Keywords
tuberculosis
nontuberculous mycobacteria
mycobacterium infections
How to Cite
Abstract
The etiologic agents of tuberculosis belong to Mycobacterium tuberculosis Complex (MT), but other pathogenic species of the same genus known as Nontuberculous Mycobacteria (NTM) are often isolated. The rapid and accurate identification of these organisms is mandatory for diagnosing, and supporting the clinician for accurate treatment. Aiming to evaluate the frequency of MT and NTM, during 2003 to 2009, 6,460 samples were analyzed, being 5,696 (88.2%) negative for mycobacteria, 715 (11.1%) positive and 49 (0.7%) no identification was done. The MT isolates were most frequent, 78.6% (562). Among the NTM, the most isolated specie was the M. gordonae 3.09% (22), followed by M. fortuitum 2.39% (17), M. avium Complex (MAC) 2.25% (16), M. kansasii 1.97% (14) and M. abscessus 1.83% (13). However, the MAC was the mostly isolated (19.4%) when they were associated with the number of patients. A decline in the frequency of MT isolation was observed for the studied period, while the frequency of NTM has increased by 22.8%. The high frequency of MT isolation from clinical samples is a steady concern of public health, but the increase of the number of patients with MNT emphasizes the relevance of the notification and the epidemiological monitoring of these patients.
References
1. Organização Mundial da Saúde - OMS. Global tuberculosis control: surveillance, planning, financing. Geneva; 2006. [acesso 2010 Out 21]. Disponível em: [http://www.who.int/tb/publications/global_report/en/index.html].
2. Centro de Vigilância Epidemiológica do Estado de São Paulo - CVE. TB em números. Tuberculose em São Paulo. [acesso 2011 Set 26]. Disponível em: [http://www.cve.saude.sp.gov.br/htm/cve_tb.html].
3. Brasil. Ministério da Saúde. Secretaria de vigilância em Saúde. Série histórica da Taxa de Incidência de Tuberculose. Brasil, Regiões e Unidades Federadas de residência por ano de diagnóstico (1990-2009). [acesso 2010 Set 3]. Disponível em: [http://portal.saude.gov.br/portal/arquivos/pdf/incidencia_tabela2.pdf ].
4. Almeida, EA. Sensibilidade de bactérias do Complexo Mycobacterium tuberculosis as drogas antituberculosas avaliadas por duas metodologias em centro terciário de referência ambulatorial [tese de doutorado]. São Paulo (SP): Instituto de Ciências Biomédicas, Universidade de São Paulo; 2009.
5. Campos, HS. Manejo da doença micobacteriana não tuberculosa. Bolet Pneumo Sanit. 2000;8(2):07-14.
6. Seiscento M, Bombarda S, Castro A, Campos JRM, Teixeira L. Derrame pleural por micobactéria não tuberculosa. J Bras Pneumol. 2005;31(5):459-63.
7. Leão SC, Viana-Niero C, Matsumoto CK, Lima KV, Lopes ML, Palaci M, et al. Epidemic of surgical-site infections by a single clone of rapidly growing mycobacteria in Brazil. Future Microbiol. 2010;5(6):971-80.
8. Blossom DB, Alelis KA, Chang DC, Flores AH, Gill J, Beall D, et al. Pseudo-outbreak of Mycobacterium abscessus Infection Caused by Laboratory Contamination. Infect Control Hosp Epidemio. 2008;29(1): 57-62.
9. Euzéby JP. List of prokaryotic names with standing in nomenclature - LPSN. Formerly List of Bacterial names with Standing in Nomenclature. [acesso 2011 Set 9]. Disponível em: [http://www.bacterio.cict.fr/m/mycobacterium.html].
10. Coelho AGV, Zamarioli LA, Reis CMPV, Nascimento ACC, Rodrigues JS. Estudo comparativo entre um sistema de sonda genética e métodos clássicos na identificação das micobactérias. J Bras Pneumol. 2008;34(11):922-6.
11. Zamarioli LA, Coelho AGV, Pereira CM, Nascimento ACC, Ueki SYM, Chimara E. Estudo descritivo da frequência de micobactérias não causadoras de tuberculosas na Baixada Santista (SP). J Bras Pneumol. 2008;34(8):590-4.
12. Pedro HSP, Pereira MIF, Goloni MRA, Ueki SYM, Chimara E. Isolamento de micobactérias não tuberculosas em São José do Rio Preto entre 1996 e 2005. J Bras Pneumol. 2008;34(11):950-5.
13. Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. Mycobacterial Diseases Subcommittee; American Thoracic Society (ATS); Infectious Disease Society of America. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175:367-416.
14. Ueki SYM, Martins MC, Telles MAS, Virgilio MC, Giampaglia, CMS, Chimara E, et al. Micobactérias não tuberculosas: diversidade das espécies no estado de São Paulo. J Bras Patol Med Lab. 2005;41(1):1-8.
15. Ministério da Saúde (Brasília – Brasil). Manual Nacional de Vigilância Laboratorial da Tuberculose e outras Micobactérias. Brasília (DF): MS; 2008.
