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Vol. 15. Issue 5.
Pages 761-769 (September - October 2009)
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Vol. 15. Issue 5.
Pages 761-769 (September - October 2009)
Artigo Original/Original Article
Open Access
Análise genotípica de isolados de Mycobacterium tuberculosis de um hospital em Lisboa, Portugal
Genotypic analysis of Mycobacterium tuberculosis isolates from a Lisbon hospital in Portugal
Visits
5854
João Perdigão1, Catarina Milho2, Lurdes Carrilho3, Laura Brum4, Isabel Portugal5,
Corresponding author
isabel.portugal@ff.ul.pt

Correspondência/Correspondence to: Isabel Portugal, Centro de Patogénese Molecular, URIA, Faculdade de Farmácia, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal
1 Licenciado em biologia microbiana e genética, mestre em biologia molecular e genética, Aluno de doutoramento em microbiologia/BsC, Microbiology and Genetics. MsC Molecular Biology and Genetics. PhD Microbiology (partway)
2 Licenciada em microbiologia/BsC, Microbiology Molecular Centro de Patogénese Molecular, URIA, Faculdade de Farmácia da Universidade de Lisboa, Portugal/Molecular Pathogenesis Centre, URIA, School of Pharmacy, Universidade de Lisboa, Portugal
3 Secção de Micobactérias do Serviço de Patologia Clínica do Hospital de Pulido Valente, Lisboa, Portugal/Mycobacteria Section, Clinical Pathology Unit, Hospital de Pulido Valente, Lisboa, Portugal
4 Professora auxiliar convidada da Faculdade de Ciências Médicas da Universidade Nova de Lisboa. Assessora de Bacteriologia do Instituto Nacional de Saúde Dr. Ricardo Jorge. Departamento de Doenças Infecciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal/Assistant Guest Professor, School of Medical Sciences, Universidade Nova de Lisboa. Bacteriology assistant, Instituto Nacional de Saúde Dr. Ricardo Jorge. Department of Infectious Diseases, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal
5 Professora auxiliar da Faculdade de Farmácia da Universidade de Lisboa. Investigadora visitante do Instituto Nacional de Saúde Dr. Ricardo Jorge, Centro de Patogénese Molecular, Faculdade de Farmácia da Universidade de Lisboa, Portugal. Departamento de Doenças Infecciosas, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal/Guest Professor, School of Pharmacy, Universidade de Lisboa. Visiting Researcher, Instituto Nacional de Saúde Dr. Ricardo Jorge, Molecular Pathogenesis Centre, School of Pharmacy, Universidade de Lisboa, Portugal. Department of Infectious Diseases, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal
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Resumo

Portugal apresenta uma das taxas de incidência de tuberculose mais altas da União Europeia, tendo a Região de Saúde de Lisboa uma taxa de incidência muito acima da média nacional. O presente estudo analisa a transmissão, susceptibilidade aos antibacilares e características de uma população de estudo de um hospital central de Lisboa. Cento e trinta e dois isolados clínicos de Mycobacterium tuberculosis foram pre-viamente testados quanto à susceptibilidade aos antibacilares de primeira linha. A taxa de multirresistência encontrada foi de 3,0%, enquanto 13,6% dos isolados eram resistentes a um ou mais antibacilares de primeira linha. A serologia para o VIH estava disponível para 98 doentes, 26 (26,5%) eram positivos. Os isolados foram genotipados por MIRU-VNTR e 53 (40,2%) dos 132 isolados encontravam-se distribuídos por 17 clusters MIRU-VNTR diferentes de dois ou mais isolados. De todos os isolados analisados, 25,8% perten-ciam à família Lisboa. Concluímos que a transmissão de estirpes de Mycobacterium tuberculosis, resistentes e susceptíveis, está a ocorrer, com especial preocupação para as estirpes Lisboa.

Rev Port Pneumol 2009; XV (5): 761-769

Palavras-chave:
Família Lisboa
tuberculose
multirresistência
MIRU
Abstract

Portugal has one of the highest tuberculosis notification rates of the European Union with Lisbon Health Region having an incidence rate well above the national average. The present study analyses the transmission, drug susceptibility and characteristics of a study population from a Central Lisbon’s Hospital. One hundred and thirty-two Mycobacterium tuberculosis clinical isolates were previously tested for drug susceptibility to first-line drugs. The multidrug (MDR) resistance rate was found to be 3.0%, while 13.6% of the isolates were resistant to one or more first-line drugs. HIV serology was available for 98 patients, 26 (26.5%) were positive. Genotyping was performed by MIRU-VNTR and 53 (40,2%) out of the 132 isolates were found to be distributed through 17 MIRU-VNTR clusters of two or more isolates. Lisboa strains accounted for 25.8% of all strains. We conclude that transmission of resistant and susceptible Mycobacterium tuberculosis strains is occurring, with special concern for Lisboa strains.

