RESUMO
Emerald tree boas (Corallus batesii) are boids that in situ occurs in forested habitats in the Amazon Basin. The mycobacterial species can infect reptiles but the species Mycolicibacterium fortuitum was identified only in feces samples of ex situ Python regius and was isolated from granulomatous lesions of an ex situ Iguana iguana when was still part of the genus Mycobacterium. This article aims to report a mycobacteria infection case in a female Corallus batesii kept under human care. The animal presented apathy and 2 months of anorexia, being found dead. The necropsy revealed presence of tracheal and pulmonary nodules besides multifocal, bacterial, granulomatous pneumonia. After Fite-Faraco histochemical staining, immunohistochemistry, semi-nested polymerase chain reaction (PCR) and genetic sequencing the Mycolicibacterium fortuitum complex was diagnosed with 99.54% of nucleotide similarity. This mycobacterial species was already pointed out as an important nosocomial pathogen and more studies are necessary to explore their zoonotic potential.
Assuntos
Boidae , Mycobacterium fortuitum , Animais , Feminino , Mycobacterium fortuitum/isolamento & purificação , Mycobacterium fortuitum/genética , Mycobacterium fortuitum/classificação , Boidae/microbiologia , Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções por Mycobacterium não Tuberculosas/veterinária , Evolução Fatal , FilogeniaRESUMO
A 40-year old female chimpanzee (Pan troglodytes) developed hyporexia, weight loss, followed by progressive and complete blindness. Tomography demonstrated an intracranial mass in the rostroventral brain involving the optic chiasm, with a presumptive diagnosis of neoplasm. However, histopathology revealed a granulomatous meningoencephalitis, and tissue samples tested positive for Mycobacterium tuberculosis.
Assuntos
Doenças dos Símios Antropoides , Cegueira , Meningoencefalite , Mycobacterium tuberculosis , Pan troglodytes , Animais , Feminino , Doenças dos Símios Antropoides/diagnóstico , Doenças dos Símios Antropoides/microbiologia , Doenças dos Símios Antropoides/patologia , Mycobacterium tuberculosis/isolamento & purificação , Cegueira/veterinária , Cegueira/etiologia , Cegueira/microbiologia , Cegueira/diagnóstico , Meningoencefalite/veterinária , Meningoencefalite/microbiologia , Meningoencefalite/diagnóstico , Granuloma/veterinária , Granuloma/microbiologia , Granuloma/patologia , Granuloma/diagnóstico , Tuberculose/veterinária , Tuberculose/diagnóstico , Tuberculose/complicaçõesRESUMO
Mycobacterium avium is a zoonotic pathogen associated with a wide range of pulmonary and extrapulmonary manifestations in a range of host species like humans, animals, and birds. The disease is more common in the avian population, and opportunistic infections have been reported in immune-compromised or debilitated animals and humans. This study reports the pathological and molecular identification of Mycobacterium avium causing avian mycobacteriosis in a loft of domestic pigeons (Columba livia var. domestica). Out of 30 pigeons aged 2-3 years, ten adult racing pigeons revealed a severe chronic and debilitating disease followed by death. The clinical signs included chronic emaciation, dullness, ruffled feathers, lameness, and greenish, watery diarrhea. Post-mortem examination of birds revealed multifocal gray- to yellow-colored raised nodules in the liver parenchyma, spleen, lungs, intestines, bone marrow, and joints. Avian mycobacteriosis was suspected based on the tissue impression smears stained by Ziehl-Neelsen staining. Histopathological examination also revealed multifocal granulomatous lesions in affected organs, which is characteristic of avian mycobacteriosis. The PCR analysis based on 16S rRNA, IS1245, and IS901 regions suggested the presence of Mycobacterium avium infection belonging to either subspecies avium or sylvaticum. This is the first detailed report of avian mycobacteriosis in pigeons from India, warranting a strict surveillance program to identify the carrier status of these microorganisms in the pigeons, which may prove a fatal zoonotic infection in humans.
