculose/diagnóstico , Aerossóis , Argentina , Técnicas Bacteriológicas/instrumentação , Meios de Cultura , Reações Falso-Positivas , Radiometria/instrumentação , Manejo de Espécimes , Esterilização/métodosRESUMO
Fifteen episodes of Mycobacterium tuberculosis laboratory cross-contamination suspected between 1996 and 2001 at 6 laboratories in Buenos Aires City and suburbs were investigated by IS6110 RFLP. Thirteen episodes were confirmed. Even though BACTEC 460 produced the highest number of confirmed episodes in a single laboratory, the most extended one occurred while employing conventional culture procedures in solid medium. The double repetitive element-polymerase chain reaction (DRE-PCR) was applied to 8 of these episodes and produced concordant results with those of the RFLP. The DRE-PCR appears to be a valuable tool for the prompt identification of false positive cultures. The timely rectification of defects in laboratory protocols can avert false diagnoses of tuberculosis and unnecessary prolonged treatments.
RESUMO
A patient with advanced HIV-1 disease bearing a rapidly growing, atypical mycobacterium is presented. Mycobacterium fortuitum was identified in sputum and purulent material obtained by aspirating subcutaneous abscesses. The treatment scheme is evaluated and the literature is reviewed.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Infecções por Mycobacterium não Tuberculosas/terapia , Mycobacterium fortuitum , Adulto , Humanos , Masculino , Infecções por Mycobacterium não Tuberculosas/microbiologiaRESUMO
A patient with advanced HIV-1 disease bearing a rapidly growing, atypical mycobacterium is presented. Mycobacterium fortuitum was identified in sputum and purulent material obtained by aspirating subcutaneous abscesses. The treatment scheme is evaluated and the literature is reviewed.
RESUMO
A steep upsurge of human immunodeficiency virus (HIV)-associated multidrug-resistant tuberculosis (MDR-TB) was recently observed at a referral treatment center in Buenos Aires City. Between January 1994 and June 1995, TB isolates resistant to at least five drugs were recovered from 101 of 272 HIV-infected inpatients. Highly resistant isolates from 77 patients underwent restriction fragment length polymorphism study with IS6110. After cross-contamination was eliminated, a single TB strain was found to have caused disease in 68 patients with a history of on-site exposure. The frequency of smear-positive pulmonary disease was higher among these patients than among non-MDR-TB HIV-infected patients (50/68 vs. 60/148, P < .001), and the 1-year survival was dramatically reduced (5/68 vs. 92/148). The strain involved in the outbreak was traced back to patients hospitalized in 1992. Institutional infection control policies were and may still be inadequate to contain the spread of TB among immunodepressed subjects, as is the case in other large urban hospitals in Argentina.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/transmissão , Infecção Hospitalar/microbiologia , Mycobacterium tuberculosis , Tuberculose Resistente a Múltiplos Medicamentos/transmissão , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Adulto , Argentina/epidemiologia , Infecção Hospitalar/transmissão , Feminino , Humanos , Masculino , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/isolamento & purificação , Polimorfismo de Fragmento de Restrição , Estudos Retrospectivos , Tuberculose Resistente a Múltiplos Medicamentos/complicações , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/microbiologiaRESUMO
Se analizaron las historias clínicas de 12 pacientes de Tuberculosis con resistencia única a rifampicina asociada al Síndrome de Inmunodeficiencia Adquirida, cuyas muestras biológicas fueron estudiadas en el Laboratorio de Bacteriología "Dr. A. Cetrángolo" durante el período comprendido entre julio de 1991 y febrero de 1994. De los 12 pacientes, 11 eran hombres y 1 pertenecía al sexo femenino. La edad estuvo comprendida entre los 20 y 35 años. Los 10 pacientes con conducta de riesgo conocida eran adictos a drogas intravenosas. La tuberculosis fue pulmonar en 8 pacientes, extrapulmonar en 3 y localización combinada en 1 caso.
Assuntos
Humanos , Masculino , Feminino , Adulto , Resistência Microbiana a Medicamentos , Rifampina , Síndrome da Imunodeficiência Adquirida/complicações , Tuberculose/epidemiologia , Tuberculose/mortalidade , Tuberculose/terapia , Bissexualidade , Homossexualidade , Meningite Criptocócica/mortalidade , Pneumonia por Pneumocystis/mortalidade , Assunção de Riscos , Sepse/mortalidade , Problemas Sociais , Transtornos Relacionados ao Uso de Substâncias , Recusa do Paciente ao TratamentoRESUMO
Se analizaron las historias clínicas de 12 pacientes de Tuberculosis con resistencia única a rifampicina asociada al Síndrome de Inmunodeficiencia Adquirida, cuyas muestras biológicas fueron estudiadas en el Laboratorio de Bacteriología "Dr. A. Cetrángolo" durante el período comprendido entre julio de 1991 y febrero de 1994. De los 12 pacientes, 11 eran hombres y 1 pertenecía al sexo femenino. La edad estuvo comprendida entre los 20 y 35 años. Los 10 pacientes con conducta de riesgo conocida eran adictos a drogas intravenosas. La tuberculosis fue pulmonar en 8 pacientes, extrapulmonar en 3 y localización combinada en 1 caso. (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Rifampina , Resistência Microbiana a Medicamentos , Síndrome da Imunodeficiência Adquirida/complicações , Tuberculose/epidemiologia , Tuberculose/terapia , Tuberculose/mortalidade , Assunção de Riscos , Transtornos Relacionados ao Uso de Substâncias , Bissexualidade , Homossexualidade , Sepse/mortalidade , Pneumonia por Pneumocystis/mortalidade , Meningite Criptocócica/mortalidade , Problemas Sociais , Recusa do Paciente ao TratamentoRESUMO
La incidencia de la infección por Micobacterias Atípicas en pacientes con SIDA se ha incrementado en los últimos años. La demora en el diagnóstico, el estadio avanzado de la enfermedad debida al VIH-1, y la elevada resistencia a los agentes antimicrobianos de primera línea hacen que la respuesta al tratamiento sea habitualmente pobre. Se presentan 14 pacientes con SIDA, atendidos en el pabellón 22 del Hospital F.J. Muñiz; 12 presentaron enfermedad por complejo MAI (2 con localización pulmonar y 10 con formas diseminadas) y en dos pacientes se identificó al M.kansasii (uno con enfermedad pulmonar y el otro con enfermedad diseminada). Los criterios de inclusión fueron: para la enfermedad pulmonar, el hallazgo de la micobacteria en dos o más muestras de esputo o LBA, con cuadro clínico compatible; y para la diseminada, el desarrollo de microorganismos en líquidos o tejidos habitualmente estériles. Se describen las características clínicas y epidemiológicas, patrón radiológico y sensibilidad a los antibióticos observadas en los 14 pacientes