Efeitos das etapas de tratamento e processamento do tecido na PCR para detecção de Mycobacterium tuberculosis em amostras fixadas em formalina e incluídas em parafina

Development and standardization of reliable methods for detection of Mycobacterium tuberculosis in clinical samples is an important goal in laboratories throughout the world. In this work, lung and spleen fragments from a patient who died with the diagnosis of miliary tuberculosis were used to evaluate the influence of the type of fixative as well as the fixation and paraffin inclusion protocols on PCR performance in paraffin embedded specimens. Tissue fragments were fixed for four h to 48 h, using either 10% non-buffered or 10% buffered formalin, and embedded in pure paraffin or paraffin mixed with bee wax. Specimens were submitted to PCR for amplification of the human beta-actin gene and separately for amplification of the insertion sequence IS6110, specific from the M. tuberculosis complex. Amplification of the beta-actin gene was positive in all samples. No amplicons were generated by PCR-IS6110 when lung tissue fragments were fixed using 10% non-buffered formalin and were embedded in paraffin containing bee wax. In conclusion, combined inhibitory factors interfere in the detection of M. tuberculosis in stored material. It is important to control these inhibitory factors in order to implement molecular diagnosis in pathology laboratories.O desenvolvimento e a padronização de métodos confiáveis para a detecção de Mycobacterium tuberculosis em amostras clínicas é um objetivo importante nos laboratórios de todo o mundo. Neste trabalho, fragmentos de pulmão e baço de paciente que morreu com o diagnóstico de tuberculose miliar foram usados para avaliar a influência do tipo de fixador e dos protocolos de fixação e inclusão em parafina na performance da PCR. Fragmentos de tecido foram fixados por quatro h a 48 h, usando formalina não tamponada a 10% ou formalina tamponada a 10% e incluídos em parafina pura ou misturada a cera de abelha. As amostras foram submetidas a PCR para amplificação do gene da beta-actina humana e, separadamente, para amplificação da sequência de inserção IS6110, específica do complexo M. tuberculosis. O resultado da amplificação do gene da beta-actina foi positivo em todas as amostras. Não foram gerados amplicons na PCR-IS6110 em amostras de tecido pulmonar fixadas usando formalina não tamponada a 10% e incluídas em parafina com cera de abelha. Em conclusão, fatores inibitórios combinados interferiram na detecção de M. tuberculosis em material de arquivo. É importante controlar estes fatores inibitórios para poder implementar o diagnóstico molecular em laboratórios de patologia

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

<p>Abstract</p> <p>Background</p> <p>Identification of nontuberculous mycobacteria (NTM) based on phenotypic tests is time-consuming, labor-intensive, expensive and often provides erroneous or inconclusive results. In the molecular method referred to as PRA-<it>hsp65</it>, a fragment of the <it>hsp65 </it>gene is amplified by PCR and then analyzed by restriction digest; this rapid approach offers the promise of accurate, cost-effective species identification. The aim of this study was to determine whether species identification of NTM using PRA-<it>hsp65 </it>is sufficiently reliable to serve as the routine methodology in a reference laboratory.</p> <p>Results</p> <p>A total of 434 NTM isolates were obtained from 5019 cultures submitted to the Institute Adolpho Lutz, Sao Paulo Brazil, between January 2000 and January 2001. Species identification was performed for all isolates using conventional phenotypic methods and PRA-<it>hsp65</it>. For isolates for which these methods gave discordant results, definitive species identification was obtained by sequencing a 441 bp fragment of <it>hsp65</it>. Phenotypic evaluation and PRA-<it>hsp65 </it>were concordant for 321 (74%) isolates. These assignments were presumed to be correct. For the remaining 113 discordant isolates, definitive identification was based on sequencing a 441 bp fragment of <it>hsp65</it>. PRA-<it>hsp65 </it>identified 30 isolates with <it>hsp65 </it>alleles representing 13 previously unreported PRA-<it>hsp65 </it>patterns. Overall, species identification by PRA-<it>hsp65 </it>was significantly more accurate than by phenotype methods (392 (90.3%) vs. 338 (77.9%), respectively; p < .0001, Fisher's test). Among the 333 isolates representing the most common pathogenic species, PRA-<it>hsp65 </it>provided an incorrect result for only 1.2%.</p> <p>Conclusion</p> <p>PRA-<it>hsp65 </it>is a rapid and highly reliable method and deserves consideration by any clinical microbiology laboratory charged with performing species identification of NTM.</p

Difference in Virulence of Mycobacterium avium Isolates Sharing Indistinguishable DNA Fingerprint Determined in Murine Model of Lung Infection

