da Silva Telles Maria Alice, Chimara Erica, Ferrazoli Lucilaine, Riley Lee W
Instituto Adolfo Lutz, Sao Paulo, Av. Dr. Arnaldo, 355, Sao Paulo, SP 01246-902, Brazil 2School of Public Health, University of California, Berkeley, CA, USA.
J Med Microbiol. 2005 Oct;54(Pt 10):975-979. doi: 10.1099/jmm.0.45965-0.
Mycobacterium kansasii is the second most common cause of non-tuberculosis mycobacterial diseases in Sao Paulo, Brazil. An important component of the management of infections caused by this organism is antibiotic susceptibility testing. The objective of this study was to determine the drug susceptibility profiles and genotypes of clinical isolates of M. kansasii obtained from patients with or without an infection that met the American Thoracic Society's case definition criteria of M. kansasii disease. One hundred and sixty-nine clinical isolates of M. kansasii collected between 1993 and 1998 in Sao Paulo, Brazil, were tested consecutively. The isolates were genotyped by PCR restriction-enzyme pattern analysis (PRA). Most of the M. kansasii strains were susceptible to isoniazid, streptomycin, rifabutin, rifampicin, clarithromycin, ethionamide, amikacin, clofazimine and cycloserine, and resistant to ethambutol, ciprofloxacin and doxycycline. Of 169 isolates, 167 belonged to the type I PRA genotype and one each belonged to type II and III genotypes. There was no correlation between PRA subtype and M. kansasii disease according to the American Thoracic Society case definition. Clinical trials may be needed to better correlate MIC values with treatment outcomes to identify appropriate parameters for drug-resistance testing of M. kansasii.
堪萨斯分枝杆菌是巴西圣保罗非结核分枝杆菌病的第二大常见病因。对该病原体所致感染进行管理的一个重要组成部分是抗生素敏感性检测。本研究的目的是确定从符合美国胸科学会堪萨斯分枝杆菌病病例定义标准的感染或未感染患者中分离出的堪萨斯分枝杆菌临床分离株的药敏谱和基因型。对1993年至1998年期间在巴西圣保罗收集的169株堪萨斯分枝杆菌临床分离株进行了连续检测。通过聚合酶链反应-限制性酶切图谱分析（PRA）对分离株进行基因分型。大多数堪萨斯分枝杆菌菌株对异烟肼、链霉素、利福布汀、利福平、克拉霉素、乙硫异烟胺、阿米卡星、氯法齐明和环丝氨酸敏感，对乙胺丁醇、环丙沙星和多西环素耐药。在169株分离株中，167株属于I型PRA基因型，各有1株属于II型和III型基因型。根据美国胸科学会病例定义，PRA亚型与堪萨斯分枝杆菌病之间无相关性。可能需要进行临床试验，以更好地将最低抑菌浓度值与治疗结果相关联，从而确定堪萨斯分枝杆菌耐药性检测的合适参数。
