Application of four molecular typing methods for analysis of Mycobacterium fortuitum group strains causing post-mammaplasty infections

A cluster of cases of post-augmentation mammaplasty surgical site infections occurred between 2002 and 2004 in Campinas, in the southern region of Brazil. Rapidly growing mycobacteria were isolated from samples from 12 patients. Eleven isolates were identified as Mycobacterium fortuitum and one as Mycobacterium porcinum by PCR-restriction digestion of the hsp65 gene. These 12 isolates, plus six additional M. fortuitum isolates from non-related patients, were typed by pulsed-field gel electrophoresis (PFGE) and three PCR-based techniques: 16S-23S rRNA internal transcribed spacer (ITS) genotyping; randomly amplified polymorphic DNA (RAPD) PCR; and enterobacterial repetitive intergenic consensus (ERIC) PCR. Four novel M. fortuitum allelic variants were identified by restriction analysis of the ITS fragment. One major cluster, comprising six M. fortuitum isolates, and a second cluster of two isolates, were identified by the four methods. RAPD-PCR and ITS genotyping were less discriminative than ERIC-PCR. ERIC-PCR was comparable to PFGE as a valuable complementary tool for investigation of this type of outbreak.Universidade Federal de São Paulo, Escola Paulista Med, Dept Microbiol Imunol & Parasitol, BR-04023062 São Paulo, SP, BrazilFleury Ctr Med Diagnost, São Paulo, BrazilInst Adolfo Lutz Registro, São Paulo, BrazilInst Vozza Med & Diagnose LTDA, Campinas, BrazilCtr Vigilancia Epidemiol Prof Alexandre Vranjac, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Microbiol Imunol & Parasitol, BR-04023062 São Paulo, SP, BrazilWeb of Scienc

Distribución de patrones PRA en aislamientos clínicos del complejo Mycobacterium avium procedentes de España y Suramérica.

Mycobacterium avium complex (MAC) infections are the most frequent systemic infections associated with advanced AIDS. DNA probes for accurate identification of mycobacteria are available but are very expensive in many Latin American settings. Consequently, most Latin American diagnostic laboratories employ inaccurate and outdated tests for mycobacteria identification. Therefore, PCR restriction analysis (PRA) of the hsp65 gene was evaluated for the identification of 163 MAC human isolates originated from Spain and South America. The predominant PRA type in each country was: M. avium type I in Argentina (23/42, 55%) and Brazil (48/72, 67%), M. avium type II in Spain (18/26, 69%) and M. avium type III in Colombia (10/23, 43%). The Colombia frequency is noteworthy, since the PRA type III was quite infrequent in the other three countries. Furthermore, its presence has not been reported outside the Americas. The advantages and disadvantages of PRA in diagnostic mycobacteriology are discussed.La infección por el complejo Mycobacterium avium (MAC) es la infección sistémica más frecuente en la fase terminal del SIDA. Las sondas de ADN disponibles en el mercado para la identificación de micobacterias son muy precisas pero extremadamente costosas. Por eso, la mayoría de los laboratorios clínicos de Latinoamérica aún tipifican micobacterias mediante pruebas fenotípicas que son lentas, laboriosas y poco precisas. En este trabajo se aplicó el análisis del polimorfismo de los fragmentos de restricción del gen hsp65 (PRA) a la identificación de MAC en 163 aislamientos clínicos procedentes de España y Suramérica. El genotipo PRA predominante en cada país fue: M. avium tipo I en Argentina (23/42, 55%) y Brasil (48/72, 67%), M. avium tipo II en España (18/26, 69%) y M. avium tipo III en Colombia (10/23, 43%). Este último genotipo, que aún no fue descrito fuera del continente americano, resultó muy infrecuente en los otros tres países del estudio. Se discuten ventajas e inconvenientes de la aplicación del PRA al diagnóstico micobacteriológico

Gargalos e recomendações para a incorporação de novas tecnologias na rede pública laboratorial de tuberculose no Brasil Bottlenecks and recommendations for the incorporation of new technologies in the tuberculosis laboratory network in Brazil

Novas tecnologias para o diagnóstico da tuberculose foram recentemente recomendadas pela Organização Mundial da Saúde (OMS). Algumas recomendações da OMS incluem a elaboração de um plano estratégico para a adequação da rede, investimentos em supervisão e controle de qualidade, implementação de um sistema de gerenciamento de ambiente laboratorial, sem o que nenhuma nova tecnologia poderá ser eficazmente incorporada. Realizamos um levantamento da rede laboratorial de tuberculose no Brasil para identificar possíveis gargalos para a incorporação dessas tecnologias. Identificamos escassez de recursos para supervisão e controle de qualidade, baixa solicitação de culturas, ausência de sistemas eficazes de informação laboratorial e o desconhecimento da rede periférica municipal quanto às necessidades futuras na infraestrutura.The World Health Organization (WHO) has recently recommended new technologies for the diagnosis of tuberculosis. The WHO recommendations include the development of a strategic plan for bringing the network up to grade; investment in supervision and quality control; and implementation of a system of laboratory environmental management. Without those measures having been taken, no new technology can be effectively incorporated. We surveyed the tuberculosis laboratory network in Brazil in order to identify possible bottlenecks for the incorporation of new technologies. We identified a lack of resources allocated to supervision and quality control; a low number of requests for cultures; a lack of effective laboratory information systems; and a lack of awareness regarding the future infrastructure needs of the laboratory network at the municipal level

Paisagem construída: fotografia e memória dos "melhoramentos urbanos" na cidade do Rio de Janeiro Constructed Landscape: photography and memory of the 'urban improvements' in the city of Rio de Janeiro

Este artigo apresenta algumas reflexões sobre os usos sociais da fotografia na documentação das transformações urbanas na cidade do Rio de Janeiro. Desde o século XIX, a imagem fotográfica foi utilizada como recurso privilegiado para a representação visual da cidade e a criação de memórias, individuais e coletivas, das grandes obras de engenharia promovidas pelo Estado. Nos primeiros anos do século XX, esse gênero de fotografia foi essencial para a difusão de uma nova imagem da então capital federal associada aos ideais de progresso e civilização. Construída entre 1904 e 1905, a Avenida Central representou uma das principais intervenções humanas na paisagem carioca, destacando-se neste empreendimento a figura de Paulo de Frontin, engenheiro que esteve à frente de diversas obras públicas do país, entre o final do século XIX e o início do século XX.<br>This paper presents some issues on the social uses of photography in the documentation related to Rio de Janeiro urban transformation. Since the XIX century, the photographic image has been used as a special resource for visual representation of the city and for individual and collective memory of the larger engineering works promoted by the State.In the early years of the XX century, this kind of photography was essential for the diffusion of a new image of Rio de Janeiro embedded with the ideals of progress and civilization. Built during the years 1904 and 1905, the Central avenue ("Avenida Central") represented one of the most important human interventions in Rio de Janeiro.s landscape. Paulo de Frontin, an outstanding engineer, was in charge of this enterprise, as other main public works of the country he led between the end of the XIX century and the beginning of the XX