Assuntos
Columbidae , Mycobacterium avium , Animais , Humanos , RNA Ribossômico 16S/genética , Mycobacterium avium/genética , Fígado/patologia , PulmãoRESUMO
Background: Mycobacteriosis is caused by bacteria belonging to the genus Mycobacterium, with considerable zoonoticpotential and risk to public health. Infection in dogs is rare and is usually associated with immunosuppression, resultingfrom eating meat or contact with contaminated soil or fomites. Dogs are also known as potential sources for the spread ofatypical tuberculosis in humans and other animals. This paper aims to describe the clinical, cytological, histopathological,and molecular findings of a male canine seen at University Veterinary Hospital of Cuiabá, Mato Grosso, with generalizedlymphadenomegaly associated Mycobacterium intracellulare infection.Case: A 2-year-old male Lhasa Apso dog was referred to the University Veterinary Hospital in Cuiabá city, located in theMidwest region of Brazil. The patient had a history of intermittent claudication of the left pelvic limb for approximately6 months and lymphadenomegaly with progression for approximately 2 months. The dog had wheezing and generalizedlymphadenopathy (submandibular, axillary, and popliteal lymph nodes); cryptorchidism was also observed. A completeblood count revealed nonspecific results, and in the serum biochemical profile, the values of urea, creatinine, albumin, andalanine aminotransferase were within the reference range. No changes were observed on the radiography of the femurotibiopatellar joints. Considering the generalised lymphadenopathy, fine needle aspiration cytology and histopathologicalexamination through biopsy of the lymph nodes was performed. On the cytology and histopathology, numerous negativeimages of moderately refringent bacillary structures distending the cytoplasm from the macrophages was found. Thesamples were also subjected to special Ziehl-Neelsen staining, which confirmed an accentuated and diffuse granulomatouslymphadenitis associated with alcohol...(AU)
Assuntos
Animais , Cães , Linfadenite/patologia , Linfadenite/veterinária , Infecção por Mycobacterium avium-intracellulare/complicações , Infecção por Mycobacterium avium-intracellulare/veterinária , Complexo Mycobacterium avium/isolamento & purificação , Reação em Cadeia da Polimerase/veterinária , Infecções por Mycobacterium/veterináriaRESUMO
The freshwater ornamental fish trade represents a major contributor to the livelihoods of many producers in Trinidad and Tobago, with stocks destined for local, regional and international markets. A review of clinical cases presented to the Aquatic Animal Health Unit at the University of the West Indies, School of Veterinary Medicine for the period September 2010 to December 2012 suggested that piscine mycobacteriosis may be widespread throughout the local ornamental fish industry. Thus, to determine the prevalence of mycobacteriosis in ornamental fish sold in pet stores, a total of 122 specimens were sourced from 24 retail suppliers across Trinidad. Fish were killed and internal organs were examined for lesions suggestive of granulomas. All wet-mount slides were acid-fast stained, regardless of the presence or absence of observed granuloma-like lesions. Histological analysis was performed on one randomly selected whole specimen from each facility. Mycobacterium sp. was identified using real-time PCR detecting the 16S rRNA gene in tissue samples. Associations between parasitism, facility biosecurity and presence of positive animals were determined. The prevalence of Mycobacterium sp. infection was 61 ± 7% (74/122), with positive specimens being acquired from 54.2% (13/24) of facilities examined. Further, 100% of facilities did not employ optimum biosecurity measures.
Assuntos
Doenças dos Peixes , Infecções por Mycobacterium , Animais , Doenças dos Peixes/microbiologia , Peixes/microbiologia , Infecções por Mycobacterium/epidemiologia , Infecções por Mycobacterium/microbiologia , Infecções por Mycobacterium/veterinária , RNA Ribossômico 16S/genética , Trinidad e Tobago/epidemiologiaRESUMO
Background: Mycobacteriosis is caused by bacteria belonging to the genus Mycobacterium, with considerable zoonoticpotential and risk to public health. Infection in dogs is rare and is usually associated with immunosuppression, resultingfrom eating meat or contact with contaminated soil or fomites. Dogs are also known as potential sources for the spread ofatypical tuberculosis in humans and other animals. This paper aims to describe the clinical, cytological, histopathological,and molecular findings of a male canine seen at University Veterinary Hospital of Cuiabá, Mato Grosso, with generalizedlymphadenomegaly associated Mycobacterium intracellulare infection.Case: A 2-year-old male Lhasa Apso dog was referred to the University Veterinary Hospital in Cuiabá city, located in theMidwest region of Brazil. The patient had a history of intermittent claudication of the left pelvic limb for approximately6 months and lymphadenomegaly with progression for approximately 2 months. The dog had wheezing and generalizedlymphadenopathy (submandibular, axillary, and popliteal lymph nodes); cryptorchidism was also observed. A completeblood count revealed nonspecific results, and in the serum biochemical profile, the values of urea, creatinine, albumin, andalanine aminotransferase were within the reference range. No changes were observed on the radiography of the femurotibiopatellar joints. Considering the generalised lymphadenopathy, fine needle aspiration cytology and histopathologicalexamination through biopsy of the lymph nodes was performed. On the cytology and histopathology, numerous negativeimages of moderately refringent bacillary structures distending the cytoplasm from the macrophages was found. Thesamples were also subjected to special Ziehl-Neelsen staining, which confirmed an accentuated and diffuse granulomatouslymphadenitis associated with alcohol...
