Epidemic of surgical-site infections by a single clone of rapidly growing mycobacteria in Brazil

Aim: Our aim is to investigate if the clusters of postsurgical mycobacterial infections, reported between 2004 and 2008 in seven geographically distant states in Brazil, were caused by a single mycobacterial strain. Materials & methods: Available information from 929 surgical patients was obtained from local health authorities. A total of 152 isolates from surgical patients were identified by PCR restriction enzyme analysis of the hsp65 gene (PRA-hsp65) and sequencing of the rpoB gene. Isolates were typed by pulsed-field gel electrophoresis (PFGE) using two restriction enzymes. Dral and Asel. A total of 15 isolates not related to surgical cases were analyzed for comparison. Results: All isolates were identified as Mycobacterium abscessus ssp. massiliense. Isolates from surgical patients and one sputum isolate grouped in a single PFGE cluster, composed of two closely related patterns, with one band difference. A total of 14 other isolates unrelated to surgical cases showed distinctive PFGE patterns. Conclusion: A particular strain of M. abscessus ssp. massiliense was associated with a prolonged epidemic of postsurgical infections in seven Brazilian states, suggesting that this strain may be distributed in Brazilian territory and better adapted to cause surgical-site infections.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Dept Microbiol Immunol & Parasitol, BR-04023062 São Paulo, BrazilUniv Fed Espirito Santo, Nucleo Doencas Infecciosas, Vitoria, ES, BrazilInst Evandro Chagas, Belem, Para, BrazilUniv Fed Rio de Janeiro, Inst Microbiol, BR-21941 Rio de Janeiro, BrazilFundacao Oswaldo Cruz, Inst Pesquisa Evandro Chagas, Rio de Janeiro, BrazilUniv Fed Goias, Dept Microbiol Imunol Parasitol & Patol, Goiania, Go, BrazilSecretaria Municipal Saude Goiania, Goiania, Go, BrazilSecretaria Estadual Saude Parana, Curitiba, Parana, BrazilLab Cent Saude Publ, Porto Alegre, RS, BrazilCtr Vigilancia Epidemiol Prof Alexandre Vranjac, São Paulo, BrazilInst Adolfo Lutz Registro, Setor Micobacterias, São Paulo, BrazilCtr Referencia Prof Helio Fraga, Rio de Janeiro, BrazilUniversidade Federal de São Paulo, Dept Microbiol Immunol & Parasitol, BR-04023062 São Paulo, BrazilFAPESP: 06/1533-9CNPq: 470594/2006-3CNPq: 475238/2008-7Web of Scienc