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Maria Telles

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Mônica Andrade

Solange Andrade Vera

Susilene Maria Tonelli Nardi

Christiane Nogueira

Universidade Federal de São Paulo (UNIFESP)

Letícia Wildner

Universidade Federal de Santa Catarina - UFSC (Federal University of Santa Catarina)

Fernando Batista

Universidade Federal do Rio Grande do Norte

Carlos de Figueiredo Antunes

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Papers by Maria Telles

Ovo desidratado para substituir ovo "in natura" na preparacao do meio Löwenstein-Jensen para cultivo de micobacterias

Revista Do Instituto Adolfo Lutz, 2001

RESUMO. Os métodos bacteriológicos são extremamente importantes para diagnosticar tuberculose pul... more RESUMO. Os métodos bacteriológicos são extremamente importantes para diagnosticar tuberculose pulmonar. O meio de cultura mais comumente usado para isolar micobactérias é o Löwenstein-Jensen (LJ), meio sólido à base de ovos. Os ovos precisam sofrer uma limpeza prévia que consiste em escoválos com água e sabão, com posterior descontaminação por 30 minutos em álcool 70%. O ovo "in natura" apresenta dois inconvenientes: esta limpeza, que é demorada e o sistema de compras e armazenamento, pois os ovos devem ser frescos. Com o propósito de simplificar este procedimento, este estudo comparou o meio preparado com ovos frescos e com ovos desidratados. Amostras clínicas foram processadas para cultura e o inoculo foi semeado nos dois tipos de meios. Os resultados das culturas mostraram que das 150 amostras positivas pela baciloscopia, 123 foram positivas no meio convencional e 24 foram negativas, enquanto que no meio teste, foram 121 positivas e 26 negativas, mostrando uma diferença que não foi significativa. Contaminações ocorreram igualmente nos dois meios (3 amostras). Ao comparar-se os dois meios a sensibilidade foi de 98% e a especificidade de 100%. Conclui-se que o ovo desidratado pode ser uma forma alternativa e vantajosa, no preparo do meio de Löwenstein-Jensen. PALAVRAS-CHAVE. meio de cultura, Löwenstein-Jensen, tuberculose, ovo desidratado. INTRODUÇÃO Em 1993 a Organização Mundial de Saúde (OMS) declarou a tuberculose uma emergência mundial devido ao fato de ser uma doença em crescimento progressivo em todo mundo e fora de controle nas áreas mais pobres do planeta 1 .

An alternative biphasic culture system for recovery of mycobacteria and for differentiation of species other than M. tuberculosis complex from blood specimens

Rev Microbiol, Sep 1, 1997

... Id: 280115. Autor: Martins, Maria Conceiçäo; Ueki, Suely Yoko Mizuka; Palhares, Maria Cecilia... more

Cabine de segurança biológica: efeito da luz ultravioleta nas micobactérias

Revista Do Instituto Adolfo Lutz, Dec 1, 2006

... Id: 461282. Autor: Ueki, Suely Yoko Mizuka; Geremias, Ana Lívia; Moniz, Letícia Lisboa; Latri... more

Mixed mycobacterial cultures: is it important to separate and to identify multiple species?

Revista Do Instituto Adolfo Lutz, 2005

Identificação de mutações no gene INHA associadas com a resistência à isoniazida no genoma de Mycobacterium tuberculosis

Culturas mistas de micobactérias: é importante isolar e identificar?