Assuntos
Animais , Cães , Complexo Mycobacterium avium/isolamento & purificação , Infecção por Mycobacterium avium-intracellulare/complicações , Infecção por Mycobacterium avium-intracellulare/veterinária , Linfadenite/patologia , Linfadenite/veterinária , Infecções por Mycobacterium/veterinária , Reação em Cadeia da Polimerase/veterináriaRESUMO
Achyrocline flaccida aqueous extract was obtained by macerating wildflowers. The phytochemical profile present in the A. flaccida aqueous extract was elucidated by HPLC-ESI-MS/MS. Toxicity was evaluated in vitro by comet assay in peripheral blood mononuclear cells (PBMCs) and in vivo using Caenorhabditis elegans as a model. The antioxidant activity was also evaluated, and antimycobacterial activity was assessed by the broth microdilution method. The compounds present in the aqueous extract mainly belonged to the flavonoid class (89%). The concentrations that showed protective effects in C. elegans against oxidative stress and antimycobacterial activity had no toxic effects. The antimycobacterial activity test demonstrated that the concentration of 1,560 µg mL-1 inhibited the growth and eradication of the mycobacterial tested strains. Based on our findings, the A. flaccida aqueous extract presents a viable potential in developing new phytotherapeutic drugs against mycobacteria of clinical relevance.
Assuntos
Achyrocline , Asteraceae , Achyrocline/química , Animais , Antibacterianos/farmacologia , Antioxidantes/química , Asteraceae/química , Brasil , Caenorhabditis elegans , Leucócitos Mononucleares , Extratos Vegetais/química , Espectrometria de Massas em TandemRESUMO
Mycobacteriosis was detected in seven out of one Atlantic mackerel (Scomber scombrus) that was purchased for human consumption from a fish market. The fish was apparently healthy but during cleaning, several granulomatous foci were noticed in the visceral organs. Histopathological examination of the lesions revealed numerous foci characterized by caseous necrosis in the center of the lesion surrounded by epithelioid giant cells. Ziehl-Neelsen staining revealed the presence of rod-shaped, acid-fast bacteria. Furthermore, immunohistochemical examination revealed the presence of a protein of mycobacterial origin in giant cells and macrophages. Based on gross and microscopic findings, mycobacteriosis was diagnosed. This report showed that due to its zoonotic potential, mycobacteriosis should be considered even in healthy-appearing fishes for human consumption.
A micobacteriose foi detectada em uma de sete cavalas do Atlântico (Scomber scombrus) que foi comprada para consumo humano em um mercado de peixe. O peixe era aparentemente saudável, mas durante a limpeza, vários focos granulomatosos foram notados nos órgãos viscerais. O exame histopatológico das lesões revelou numerosos focos caracterizados por necrose caseosa no centro da lesão circundada por células gigantes epitelioides. A coloração de Ziehl-Neelsen revelou a presença de bactérias em forma de bastonete, com rápida acidez. Além disso, o exame imunohistoquímico revelou a presença de uma proteína de origem micobacteriana em células gigantes e macrófagos. Com base em achados grosseiros e microscópicos, a micobacteriose foi diagnosticada. Este relatório mostrou que devido a seu potencial zoonótico, a micobacteriose deve ser considerada mesmo em peixes saudáveis para consumo humano.