Rev Port Pneumol 2009; XV (5): 761-769

Key-words:
Lisboa family
tuberculosis
multidrug resistance
MIRU
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Bibliography
[1.]
T.B. Euro.
Surveillance of tuberculosis cases in Europe.
Report on tuberculosis cases notified in 2006, Institut de veille sanitaire, (2008),
[2.]
DGS.
Programa Nacional de Luta contra a Tuberculose.
Tuberculose: Ponto da Situação em Portugal em 2006, dados preliminares em Março 2007, Direcção-Geral de Saúde, (2007),
[3.]
J. Perdigão, et al.
Multidrug-resistant tuberculosis in Lisbon, Portugal: A Molecular Epidemiological Perspective.
Microb Drug Resist, 14 (2008), pp. 133-143
[4.]
DGS.
Programa Nacional de Luta contra a Tuberculose.
Ponto da situação epidemiológica e indicadores de desempenho, Ano de 2003, Direcção-Geral de Saúde, (2005),
[5.]
I. Portugal, et al.
Outbreak of multiple drug-resistant tuberculosis in Lisbon: detection by restriction fragment length polymorphism analysis.
Int J Tuberc Lung Dis, 3 (1999), pp. 207-213
[6.]
I. Portugal, S. Maia, J. Moniz-Pereira.
Discrimination of multidrug-resistant Mycobacterium tuberculosis IS6110 fingerprint subclusters by rpoB gene mutation analysis.
J Clin Microbiol, (1999),
[7.]
D. Alland, et al.
Transmission of tuberculosis in New York City.
An analysis by DNA fingerprinting and conventional epidemiologic methods. N Engl J Med, 330 (1994), pp. 1710-1716
[8.]
P.F. Barnes, M.D. Cave.
Molecular epidemiology of tuberculosis.
N Engl J Med, 349 (2003), pp. 1149-1156
[9.]
P.M. Small, et al.
The epidemiology of tuberculosis in San Francisco.
A population-based study using conventional and molecular methods. N Engl J Med, 330 (1994), pp. 1703-1709
[10.]
S.E. Weis, et al.
Transmission dynamics of tuberculosis in Tarrant county, Texas.
Am J Respir Crit Care Med, 166 (2002), pp. 36-42
[11.]
J.E. Golub, et al.
Transmission of Mycobacterium tuberculosis through casual contact with an infectious case.
Arch Intern Med, 161 (2001), pp. 2254-2258
[12.]
D. van Soolingen, et al.
Occurrence and stability of insertion sequences in Mycobacterium tuberculosis complex strains: evaluation of an insertion sequence-dependent DNA polymorphism as a tool in the epidemiology of tuberculosis.
J Clin Microbiol, 29 (1991), pp. 2578-2586
[13.]
K.S. Blackwood, J.N. Wolfe, A.M. Kabani.
Application of mycobacterial interspersed repetitive unit typing to Manitoba tuberculosis cases: can restriction fragment length polymorphism be forgotten?.
J Clin Microbiol, 42 (2004), pp. 5001-5006
[14.]
P. Supply, et al.
Automated high-throughput genotyping for study of global epidemiology of Mycobacterium tuberculosis based on mycobacterial interspersed repetitive units.
J Clin Microbiol, 39 (2001), pp. 3563-3571
[15.]
P. Supply, et al.
Proposal for standardization of optimized mycobacterial interspersed repetitive unit-variable-number tandem repeat typing of Mycobacterium tuberculosis.
J Clin Microbiol, 44 (2006), pp. 4498-4510
[16.]
H. van Deutekom, et al.
Molecular typing of Myco-bacterium tuberculosis by mycobacterial interspersed repetitive unit-variable-number tandem repeat analysis, a more accurate method for identifying epidemiological links between patients with tuberculosis.
J Clin Microbiol, 43 (2004), pp. 4473-4479
[17.]
M. Murray, D. Alland.
Methodological problems in the molecular epidemiology of tuberculosis.
Am J Epidemiol, 155 (2002), pp. 565-571
[18.]
J. Olano, et al.
Mutations in DNA repair genes are associated with the Haarlem lineage of Mycobacterium tuberculosis independently of their antibiotic resistance.
Tuberculosis, 87 (2007), pp. 502-508
[19.]
A.G. Tsolaki, et al.
Genomic deletions classify the Beijing/W strains as a distinct genetic lineage of Myco-bacterium tuberculosis.
J Clin Microbiol, 43 (2005), pp. 3185-3191
[20.]
A.G. Tsolaki, et al.
Functional and evolutionary genomics of Mycobacterium tuberculosis: insights from genomic deletions in 100 strains.
Proc Natl Acad Sci USA, 101 (2004), pp. 4865-4870
[21.]
R. Brosch, et al.
A new evolutionary scenario for the Mycobacterium tuberculosis complex.
Proc Natl Acad Sci USA, 99 (2002), pp. 3684-3689
[22.]
I. Filliol, et al.
Global phylogeny of Mycobacterium tuberculosis based on single nucleotide polymorphism (SNP) analysis: insights into tuberculosis evolution, phylogenetic accuracy of other DNA fingerprinting systems, and recommendations for a minimal standard SNP set.
J Bacteriol, 188 (2006), pp. 759-772
[23.]
B. Lopez, et al.
A marked difference in pathogenesis and immune response induced by different Mycobacterium tuberculosis genotypes.
Clin Exp Immunol, 133 (2003), pp. 30-37
[24.]
S.M. Newton, et al.
A deletion defining a common Asian lineage of Mycobacterium tuberculosis associates with immune subversion.
Proc Natl Acad Sci USA, 103 (2006), pp. 15594-15598
[25.]
M.E. Rad, et al.
Mutations in putative mutator genes of Mycobacterium tuberculosis strains of the W-Beijing family.
Emerg Infect Dis, 9 (2003), pp. 838-845
[26.]
N.R. Gandhi, et al.
Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa.
[27.]
G.R. Davies, et al.
Emergence of multidrug-resistant tuberculosis in a community-based directly observed treatment programme in rural South Africa.
Int J Tuberc Lung Dis, 3 (1999), pp. 799-804
Copyright © 2009. Sociedade Portuguesa de Pneumologia/SPP
Pulmonology
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