Revista Do Instituto Adolfo Lutz, 2005

Martin, A. et al. Multicenter study of MTT and resazurin assays for testing susceptibility to first-line anti-tuberculosis drugs. Int. J. Tuberc. Lung Dis. 9, 901-906

The International Journal of Tuberculosis and Lung Disease

A multicentre evaluation was performed to assess two rapid low-cost methods, MTT (3-[4.5dimethylt... more A multicentre evaluation was performed to assess two rapid low-cost methods, MTT (3-[4.5dimethylthiazol-2-yl]-2.5-diphenyltetrazolium bromide) and resazurin assays, for testing the susceptibility of Mycobacterium tuberculosis to the first-line anti-tuberculosis drugs rifampicin (RMP), isoniazid (INH), ethambutol (EMB) and streptomycin (SM). M E T H O D S : Thirty coded M. tuberculosis strains were sent to seven laboratories located in Latin America, representing six countries. Each site performed the colorimetric assays, MTT and resazurin, blind for the first-line drugs RMP, INH, EMB and SM. The minimum inhibitory concentration results obtained were compared to the conventional proportion method on Löwenstein-Jensen medium. R E S U L T S : After establishing the breakpoint concentrations, excellent results were obtained for RMP, INH and EMB, with levels of specificity and sensitivity of between 96% and 99%. C O N C L U S I O N : MTT and resazurin assays are promising, accessible new alternative methods for middle-and low-resource countries that need low-cost methods to perform rapid susceptibility testing of M. tuberculosis to key anti-tuberculosis drugs.

124-PA11 Rapid drug susceptibility testing of Mycobacterium tuberculosis by a microdilution broth minimum inhibitory concentration (MIC) method

Tubercle and Lung Disease, 1995

Chapter 11: Biosafety and Hospital Control

Bottlenecks and recommendations for the incorporation of new technologies in the tuberculosis laboratory network in Brazil

Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia

The World Health Organization (WHO) has recently recommended new technologies for the diagnosis o... more 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.

Multicentre evaluation of an automated BACTEC 960 system for susceptibility testing of Mycobacterium tuberculosis

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2007

Three mycobacteria reference laboratories in the south-eastern part of Brazil. To evaluate the au... more Three mycobacteria reference laboratories in the south-eastern part of Brazil. To evaluate the automated Mycobacteria Growth Indicator Tube (MGIT) for drug susceptibility testing of Mycobacterium tuberculosis. Performance of the automated BACTEC MGIT 960 (M960) system for testing M. tuberculosis susceptibility to streptomycin (SM), isoniazid (INH), rifampicin (RMP) and ethambutol (EMB) was evaluated with 95 clinical isolates and compared to the results of the radiometric BACTEC 460TB (B460) system, the proportion method (PM), and the resistance ratio method (RRM). Judicial susceptibility profiles of 88 isolates were defined based on two or more concordant results among B460, PM and RRM, and used as a reference for comparison with M960 results. Agreement rates between M960 and conventional methods were 95.2% with B460, 96.6% with the PM and 93.4% with the RRM. The lowest agreement rates were obtained for SM with the RRM and for EMB with B460. When comparing M960 with judicial suscept...

Mycobacterium tuberculosis bacteremia diagnosed in an HIV-negative patient in Brazil: a rare or an under-reported event?

The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases, 2004

A case of Mycobacterium tuberculosis bacteremia in an HIV negative immunodepressed patient was de... more

PCR-restriction enzyme analysis of a bone marrow isolate from a human immunodeficiency virus-positive patient discloses polyclonal infection with two Mycobacterium avium strains

Journal of clinical microbiology, 2000

Polyclonal infection by Mycobacterium avium was detected by hsp65 PCR-restriction enzyme analysis... more Polyclonal infection by Mycobacterium avium was detected by hsp65 PCR-restriction enzyme analysis (PRA) in a bone marrow isolate from an AIDS patient. Two M. avium strains, differing in colony morphology, PRA HaeIII digestion pattern, insertion element (IS) 1245 amplification, and restriction fragment length polymorphism fingerprints with IS1245 and IS1311 probes, were isolated.