Assuntos
Animais , Perciformes/microbiologia , Infecções por Mycobacterium/diagnóstico , Infecções por Mycobacterium/veterinária , Imuno-Histoquímica/veterinária , Zoonoses Bacterianas/diagnósticoRESUMO
INTRODUCTION: Zoonotic tuberculosis is a disease of public health importance worldwide, especially in developing countries. The present study aimed to investigate the role played by Mycobacterium bovis and other mycobacteria as etiologic agents of bubaline tuberculosis (TB) in the Brazilian Amazon region. METHODOLOGY: Granulomatous lesions suggestive of TB obtained from 109 buffaloes (n =109) during sanitary inspection at slaughter were subjected to histopathological evaluation, immunohistochemical (IHC) detection of Mycobacterium antigens, and to molecular tests (PCR) to detect hsp65, IS6110 and RD4 genes, which are specific to Mycobacterium spp., Mycobacterium tuberculosis Complex (MTBC) and M. bovis, respectively. RESULTS: PCR results indicated Mycobacterium infection in 87.2% of the cases, of which 69.5% were positive for M. bovis, 27.4% belonged to MTBC, and 3.1% were probably non-TB mycobacteria. There was good agreement between the genus-specific molecular technique and the histopathological analysis. This high frequency of TB cases caused by non-M. bovis suggests a diversified scenario of mycobacteria associated with bubaline TB in the Brazilian Amazon region. CONCLUSIONS: The results reinforce the need of discussing the inclusion of more accurate techniques in examinations carried out by Inspection Services in Brazil.
Assuntos
Búfalos , Mycobacterium bovis/isolamento & purificação , Tuberculose/veterinária , Matadouros , Animais , Brasil/epidemiologia , Humanos , Mycobacterium bovis/genética , Tuberculose/epidemiologia , Tuberculose/microbiologia , Zoonoses/prevenção & controleRESUMO
Achyrocline flaccida (Weinm) DC. essential oil was obtained by hydrodistillation of wild flowers from southern Brazil. We explored, for the first time, the phytochemical composition, toxicity, resistance to oxidative stress in Caenorhabditis elegans, and antimycobacterial activities of A. flaccida essential oil. Twenty-four compounds were identified by GC-FID-MS and the major constituents identified were α-pinene (41.10%) and caryophyllene (30.52%). The essential oil showed no signs of genotoxicity in the comet assay and presented relevant antioxidant capacity since it prevented ROS production in the C. elegans model. Furthermore, the minimal inhibitory concentrations (MIC) results showed that M. abscessus, M. massiliense, and M. fortuitum had their growth inhibited by A. flaccida essential oil. Therefore, the essential oil of this plant is a promising alternative in the search for new compounds capable of decreasing oxidative stress and treating mycobacteriosis.
Assuntos
Achyrocline , Óleos Voláteis , Animais , Brasil , Caenorhabditis elegans , Óleos Voláteis/farmacologia , Compostos Fitoquímicos/farmacologiaRESUMO
In this manuscript, we report, for the first time, the photoinactivation evaluation of tetra-cationic porphyrins with peripheral Pt (II)-bpy complexes in the photodynamic inactivation (PDI) of rapidly growing mycobacterial strains (RGM). Two different isomeric Pt (II)-porphyrins were synthetized and applied. PDI experiments in the strains of Mycobacteroides abscessus subsp. Abscessus (ATCC 19977), Mycolicibacterium fortuitum (ATCC 6841), Mycobacteroides abscessus subsp. Massiliense (ATCC 48898), and Mycolicibacterium smegmatis (ATCC 700084) conducted with adequate concentration (without aggregation) of photosensitizers (PS) under white-light illumination for 90 min showed that the most effective PS significantly reduced the concentration of viable mycobacteria. The present results show that positively charged porphyrins at the meta position (3-PtTPyP) are more efficient PS against M. abscessus, M. fortuitum, M. massiliense, and M. smegmatis. The effectiveness of the molecule as PS for PDI studies is also clear with mycobacteria, which is strongly related with the porphyrin peripheral charge and coordination platinum (II) compounds and consequently their solubility in physiological media. Tetra-cationic PS may be promising anti-mycobacterial PDI agents with potential applications in medical clinical cases and bioremediation.