Background: Opportunistic Mycobacterium avium typically causes disease in immunocompromised patients and in some groups of apparently healthy individuals. the high virulence of some bacterial lineages increases the disease risk. High-resolution molecular genotyping studies of M. avium clinical isolates demonstrated that some genotype patterns were more prevalent than others, suggesting that close genetic relatedness of these successful isolates sharing a similar genotype could determine similar biological properties associated with high virulence.Methods and Findings: in this study, we aimed to compare the virulence and pathogenic properties of two epidemiologically unrelated M. avium isolates sharing an indistinguishable DNA fingerprint in a well-characterized model of pulmonary infection in mice, resistant or susceptible to mycobacteria. the mice, C57BL/6 wild-type or IFN-gamma gene disrupted (GKO), respectively, were intratracheally infected with two isolates, H27 (human blood isolate) and P104 (pig lymph node isolate), and the lungs were examined for bacterial loads, histopathology and cytokine gene expression. the obtained data demonstrated significant differences in the virulence properties of these strains. Although the H27 strain grew significantly faster than P104 in the early stage of infection, this bacterium induced protective immunity that started to reduce bacterial numbers in the wild-type mice, whereas the P104 strain established a chronic infection. in the GKO mice, both strains were capable of causing a chronic infection, associated with higher bacterial burdens and severe lung pathology, in a similar manner.Conclusions/Significance: the results demonstrated that the studied isolates differed in the pathogenic properties although were indistinguishable by actually widely used genotyping techniques demonstrating that the genotype similarity does not predict similarity in virulence of M. avium isolates.Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Univ Estadual Norte Fluminense, Lab Biol Recognit, Rio de Janeiro, BrazilUniv Estadual Norte Fluminense, Lab Anim Morphol & Pathol, Rio de Janeiro, BrazilInst Butantan, Lab Immunochem, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Microbiol Immunol & Parasitol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Microbiol Immunol & Parasitol, São Paulo, BrazilFAPERJ: E-26/111.6111CNPq: 410555Web of Scienc

Profiling Mycobacterium ulcerans with hsp65

Univ Fed Sao Paulo, Escola Paulista Med, Dept Microbiol, BR-04023062 Sao Paulo, BrazilInst Trop Med, B-2000 Antwerp, BelgiumUniv Fed Sao Paulo, Escola Paulista Med, Dept Microbiol, BR-04023062 Sao Paulo, BrazilWeb of Scienc

Microcolony detection of Mycobacterium Bovis in Middlebrook 7H11 thin layer culture

The aim of this article is to evaluate the efficiency of the cultivation technique in thin layer of Middlebrook 7H11 (TL7H11) for isolating Mycobactererium bovis from suggestive lesions of tuberculosis in cattle and to compare the results with traditional methods of cultivation. At the first step it was used M. bovis AN5 and M. tubercuolosis H37Rv standard strain. The both performance were compared between the cultivation in TL7H11 and in the Stonebrink and Petragnani media. The strains presented visible growing in TL7H11 at the third day of cultivation, while the Stonebrink and Petragnani there were growing just at the 14 day. At the 13 day of cultivation it was possible to differentiate both strains by their colony morphological characteristics. The second step was to cultivate 62 clinicals samples in TL7H11 and Stonebrink for tentative isolation of M. bovis. The isolated samples were detected in TL7H11 until 21 days of cultivation whereas none samples weregrown in Stonebrink tubes. The median time of growing in TL7H11 was 19,0 days against 49,0 days of Stonebrink (p=0,014).O presente trabalho teve por objetivo avaliar a eficiência da técnica de cultivo em camada delgada de ágar Middlebrook 7H11 (TL7H11) no isolamento de Mycobacterium bovis de lesões sugestivas de tuberculose em bovinos, comparando seus resultados com os métodos tradicionais de cultivo. Numa primeira fase foram utilizadas estirpes padrão de M. bovis AN5 e M. tuberculosis H37Rv mantidas em laboratório, para comparação de desempenho entre o cultivo em TL7H11 e nos meios de Stonebrik e Petragnani. Ambas estirpes apresentaram crescimento visível em TL7H11 no terceiro dia de cultivo enquanto que nos meios de Stonebrink e Petragnani só houve crescimento a partir do 14º dia. Aos 13 dias de cultivo em TL7H11 foi possível diferenciar as duas estirpes pelas características morfológicas das colônias. Numa segunda fase, 62 amostras de campo foram cultivadas em TL7H11 e Stonebrink para isolamento de M. bovis. As amostras isoladas foram detectadas pelo TL7H11 até os 21 dias de cultivo contra nenhum crescimento dos tubos de Stonebrink. O tempo médio de crescimento no TL7H11 foi de 19,0 dias contra 49,0 dias do meio de Stonebrink (p = 0,014)

Mycobacterium haemophilum: Emerging or Underdiagnosed in Brazil?