Single and double drug susceptibility testing of Mycobacterium avium complex and mycobacteria other than the tubercle (MOTT) bacilli by a micro-dilution broth minimum inhibitory concentration (MIC) method

Tubercle and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 1994

The incidence of Mycobacterioses is increasing annually, especially in patients with AIDS. There ... more The incidence of Mycobacterioses is increasing annually, especially in patients with AIDS. There is no clear correlation between in vitro drug susceptibility testing of mycobacteria other than the tubercle (MOTT) bacilli and the in vivo response. Although in vitro, MOTT bacilli appear resistant, some patients respond to treatment possibly as a result of a synergistic action between the drugs being used. To produce a simple method to determine which individual drugs or combinations of drugs will be effective in killing the causative organism. A broth microdilution method, using microtitre plates, was used to determine the minimum inhibitory concentration (MIC) of the drugs alone and then in combination. It was found that the MIC values of the test drugs varied between but were constant within each of the species. Mycobacterium xenopi, M. malmoense and M. kansasii showed a large amount of susceptibility while M. avium complex, M. fortuitum and M. chelonae were limited in their respons...

Cord factor detection and macroscopic evaluation of mycobacterial colonies: an efficient combined screening test for the presumptive identification of Mycobacterium tuberculosis complex on solid media* , ** Detecção do fator corda e avaliação do aspecto macroscópico das colônias de micobactérias:...

Objective: The rapid differentiation between Mycobacterium tuberculosis and nontuberculous mycoba... more Objective: The rapid differentiation between Mycobacterium tuberculosis and nontuberculous mycobacteria is fundamental for patients co-infected with tuberculosis and HIV. To that end, we use two methods in our laboratory: detection of cord factor and PCR-restriction enzyme analysis (PRA). The objective of this study was to evaluate the accuracy of a screening test on solid medium as a rapid method for the presumptive identification of M. tuberculosis complex, considering costs and turnover time. Methods: A total of 152 strains were submitted to a combined screening test, consisting of the detection of cord factor under microscopy (Ziehl-Neelsen staining) and evaluation of the macroscopic aspect of colonies, as well as to PRA, which was used as the gold standard. Costs were estimated by calculating the price of all of the materials needed for each test. Results: The overall accuracy of cord factor detection alone was 95.4% (95% CI: 90.7-98.1%), and that of the combined screening test...

Molecular characterization of Mycobacterium kansasii isolates in the State of São Paulo between 1995-1998

Memorias Do Instituto Oswaldo Cruz, 2004

Mycobacterium kansasii is the most common cause of pulmonary nontuberculous mycobacteria infectio... more Mycobacterium kansasii is the most common cause of pulmonary nontuberculous mycobacteria infection and classical identification of this pathogen needs a time consuming phenotypic tests. Polymerase chain reactionrestriction fragment lenght polymorphism analysis (PRA) of the gene enconding for the 65kDa heat shock (hsp65) protein offers an easy, rapid, and inexpensive procedure to identify and subtype M. kansasii isolates. In the present study, we performed a retrospective analysis of patients who had mycobacteria identified on the basis of phenotypic tests by means of a review of database at Mycobacteria Laboratory of the Instituto Adolfo Lutz in the period 1995-1998. A total of 9381 clinical isolates were analyzed of which 7777 (82.9%) were identified as M. tuberculosis complex and 1604 (17.1%) as nontuberculous mycobacteria. Of the 296 M. kansasii isolates, 189 (63.8%) isolates obtained from 119 patients were viable and were analyzed by PRA-hsp65. Hundred eight two (98.9%) were classified as M. kansasii type I. Two isolates were classified as type II and III and five isolates were characterized as other Mycobacterium species. Clinical isolates of M. kansasii in the state of São Paulo was almost exclusively subtype I regardless of HIV status.