Assuntos
Mycobacterium , Porfirinas , Cátions , Luz , Fármacos Fotossensibilizantes/farmacologiaRESUMO
We report a case of fungal and mycobacterial co-infection in an immunosuppressed patient from Southern Brazil. Histoplasmosis was diagnosed in an AIDS patient admitted to the hospital with nonspecific respiratory signs. However, 4 months post hospital discharge, the patient worsened and a co-infection with Mycobacterium avium was detected. Physicians must consider and investigate a broad spectrum of diseases which can occur as co-infections and which share the same clinical symptoms and signs in immunosuppressed patients.
RESUMO
Background: The Harpy eagle (Harpia harpyia) is the largest raptor in the Neotropical region, distributed in low densities within primary forest habitats from southern Mexico to east-central Brazil, including Central America and Panama.Although locally extinct due to habitat degradation, human poaching and reduction of tropical forests in recent decades,some remnant populations are known to be small and isolated. Thus, information on its ecology, including infectiousdiseases, is critical for conservation efforts and management of populations of this emblematic species in the wild. AvianMycobacteriosis (AM) is a chronic disease affecting a wide range of birds and mammals and clinical cases have beensporadically reported, although in harpy eagles, has not been documented. In addition, scant information exists on pathologies affecting raptors, therefore, this report expands the knowledge on infectious diseases affecting wild birds. This studydescribes the first case of AM in an immature harpy eagle rescued from Darien gap and presents details of the clinicalmanifestation of the disease and its histological findings.Case: An immature harpy eagle was presented to a rescue center after being confiscated by Ministry of Environmentfrom a local farm in a remote region of Eastern Panama, in the Darien gap. The raptor had a history of having been keptin captivity for approximately five weeks, cohabiting with backyard poultry and fed corn, raw duck and chicken providedby farm owners. Stagnant water was offered for drinking. The harpy eagle arrived to the facility very lethargic and emaciated. Physical examination revealed damaged plumage, poor body condition and dyspnea. Complete blood count revealedanemia and leukocytosis based on lymphocytosis and eosinophilia. Biochemical profile evidenced an increased level ofaspartate aminotransferase (AST), phosphorus and total plasma protein. Most remarkable radiographic findings weresplenomegaly...(AU)
Assuntos
Animais , Aves Predatórias/microbiologia , Infecções por Mycobacterium/patologia , Infecções por Mycobacterium/veterinária , Mycobacterium avium/isolamento & purificação , PanamáRESUMO
Background: The Harpy eagle (Harpia harpyia) is the largest raptor in the Neotropical region, distributed in low densities within primary forest habitats from southern Mexico to east-central Brazil, including Central America and Panama.Although locally extinct due to habitat degradation, human poaching and reduction of tropical forests in recent decades,some remnant populations are known to be small and isolated. Thus, information on its ecology, including infectiousdiseases, is critical for conservation efforts and management of populations of this emblematic species in the wild. AvianMycobacteriosis (AM) is a chronic disease affecting a wide range of birds and mammals and clinical cases have beensporadically reported, although in harpy eagles, has not been documented. In addition, scant information exists on pathologies affecting raptors, therefore, this report expands the knowledge on infectious diseases affecting wild birds. This studydescribes the first case of AM in an immature harpy eagle rescued from Darien gap and presents details of the clinicalmanifestation of the disease and its histological findings.Case: An immature harpy eagle was presented to a rescue center after being confiscated by Ministry of Environmentfrom a local farm in a remote region of Eastern Panama, in the Darien gap. The raptor had a history of having been keptin captivity for approximately five weeks, cohabiting with backyard poultry and fed corn, raw duck and chicken providedby farm owners. Stagnant water was offered for drinking. The harpy eagle arrived to the facility very lethargic and emaciated. Physical examination revealed damaged plumage, poor body condition and dyspnea. Complete blood count revealedanemia and leukocytosis based on lymphocytosis and eosinophilia. Biochemical profile evidenced an increased level ofaspartate aminotransferase (AST), phosphorus and total plasma protein. Most remarkable radiographic findings weresplenomegaly...