Fleury Ctr Diagnost Med, Microbiol Sect, BR-04344070 Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo, BrazilOswaldo Cruz Hosp, Sao Paulo, BrazilAlbert Einstein Hosp, Sao Paulo, BrazilSirio Libanes Hosp, Sao Paulo, BrazilServidores Estado Hosp, Rio De Janeiro, BrazilAlianca Hosp, Salvador, BA, BrazilLamina Lab, Rio De Janeiro, BrazilInst Oswaldo Cruz, BR-20001 Rio De Janeiro, BrazilUniv Fed Sao Paulo, Sao Paulo, BrazilWeb of Scienc

Avaliação da virulência em hamsters (Mesocricetus auratus) de estirpes de Mycobacterium avium presentes na população de suínos do sul do Brasil

The finding of four clusters of M. avium (PIG-A, B, C and D), typed by the IS1245-RFLP method, infecting the swine population of the south region of Brazil, the possible existence of virulence differences among them, the role of the virulence in the transmission mechanisms of infections and the existence of reasonable doubts regarding the importance of horizontal transmission for swine micobacteriosis, the virulence of these four strains of M. avium were compared. Bacteria from each cluster were inoculated in 48 hamsters by intra-peritoneal route. On the 2nd, 13th, 26th, and 40th days after inoculation, (T1 to T4), 12 animals of each cluster were sacrificed with vapors of ethyl ether and the bacteria were quantified in the liver, spleen and lung. Results were expressed as cfu/g of organ. The presence of the strains was verified in the blood and histological exams were also accomplished. The four strains induced granulomatous lesions in the liver and spleen since 2 days after inoculation and were disseminated to the lungs through the blood stream. The cfu counts from spleen were always bigger them that obtained from liver and lungs. Differences among strains were observed through the analysis of cfu counts from spleen (T1: p; PIG-A&gt;; PIG-D&gt;; PIG-C.Tendo sido comprovada a existência de quatro famílias molecularmente distintas de M. avium (PIG-A, B, C e D) circulando em suínos da região sul do Brasil, e havendo dúvidas a respeito da importância da transmissão horizontal como mecanismo de manutenção da doença, o presente teve por objetivo estudar a virulência dessas estirpes, informação importante para o aperfeiçoamento dos métodos de controle. Uma estirpe representante de cada família foi inoculada pela via intra-peritoneal em 48 hamsters com uma dose de 30.000 U.F.C. por animal. Após 2, 13, 26 e 40 dias da inoculação (T1 a T4), 12 hamsters inoculados de cada família foram anestesiados, sacrificados e os agentes foram quantificados no fígado, baço e pulmão. Os resultados foram expressos em número de U.F.C./g de órgão. A presença das estirpes foi pesquisada no sangue e também foram realizados exames histológicos. As estirpes PIG-A, B, C e D induziram a formação de lesões granulomatosas no fígado e baço a partir do segundo dia pós-inoculação e disseminaram-se pela via hemática, alcançando os pulmões. O baço sempre apresentou maiores contagens de U.F.C., seguido pelo figado e pulmões. Diferenças entre as estirpes foram constatadas através de análises das contagens de U.F.C de baço (T1: p; PIG-A&gt;; PIG-D&gt;; PIG-C

Genomic epidemiology of a national outbreak of post-surgical Mycobacterium abscessus wound infections in Brazil.

An epidemic of post-surgical wound infections, caused by a non-tuberculous mycobacterium, has been on-going in Brazil. It has been unclear whether one or multiple lineages are responsible and whether their wide geographical distribution across Brazil is due to spread from a single point source or is the result of human-mediated transmission. 188 isolates, collected from nine Brazilian states, were whole genome sequenced and analysed using phylogenetic and comparative genomic approaches. The isolates from Brazil formed a single clade, which was estimated to have emerged in 2003. We observed temporal and geographic structure within the lineage that enabled us to infer the movement of sub-lineages across Brazil. The genome size of the Brazilian lineage was reduced relative to most strains in the three subspecies of Mycobacterium abscessus and contained a novel plasmid, pMAB02, in addition to the previously described pMAB01 plasmid. One lineage, which emerged just prior to the initial outbreak, is responsible for the epidemic of post-surgical wound infections in Brazil. Phylogenetic analysis indicates that multiple transmission events led to its spread. The presence of a novel plasmid and the reduced genome size suggest that the lineage has undergone adaptation to the surgical niche