Drug resistance of M. Tuberculosis isolated from patients with HIV infection seen at an AIDS Reference Center in São Paulo, Brazil

Revista do Instituto de Medicina Tropical de São Paulo, 1996

M. tuberculosis-positive cultures were obtained from 228 patients seen in our service and drug se... more M. tuberculosis-positive cultures were obtained from 228 patients seen in our service and drug sensitivity assays were carried out from January 1992 to December 1994. A survey of the medical records of these patients showed resistance to one or more drugs in 47 (20.6%), 25 of whom (10.9%), who reported previous treatment, were considered to have acquired resistance. Among the antecedents investigated, only previous treatment and alcoholism were the factors independently associated with the occurrence of resistance. The survival of patients with resistant strains was lower than that of patients attacked by non-resistant M. tuberculosis. We conclude that in the present series M. tuberculosis resistance to tuberculostatic agents was predominantly of the acquired type.

Mycobacterium avium complex (MAC) isolated from AIDS patients and the criteria required for its implication in disease

Revista do Instituto de Medicina Tropical de São Paulo, 1995

Before the AIDS pandemia, the Mycobacterium avium complex (MAC) was responsible in most cases for... more Before the AIDS pandemia, the Mycobacterium avium complex (MAC) was responsible in most cases for the pneumopathies that attack patients with basic chronic pulmonary diseases such as emphysema and chronic bronchitis36. In 1981, with the advent of the acquired immunodeficiency syndrome (AIDS), MAC started to represent one of the most frequent bacterial diseases among AIDS patients, with the disseminated form of the disease being the major clinical manifestation of the infection8. Between January 1989 and February 1991, the Section of Mycobacteria of the Adolfo Lutz Institute, São Paulo, isolated MAC from 103 patients by culturing different sterile and no-sterile processed specimens collected from 2304 patients seen at the AIDS Reference and Training Center and/or Emilio Ribas Infectology Institute. Disseminated disease was diagnosed in 29 of those patients on the basis of MAC isolation from blood and/or bone marrow aspirate. The other 74 patients were divided into categories highly (...

408-PA12 Antimicrobial resistance of Mycobacterium tuberculosis (M. tuberculosis) strains isolated from HIV-infected patients in the city of São Paulo (Brazil): resistance profile

Tubercle and Lung Disease, 1995

407-PA12 Antimicrobial resistance of Mycobacterium tuberculosis (M. tuberculosis) strains isolated from HIV-infected patients in the city of São Paulo (Brazil): predisposing factors

Tubercle and Lung Disease, 1995

Ovo desidratado para substituir ovo "in natura" na preparacao do meio Löwenstein-Jensen para cultivo de micobacterias

Revista Do Instituto Adolfo Lutz, 2001

RESUMO. Os métodos bacteriológicos são extremamente importantes para diagnosticar tuberculose pul... more RESUMO. Os métodos bacteriológicos são extremamente importantes para diagnosticar tuberculose pulmonar. O meio de cultura mais comumente usado para isolar micobactérias é o Löwenstein-Jensen (LJ), meio sólido à base de ovos. Os ovos precisam sofrer uma limpeza prévia que consiste em escoválos com água e sabão, com posterior descontaminação por 30 minutos em álcool 70%. O ovo "in natura" apresenta dois inconvenientes: esta limpeza, que é demorada e o sistema de compras e armazenamento, pois os ovos devem ser frescos. Com o propósito de simplificar este procedimento, este estudo comparou o meio preparado com ovos frescos e com ovos desidratados. Amostras clínicas foram processadas para cultura e o inoculo foi semeado nos dois tipos de meios. Os resultados das culturas mostraram que das 150 amostras positivas pela baciloscopia, 123 foram positivas no meio convencional e 24 foram negativas, enquanto que no meio teste, foram 121 positivas e 26 negativas, mostrando uma diferença que não foi significativa. Contaminações ocorreram igualmente nos dois meios (3 amostras). Ao comparar-se os dois meios a sensibilidade foi de 98% e a especificidade de 100%. Conclui-se que o ovo desidratado pode ser uma forma alternativa e vantajosa, no preparo do meio de Löwenstein-Jensen. PALAVRAS-CHAVE. meio de cultura, Löwenstein-Jensen, tuberculose, ovo desidratado. INTRODUÇÃO Em 1993 a Organização Mundial de Saúde (OMS) declarou a tuberculose uma emergência mundial devido ao fato de ser uma doença em crescimento progressivo em todo mundo e fora de controle nas áreas mais pobres do planeta 1 .