Assuntos
Animais , Aves Predatórias/microbiologia , Infecções por Mycobacterium/patologia , Infecções por Mycobacterium/veterinária , Mycobacterium avium/isolamento & purificação , PanamáRESUMO
Rapidly growing mycobacteria (RGM) are opportunistic pathogens found in the environment. When in biofilms, mycobacteria is highly resistant to antibacterial treatments. The purpose of this study is to evaluate the antibiofilm activity of antimicrobials commonly used in therapy against mycobacteria. The antimicrobial susceptibility of Mycobacterium abscessus, Mycobacterium fortuitum and Mycobacterium massiliense was determined in planktonic and sessile populations. The antimicrobials amikacin, ciprofloxacin, clarithromycin, doxycycline, imipenem and sulfamethoxazole were tested. For each drug, it was evaluated the susceptibility of the pathogen, the ability to inhibit biofilm formation and the resistance of biofilms to antimicrobial activity. Results showed although, the antimicrobials tested are used as an alternative therapy for RGM, M. abscessus proved to be resistant to clarithromycin, beside that, M. massiliense showed a resistant profile to clarithromycin and sulfamethoxazole. Moreover, the inhibition of biofilm formation and its destruction have not been fully met. Considering that the biofilms are a known form of bacterial resistance, the failure of alternatives to inhibit or destroy biofilms can trigger the recurrence of infections. In RGM, besides causing treatment failures, biofilms are a factor of pathogenic risk, since these microorganisms are found in environmental sources and can cause infections easily.
Assuntos
Anti-Infecciosos/farmacologia , Biofilmes/efeitos dos fármacos , Micobactérias não Tuberculosas/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Farmacorresistência Bacteriana , Violeta Genciana/análise , Testes de Sensibilidade Microbiana , Micobactérias não Tuberculosas/fisiologia , Espectrofotometria , Coloração e RotulagemAssuntos
Humanos , Masculino , Adulto , Orofaringe , Infecções Bacterianas , HIV , Imunocompetência , Micobactérias não Tuberculosas , Infecções por MycobacteriumRESUMO
A 3-year-old male black swan (Cygnus atratus), belonging to a private collection, died suddenly and was subjected to post mortem examination. At necropsy, caseous exudate was observed in the lungs and air sacs; granulomatous lesions characterized by epithelioid macrophages and abundant mycobacteria were observed microscopically. Avian tuberculosis associated with Mycobacterium bovis was confirmed by bacteriologic isolation, biochemical tests and molecular methods. The organism was identified as spoligotype SB0140, which is frequently found in cattle and people in North America. In this case, interspecies transmission could have been the source of infection because the swan cohabited with cattle.
Assuntos
Anseriformes/microbiologia , Mycobacterium bovis/isolamento & purificação , Infecções Respiratórias/veterinária , Tuberculose/veterinária , Animais , Evolução Fatal , Pulmão/microbiologia , Pulmão/patologia , Masculino , México , Mycobacterium bovis/genética , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/microbiologia , Tuberculose/diagnóstico , Tuberculose/microbiologiaRESUMO
Las Micobacterias de crecimiento rápido (MCR) son patógenos oportunistas capaces de ocasionar infecciones en piel, pulmonares y diseminadas. En Venezuela existe un incremento de estas infecciones derivadas de procedimientos invasivos, entre ellas cirugías estéticas. El tratamiento de esas infecciones requiere la administración de al menos dos antibióticos por varios meses. En la presente revisión se describe los mecanismos de resistencia a los antibióticos que se han reportado en las MCR, principalmente las tres especies que frecuentemente se han asociado a infecciones en piel: M. abscessus, M. chelonae y M. fortuitum. Los factores más importantes relacionados a la resistencia en los esquemas de tratamiento son: cambios relacionados en la permeabilidad de la membrana al antibiótico, la inactivación enzimática y modificaciones del sitio blanco. En MCR se han evidenciado la presencia de betalactamasas con actividad penicilinasas y cefalosporinasas y de acetil-transferasas que pueden modificar los aminoglicósidos. Las modificaciones de las regiones ARNr 23S y ARNr 16S han permitido explicar, en parte, la resistencia a macrólidos y aminoglicósidos. La metilación de los sitios blanco de acción de los macrólidos es otro factor importante, sobre todo en especies como M. abscessus. Éste último mecanismo explica la falla terapéutica que se ha reportado en pacientes tanto en infecciones pulmonares como en infecciones en piel. Es necesario ampliar el estudio sobre los mecanismos de resistencia en estas especies, tomando en consideración las complicaciones que llevan estas infecciones y los tiempos prolongados de tratamientos pudiendo generar efectos secundarios en los pacientes y la frustración cuando ocurre la falla terapéutica.