16. RESOLUÇÃO ANVISA - RDC nº 8, de 27 de fevereiro de 2009. LEGISLAÇÃO ANVISA - MS D.O.U. - Poder Executivo, de 02 de março de 2009.
17. Ryoo SW, Shin S, Shim M-S, Park Y-S, Lew WJ, Park S-N, et al. Spread of Nontuberculous Mycobacteria From 1993 to 2006 in Koreans. J Clin Lab Anal. 2008;22:415-20.
18. Shenai S, Rodrigues C, Mehta A. Time to identify and define non-tuberculous mycobacteria in a tuberculosis-endemic region. Int J Tuberc Lung Dis. 2010;14(8):1001–8.
19. Couto I, Machado D, Viveiros M, Rodrigues L, Amaral L. Identification of nontuberculous mycobacteria in clinical samples using molecular methods: a 3-yaer study. Clin Microbiol Infect. 2010;16(8):1161-1164.
20. Arend SM, Soolingen D, Ottenhoff THM. Diagnosis and treatment of lung infection with nontuberculous mycobacteria. Infect Dis. 2009;15:201-8.
21. Chung MJ, Lee KS, Koh WJ, Kim TS, Kang EY, Kim SM, et al. Drug-sensitive tuberculosis, multidrug-resistant tuberculosis, and nontuberculous mycobacterial pulmonary disease in nonAIDS adults: comparisons of thin-section CT findings. Eur Radiol. 2006;16:1934–41.
22. R Development Core Team (2009). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0. [acesso 2011 Set 3] Disponível em: [http://www.R-project.org].
23. Chimara E, Ferrazoli L, Ueky SY, Martins MC, Durham AM, Arbeit RD, et al. Reliable identification of mycobacterial species by PCR-restriction enzyme analysis (PRA)-hsp65 in a reference laboratory and elaboration of a sequence-based extended algorithm of PRA-hsp65 patterns. BMC Microbiol. 2008;20:8:48.
24. Scheinfeld NS, Tomar S, Kress DW, Restauri N, Allan JM. Mycobacterium Avium-Intracellulare Infection. 2010. Medscape Reference: Drugs, Diseases e Procedures. [acesso 2010 Nov 02]. Disponível em: [http://emedicine.medscape.com/article/1105447-overview].
25. Ferrazoli L, Silva EAM, Martins MC, Ichikawa T, Palaci M. Micobactérias outras que não o Mycobacterium tuberculosis. Análise da ocorrência e de aspectos relevantes ao diagnóstico da infecção. Hansen Int. 1992;17(1/2):15-20.
26. Barreto AMW, Campos CED. Micobactérias “não tuberculosas” no Brasil. Bol Pneumo Sanit. 2000;8(1):23-32.
27. Shin JH, Lee EJ, Lee HR, Ryu SM, Kim HR, Chang CL, et al. Prevalence of non-tuberculous mycobacteria in a hospital environment. J Hosp Inf. 2007;65:143-8.
28. Piersimoni C, Scarparo C. Pulmonary infections associated with non-tuberculous mycobacteria in immunocompetent patients. Lancet. 2008;8:323-34.
29. Moraes PRS, Chimara E, Telles MAS, Ueki SYM, Cunha EAT, Honer MR, et al. Identification of nom-tuberculous mycobacteria from the central public health laboratory from Mato Grosso do Sul and analysis of clinical relevance. Braz J Microbiol. 2008;39:268-72.
30. Salicio Y, Álvaro AI, Bermejo AI, Navascués A, Ojer M, Ruz A, et al. Relevancia clínica de los aislamientos de micobacterias no tuberculosas. An Sist Sanit Navar. 2008;31(1):33-42.
31. Nogueira PA, Abrahão RMCM, Malucelli MIC. Análise dos resultados de exames de escarro, provenientes de unidade de saúde, hospitais e presídios do município de São Paulo, para o diagnóstico da tuberculose. Informe Epidem SUS. 2000;9(4):263-71.
32. Ministério da Saúde (Rio de Janeiro – Brasil). Controle da tuberculose: uma proposta de integração ensino-serviço. 5a ed. Rio de Janeiro (RJ): Fundação Nacional de Saúde; 2002.
33. Nogueira JA, Marques RRC, Silva TR, França UM, Villa TCS, Palha PF. Caracterização clínico-epidemiológica dos pacientes com diagnóstico de tuberculose resistente às drogas em João Pessoa, PB. Rev Eletr Enf. 2008;10(4):979-89.
34. Zocche TL, Silva RM. Tuberculose no município de Tubarão nos anos 2000-2006. Pulmão. 2009;18(2):70-6.
35. Billinger ME, Olivier KN, Viboud C, Montes de Oca R, Steiner C, Holland SM, et al. Nontuberculous mycobacteria associated lung disease in hospitalized persons, United States, 1998-2005. Emerg Infec Dis 2009;15(10):1562-9.
36. Prevots DR, Shaw PA, Strickland D, Jackson LA, Raebel MA, Blosky MA, et al. Nontuberculous mycobacterial lung disease prevalence at four integrated health care delivery systems. Am J Respir Crit Care Med 2010;182(7):970-6.
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