Diversity of Pulsed-Field Gel Electrophoresis Patterns of Mycobacterium abscessus Type 2 Clinical Isolates

Abstract

Outbreaks of infections caused by rapidly growing mycobacteria (RGM) related to surgical and cosmetic procedures have concerned Brazilian health care authorities since 2003 (5, 12, 19, 22-24, 28). More than 2,000 notifications received between 2004 and 2008 by the Brazilian National Health Surveillance Agency (ANVISA) reported cases of RGM surgical-site infections after laparoscopic, arthroscopic, or plastic surgeries (4, 19). Most isolates recovered from surgical patients studied so far showed three common features: an uncommon pattern when they were submitted to PCR-restriction enzyme analysis of the hsp65 gene (PRA-hsp65), called Mycobacterium abscessus type 2 by Devallois et al. (10) and others (19); two characteristic substitutions [C(2683)T and T(2874)C] in the sequence of region V of the rpoB gene (2, 19, 28); and two highly similar patterns with one band difference when they were typed by pulsed-field gel electrophoresis (PFGE) using DraI and AseI restriction enzymes (5,12,19,28

Rapid tests for the detection of the Mycobacterium abscessus subsp. bolletii strain responsible for an epidemic of surgical-site infections in Brazil

“…Only one isolate per patient was included. These isolates had been previously characterised by rpoB gene sequencing, PFGE-DraI and PFGE-AseI , da Costa et al 2009, Duarte et al 2009, Leão et al 2010, Matsumoto et al 2011.…”

“…Isolates showing highly similar PFGE patterns (differing from the epidemic strain patterns by up to three bands) corresponded to subtypes of the epidemic strain, according to van Belkum et al (2007), and were categorised as genetically related (Matsumoto et al 2011).…”

“…PFGE typing -PFGE typing was performed as described in previous publications from our group (Leão et al 2010, Matsumoto et al 2011. PFGE patterns were analysed using the BioNumerics v. 5.1 program (Applied Maths, Sint-Martens-Laten, Belgium).…”

“…Additionally, this strain was isolated from sputum, bronchoalveolar lavage fluid (BAL) and urine from patients unrelated to the outbreak (Matsumoto et al 2011). The reports of RGM infections related to surgical procedures diminished significantly after 2008, although in 2010 additional surgical patients infected by the same strain were reported in the states of Amazonas (AM) and Rio Grande do Sul (RS), demonstrating that these infections may become endemic to Brazil.…”

“…abscessus (Sampaio et al 2006) and M. abscessus subsp. bolletii (Matsumoto et al 2011). Sequencing and PFGE are not available in most public laboratories in Brazil and the epidemiological surveillance of this outbreak has suffered from the lack of a simple and rapid test to screen M. abscessus subsp.…”