An alternative biphasic culture system for recovery of mycobacteria and for differentiation of species other than M. tuberculosis complex from blood specimens

Rev Microbiol, Sep 1, 1997

... Id: 280115. Autor: Martins, Maria Conceiçäo; Ueki, Suely Yoko Mizuka; Palhares, Maria Cecilia... more

Cabine de segurança biológica: efeito da luz ultravioleta nas micobactérias

Revista Do Instituto Adolfo Lutz, Dec 1, 2006

... Id: 461282. Autor: Ueki, Suely Yoko Mizuka; Geremias, Ana Lívia; Moniz, Letícia Lisboa; Latri... more

Mixed mycobacterial cultures: is it important to separate and to identify multiple species?

Revista Do Instituto Adolfo Lutz, 2005

Identificação de mutações no gene INHA associadas com a resistência à isoniazida no genoma de Mycobacterium tuberculosis

Culturas mistas de micobactérias: é importante isolar e identificar?

Revista Do Instituto Adolfo Lutz, 2005

Martin, A. et al. Multicenter study of MTT and resazurin assays for testing susceptibility to first-line anti-tuberculosis drugs. Int. J. Tuberc. Lung Dis. 9, 901-906

The International Journal of Tuberculosis and Lung Disease

A multicentre evaluation was performed to assess two rapid low-cost methods, MTT (3-[4.5dimethylt... more A multicentre evaluation was performed to assess two rapid low-cost methods, MTT (3-[4.5dimethylthiazol-2-yl]-2.5-diphenyltetrazolium bromide) and resazurin assays, for testing the susceptibility of Mycobacterium tuberculosis to the first-line anti-tuberculosis drugs rifampicin (RMP), isoniazid (INH), ethambutol (EMB) and streptomycin (SM). M E T H O D S : Thirty coded M. tuberculosis strains were sent to seven laboratories located in Latin America, representing six countries. Each site performed the colorimetric assays, MTT and resazurin, blind for the first-line drugs RMP, INH, EMB and SM. The minimum inhibitory concentration results obtained were compared to the conventional proportion method on Löwenstein-Jensen medium. R E S U L T S : After establishing the breakpoint concentrations, excellent results were obtained for RMP, INH and EMB, with levels of specificity and sensitivity of between 96% and 99%. C O N C L U S I O N : MTT and resazurin assays are promising, accessible new alternative methods for middle-and low-resource countries that need low-cost methods to perform rapid susceptibility testing of M. tuberculosis to key anti-tuberculosis drugs.

124-PA11 Rapid drug susceptibility testing of Mycobacterium tuberculosis by a microdilution broth minimum inhibitory concentration (MIC) method

Tubercle and Lung Disease, 1995

Chapter 11: Biosafety and Hospital Control

Bottlenecks and recommendations for the incorporation of new technologies in the tuberculosis laboratory network in Brazil

Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia

The World Health Organization (WHO) has recently recommended new technologies for the diagnosis o... more 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.

Multicentre evaluation of an automated BACTEC 960 system for susceptibility testing of Mycobacterium tuberculosis

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2007

Three mycobacteria reference laboratories in the south-eastern part of Brazil. To evaluate the au... more Three mycobacteria reference laboratories in the south-eastern part of Brazil. To evaluate the automated Mycobacteria Growth Indicator Tube (MGIT) for drug susceptibility testing of Mycobacterium tuberculosis. Performance of the automated BACTEC MGIT 960 (M960) system for testing M. tuberculosis susceptibility to streptomycin (SM), isoniazid (INH), rifampicin (RMP) and ethambutol (EMB) was evaluated with 95 clinical isolates and compared to the results of the radiometric BACTEC 460TB (B460) system, the proportion method (PM), and the resistance ratio method (RRM). Judicial susceptibility profiles of 88 isolates were defined based on two or more concordant results among B460, PM and RRM, and used as a reference for comparison with M960 results. Agreement rates between M960 and conventional methods were 95.2% with B460, 96.6% with the PM and 93.4% with the RRM. The lowest agreement rates were obtained for SM with the RRM and for EMB with B460. When comparing M960 with judicial suscept...

