THAIS SABATO ROMANO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina

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Revista / Livro: American Journal of Infection Control ×

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  • article 25 Citação(ões) na Scopus
    Pseudooutbreak of rapidly growing mycobacteria due to Mycobacterium abscessus subsp bolletii in a digestive and respiratory endoscopy unit caused by the same clone as that of a countrywide outbreak
    (2016) GUIMARAES, Thais; CHIMARA, Erica; PRADO, Gladys Villas Boas do; FERRAZOLI, Lucilaine; CARVALHO, Natalia Garcia Fernandes; SIMEAO, Fernanda Cristina dos Santos; SOUZA, Andreia Rodrigues de; COSTA, Christiane A. R.; NIERO, Cristina Viana; BRIANESI, Urze Adomaitis; GIOIA, Thais Romano di; GOMES, Laura Maria Brasileiro; SPADAO, Fernanda de Souza; SILVA, Maria das Gracas; MOURA, Eduardo Guimaraes Hourneaux de; LEVIN, Anna S.
    Background: The nontuberculous mycobacteria (NTM) are widely spread. In Brazil, 2,520 cases of rapidly growing mycobacteria (RGM) infections after medical procedures were reported, with 5.4% of cases related to nonsurgical invasive procedures and with an occurrence of 1 clone (BRA100) of Mycobacterium abscessus subsp bolletii. Objective: To describe a pseudooutbreak of M abscessus subsp bolletii in an endoscopy and bronchoscopy unit. Methods: The alert for a pseudooutbreak was given when 3 patients, in the same week, had a positive bronchoalveolar lavage culture for M abscessus subsp bolletii. The patients had no symptoms/signs of mycobacterial infection; thus, contamination of bronchoscopes was suspected. Samples for culturing were collected from bronchoscopes, digestive endoscopes, automated disinfection machines, and the water supply. Clinical samples were identified by polymerase chain reaction restriction-enzyme analysis (PRA) of the hsp65 gene and their pulsed-field gel electrophoresis pattern was compared with environmental samples. Results: The investigation demonstrated a contamination of bronchoscopes, digestive endoscopes, and disinfection machines. Molecular typing demonstrated that all strains belonged to the same clone (MAB01), identical to clone BRA100. Discussion: Cross-transmission due to poor disinfection as well as resistance to glutaraldehyde may play roles in the spread of MAB01 M abscessus subsp bolletii, which may have a unique resistance to the environment and adaption to human hosts. However the water supply may have played a role. Attention is needed to ensure the quality of water used to rinse disinfected equipment.