An outbreak of infections affecting 311 patients who had undergone different invasive procedures occurred in 2004and 2005 in the city of Belém, in the northern region of Brazil. Sixty-seven isolates were studied; 58 were from patients who had undergone laparoscopic surgeries, 1 was from a patient with a postinjection abscess, and 8 were from patients who had undergone mesotherapy. All isolates were rapidly growing nonpigmented mycobacteria and presented a pattern by PCR-restriction enzyme analysis of the hsp65 gene with BstEII of bands of 235 and 210 bp and with HaeIII of bands of 200, 70, 60, and 50 bp, which is common to Mycobacterium abscessus type 2, Mycobacterium bolletii, and Mycobacterium massiliense. hsp65 and rpoB gene sequencing of a subset of 20 isolates was used to discriminate between these three species. hsp65 and rpoB sequences chosen at random from 11 of the 58 isolates from surgical patients and the postinjection abscess isolate presented the highest degrees of similarity with the corresponding sequences of M. massiliense. In the same way, the eight mesotherapy isolates were identified as M. bolletii. Molecular typing by pulsed-field gel electrophoresis (PFGE) grouped all 58 surgical isolates, while the mesotherapy isolates presented three different PFGE patterns and the postinjection abscess isolate showed a unique PFGE pattern. In conclusion, molecular techniques for identification and typing were essential for the discrimination of two concomitant outbreaks and one case, the postinjection abscess, not related to either outbreak, all of which were originally attributed to a single strain of M. abscessus.Rapidly growing mycobacteria (RGM) are widely distributed in the environment, especially in water (rivers, lakes, potable water), and can contaminate reagents and medical equipment. Most RGM infections in humans are caused by species belonging to the Mycobacterium fortuitum, Mycobacterium chelonae-Mycobacterium abscessus, and Mycobacterium smegmatis groups (6).The M. chelonae-M. abscessus group comprises two genomospecies, M. chelonae and M. abscessus, which have been differentiated on the basis of Ͻ70% genomic homology by DNA-DNA hybridization (16, 18). These species have been isolated from sporadic cases of chronic lung disease associated with bronchiectasis and cystic fibrosis, disseminated cutaneous infections, and postsurgical wound infections. They have also been implicated in outbreaks in cardiac, ophthalmologic, and plastic surgeries and pseudo-outbreaks related to contaminated bronchoscopes and contaminated laboratory reagents (6,12,20,25,26). Mycobacterium immunogenum was included in this group in 2001. It was isolated from metalworking fluids and was associated with cases of hypersensitivity pneumonitis in factory workers. This species has also been detected in cutaneous, catheter-related, articular, and lung infections; in an outbreak related to ophthalmologic surgeries; and in a pseudo-outbreak related to bronchoalveolar lavage procedures (19,27). Mycobacterium massiliense was vali...

Since 2004, a series of localized skin and soft tissue infections caused by rapidly growing mycobacteria have occurred in Brazil in patients who have undergone invasive procedures, such as laparoscopic, arthroscopic, plastic surgery, or cosmetic interventions (12,16,23,37). In 4 years, more than 2,000 cases were officially reported to Brazilian federal authorities, who consider this problem an epidemiological emergency (5). Almost all isolates studied so far have belonged to the Mycobacterium chelonae-M. abscessus group (39). The majority of them were identified as members of two recently described emerging pathogens, Mycobacterium massiliense (3) and Mycobacterium bolletii (1), both of which belong to the Mycobacterium chelonae-M. abscessus group.All five members of the Mycobacterium chelonae-M. abscessus group, M. chelonae, M. abscessus (21), Mycobacterium immunogenum (40), M. massiliense (3), and M. bolletii (1), are nearly indistinguishable phenotypically. Common features include growth in less than 7 days, the absence of pigmentation, better growth at 30°C than at 35°C, a positive 3-day arylsulfatase test result, a negative nitrate reductase test result, and a negative iron uptake test result (41). Two biochemical tests, sodium chloride tolerance and the utilization of citrate, are useful in distinguishing the five members (1,3,40,41).Antimicrobial susceptibility can also be used to differentiate the members of the M. chelonae-M. abscessus group. M. abscessus is generally susceptible to cefoxitin (MIC Ͻ 16 g/ml)

RESUMO: "Atividade anti-infl amatória de alkalóides: Uma revisão do século XX". Muitas substâncias que interferem na resposta infl amatória têm sido isoladas de plantas. Esta revisão mostra alguns alcalóides de origem vegetal que no período de 1907-2000 foram avaliados quanto a uma possível atividade anti-infl amatória. Os alcalóides foram classifi cados em subgrupos de acordo com suas estruturas químicas e os dados farmacológicos foram obtidos de diferentes modelos experimentais. Dos 171 alcalóides avaliados, 137 apresentaram atividade anti-infl amatória, e, entre eles, os alcalóides do tipo isoquinolínicos foram os mais estudados. O modelo de edema de pata induzido por carragenina foi o mais empregado para avaliação da atividade anti-infl amatória. Nesta revisão 174 referências foram consultadas. Unitermos: Alcalóides, atividade anti-infl amatória, infl amação, modelos experimentais.ABSTRACT: Many substances which interfere with the infl ammatory response have been isolated from plants. This review shows some alkaloids of vegetal origin which in the period of 1907 to 2000 were evaluated regarding a possible anti-infl ammatory activity. The alkaloids were classifi ed in sub-groups in accordance with their chemical structures and the pharmacological data were obtained from different experimental models. Of the 171 evaluated alkaloids, 137 presented anti-infl ammatory activity, and among those, the isoquinoline type was the most studied. The Carrageenin-induced paw edema was the most used model for evaluating the anti-infl ammatory activity. In this review, 174 references were cited.

A particular strain of M. abscessus ssp. massiliense was associated with a prolonged epidemic of postsurgical infections in seven Brazilian states, suggesting that this strain may be distributed in Brazilian territory and better adapted to cause surgical-site infections.

The frequency of the Beijing genotype of Mycobacterium tuberculosis as a cause of tuberculosis (TB)

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Rio de Janeiro is endemic for tuberculosis (TB) and presents the second largest prevalence of the disease in Brazil. Here, we present the bacterial population structure of 218 isolates of Mycobacterium tuberculosis, derived from 186 patients that were diagnosed between January 2008 and December 2009. Genotypes were generated by means of spoligotyping, 24 MIRU-VNTR typing and presence of fbpC103, RDRio and RD174. The results confirmed earlier data that predominant genotypes in Rio de Janeiro are those of the Euro American Lineages (99%). However, we observed differences between the classification by spoligotyping when comparing to that of 24 MIRU-VNTR typing, being respectively 43.6% vs. 62.4% of LAM, 34.9% vs. 9.6% of T and 18.3% vs. 21.5% of Haarlem. Among isolates classified as LAM by MIRU typing, 28.0% did not present the characteristic spoligotype profile with absence of spacers 21 to 24 and 32 to 36 and we designated these conveniently as “LAM-like”, 79.3% of these presenting the LAM-specific SNP fbpC103. The frequency of RDRio and RD174 in the LAM strains, as defined both by spoligotyping and 24 MIRU-VNTR loci, were respectively 11% and 15.4%, demonstrating that RD174 is not always a marker for LAM/RDRio strains. We conclude that, although spoligotyping alone is a tool for classification of strains of the Euro-American lineage, when combined with MIRU-VNTRs, SNPs and RD typing, it leads to a much better understanding of the bacterial population structure and phylogenetic relationships among strains of M. tuberculosis in regions with high incidence of TB.