Mycobacterium tuberculosis bacteremia diagnosed in an HIV-negative patient in Brazil: a rare or an under-reported event?

The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases, 2004

A case of Mycobacterium tuberculosis bacteremia in an HIV negative immunodepressed patient was de... more

PCR-restriction enzyme analysis of a bone marrow isolate from a human immunodeficiency virus-positive patient discloses polyclonal infection with two Mycobacterium avium strains

Journal of clinical microbiology, 2000

Polyclonal infection by Mycobacterium avium was detected by hsp65 PCR-restriction enzyme analysis... more Polyclonal infection by Mycobacterium avium was detected by hsp65 PCR-restriction enzyme analysis (PRA) in a bone marrow isolate from an AIDS patient. Two M. avium strains, differing in colony morphology, PRA HaeIII digestion pattern, insertion element (IS) 1245 amplification, and restriction fragment length polymorphism fingerprints with IS1245 and IS1311 probes, were isolated.

Single and double drug susceptibility testing of Mycobacterium avium complex and mycobacteria other than the tubercle (MOTT) bacilli by a micro-dilution broth minimum inhibitory concentration (MIC) method

Tubercle and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 1994

The incidence of Mycobacterioses is increasing annually, especially in patients with AIDS. There ... more The incidence of Mycobacterioses is increasing annually, especially in patients with AIDS. There is no clear correlation between in vitro drug susceptibility testing of mycobacteria other than the tubercle (MOTT) bacilli and the in vivo response. Although in vitro, MOTT bacilli appear resistant, some patients respond to treatment possibly as a result of a synergistic action between the drugs being used. To produce a simple method to determine which individual drugs or combinations of drugs will be effective in killing the causative organism. A broth microdilution method, using microtitre plates, was used to determine the minimum inhibitory concentration (MIC) of the drugs alone and then in combination. It was found that the MIC values of the test drugs varied between but were constant within each of the species. Mycobacterium xenopi, M. malmoense and M. kansasii showed a large amount of susceptibility while M. avium complex, M. fortuitum and M. chelonae were limited in their respons...

Cord factor detection and macroscopic evaluation of mycobacterial colonies: an efficient combined screening test for the presumptive identification of Mycobacterium tuberculosis complex on solid media* , ** Detecção do fator corda e avaliação do aspecto macroscópico das colônias de micobactérias:...

Objective: The rapid differentiation between Mycobacterium tuberculosis and nontuberculous mycoba... more Objective: The rapid differentiation between Mycobacterium tuberculosis and nontuberculous mycobacteria is fundamental for patients co-infected with tuberculosis and HIV. To that end, we use two methods in our laboratory: detection of cord factor and PCR-restriction enzyme analysis (PRA). The objective of this study was to evaluate the accuracy of a screening test on solid medium as a rapid method for the presumptive identification of M. tuberculosis complex, considering costs and turnover time. Methods: A total of 152 strains were submitted to a combined screening test, consisting of the detection of cord factor under microscopy (Ziehl-Neelsen staining) and evaluation of the macroscopic aspect of colonies, as well as to PRA, which was used as the gold standard. Costs were estimated by calculating the price of all of the materials needed for each test. Results: The overall accuracy of cord factor detection alone was 95.4% (95% CI: 90.7-98.1%), and that of the combined screening test...