The rapid growing mycobacteria (RGM) are opportunist pathogens able to cause skin, pulmonary and disseminated infections. In Venezuela there is an increase in the prevalence of these infections especially following esthetic surgery. The treatment of such infections is cumbersome requiring the administration of at least two antibiotics for several months. In the present review we describe the principal antibiotic resistance mechanisms reported for RGM, particular for the species most frequently associated with skin and soft tissue infection: M. abscessus, M. chelonae and M. fortuitum. The most important factors associated with resistance to antibiotics are impermeability of the cell membrane, enzymatic inactivation and changes in the target site. In RGM the presence of the beta-lactamases with penicillinases and cephalosporinase activity has been demonstrated and the presence of acetyl-transferases which can modify aminoglycosides. Changes in the 23S rRNA and 16S rRNA regions has allowed to explain, partly macrolide and aminoglycoside resistance. Mutation in the macrolide target site is another important resistance mechanism, particularly for the species group M. abscessus. This last mechanism can explain treatment failure reported in the patients with pulmonary or skin infection. We conclude that there is a need for more extensive studies about the mechanisms of antibiotic resistance of RGM; taking into account the complications of these infections, the prolonged treatment long time, producing secondary effects and the frustrations of patient and physician caused by therapeutic failures.
Assuntos
Humanos , Masculino , Feminino , Infecções Bacterianas , Resistência Microbiana a Medicamentos , Mycobacterium , Infecções por MycobacteriumRESUMO
Introducción: la Mycobacteriosis es una enfermedad producida por Mycobacterias ambientales, su diagnóstico hasta hace pocos años era un hecho ocasional, actualmente ha pasado a ser una patología relativamente frecuente, sobre todo en los pacientes SIDA y asociada a enfermedades pulmonares crónicas. Requiere tratamientos agresivos y prolongados, así como la exéresis quirúrgica en casos de afección pulmonar localizada. Objetivo: determinar la importancia de la cirugía como tratamiento alternativo en caso de fracaso del tratamiento farmacológico.Presentación de los casos: se presentan dos casos con diagnóstico de Mycobacteriosis ambiental, por Mycobacterium Avium. Pacientes con síntomas respiratorios de larga fecha de evolución, principalmente tos y expectoración, asociado a fiebre. En el segundo caso se recoge el antecedente de neumonías frecuentes durante la infancia, con diagnóstico de Bronquiectasias. En ambos se les aisló en el cultivo del esputo un Mycobacterium Avium, la prueba de Mantoux resultó negativa (0 mm) y en los estudios imagenológicos se presentan las formas típicas de esta enfermedad, dadas por lesiones fibrocavitarias en los lóbulos superiores.Conclusiones: en los casos presentados, hubo fracaso en el tratamiento farmacológico recomendados en la actualidad, manteniendo cultivos de esputo positivos a Mycobacterium Avium. Se realizó tratamiento quirúrgico, obteniendo resultados positivos, con esputos negativos y mejoría del estado clínico(AU)
Introduction. Mycobacteriosis is a disease caused by environmental mycobacteria, until a few years ago its diagnosis was an occasional event. Today it has become a relatively frequent pathology, mainly in patients with AIDS and associated to chronic lung diseases. It requires aggressive treatments as well as surgical exeresis in the event of localized lung affections. Objective. determine the importance of the surgery as an alternative treatment when the pharmacological treatment fails. Case Presentation. two cases were presented with a diagnosis of environmental mycobacteriosis, caused by Mycobacterium Avium. Patients had respiratory symptoms of long evolution, mainly cough, expectoration, and associated fever. In the second case there were records of frequent pneumonias during childhood with diagnosed bronchiecstasias. In both cases in the sputum culture the Mycobacterium Avium was isolated, the Mantoux test was negative (0 mm) and in the radiological studies there were shapes that are usually seen in this disease caused by fibrocavitary lesions in the upper lobes. Conclusions. in the cases that were presented the pharmacological treatment normally recommended at present times failed, and the sputum cultures positive to Mycobacterium Avium persisted. Surgical treatment was conducted with positive results, negative sputums and improvement in the clinical condition(AU)