Molecular characterization of Mycobacterium kansasii isolates in the State of São Paulo between 1995-1998

Memorias Do Instituto Oswaldo Cruz, 2004

Mycobacterium kansasii is the most common cause of pulmonary nontuberculous mycobacteria infectio... more Mycobacterium kansasii is the most common cause of pulmonary nontuberculous mycobacteria infection and classical identification of this pathogen needs a time consuming phenotypic tests. Polymerase chain reactionrestriction fragment lenght polymorphism analysis (PRA) of the gene enconding for the 65kDa heat shock (hsp65) protein offers an easy, rapid, and inexpensive procedure to identify and subtype M. kansasii isolates. In the present study, we performed a retrospective analysis of patients who had mycobacteria identified on the basis of phenotypic tests by means of a review of database at Mycobacteria Laboratory of the Instituto Adolfo Lutz in the period 1995-1998. A total of 9381 clinical isolates were analyzed of which 7777 (82.9%) were identified as M. tuberculosis complex and 1604 (17.1%) as nontuberculous mycobacteria. Of the 296 M. kansasii isolates, 189 (63.8%) isolates obtained from 119 patients were viable and were analyzed by PRA-hsp65. Hundred eight two (98.9%) were classified as M. kansasii type I. Two isolates were classified as type II and III and five isolates were characterized as other Mycobacterium species. Clinical isolates of M. kansasii in the state of São Paulo was almost exclusively subtype I regardless of HIV status.

Drug resistance of M. Tuberculosis isolated from patients with HIV infection seen at an AIDS Reference Center in São Paulo, Brazil

Revista do Instituto de Medicina Tropical de São Paulo, 1996

M. tuberculosis-positive cultures were obtained from 228 patients seen in our service and drug se... more M. tuberculosis-positive cultures were obtained from 228 patients seen in our service and drug sensitivity assays were carried out from January 1992 to December 1994. A survey of the medical records of these patients showed resistance to one or more drugs in 47 (20.6%), 25 of whom (10.9%), who reported previous treatment, were considered to have acquired resistance. Among the antecedents investigated, only previous treatment and alcoholism were the factors independently associated with the occurrence of resistance. The survival of patients with resistant strains was lower than that of patients attacked by non-resistant M. tuberculosis. We conclude that in the present series M. tuberculosis resistance to tuberculostatic agents was predominantly of the acquired type.

Mycobacterium avium complex (MAC) isolated from AIDS patients and the criteria required for its implication in disease

Revista do Instituto de Medicina Tropical de São Paulo, 1995

Before the AIDS pandemia, the Mycobacterium avium complex (MAC) was responsible in most cases for... more Before the AIDS pandemia, the Mycobacterium avium complex (MAC) was responsible in most cases for the pneumopathies that attack patients with basic chronic pulmonary diseases such as emphysema and chronic bronchitis36. In 1981, with the advent of the acquired immunodeficiency syndrome (AIDS), MAC started to represent one of the most frequent bacterial diseases among AIDS patients, with the disseminated form of the disease being the major clinical manifestation of the infection8. Between January 1989 and February 1991, the Section of Mycobacteria of the Adolfo Lutz Institute, São Paulo, isolated MAC from 103 patients by culturing different sterile and no-sterile processed specimens collected from 2304 patients seen at the AIDS Reference and Training Center and/or Emilio Ribas Infectology Institute. Disseminated disease was diagnosed in 29 of those patients on the basis of MAC isolation from blood and/or bone marrow aspirate. The other 74 patients were divided into categories highly (...

408-PA12 Antimicrobial resistance of Mycobacterium tuberculosis (M. tuberculosis) strains isolated from HIV-infected patients in the city of São Paulo (Brazil): resistance profile

Tubercle and Lung Disease, 1995

407-PA12 Antimicrobial resistance of Mycobacterium tuberculosis (M. tuberculosis) strains isolated from HIV-infected patients in the city of São Paulo (Brazil): predisposing factors

Tubercle and Lung Disease, 1995