Lorena Nádia Suely de Oliveira, Duarte Rafael Silva, Pitombo Marcos Bettini
Faculdade de Ciências Médicas - Universidade do Estado do Rio de Janeiro - RJ-BR.
Rev Col Bras Cir. 2009 Jul;36(3):266-7. doi: 10.1590/s0100-69912009000300015.
Between August 2006 and February 2007, in the state of Rio de Janeiro, Brazil, a massive outbreak of RGM infections after video laparoscopy was mainly associated to the recently described Mycobacterium massiliense species. All confirmed and probable cases reports described the use of high-level disinfection of medical devices by using 2% glutaraldehyde (2% GA) for 30 min before the surgical procedures. We investigated the susceptibility of the M. massiliense isolates recovered during the outbreak to high-level disinfection after 30 min, 1h, 6h and 10h of exposure to the commercial disinfectants. Reference strains for official mycobactericidal tests such as Mycobacterium abscessus, Mycobacterium bovis, Mycobacterium chelonae, Mycobacterium neoaurum and Mycobacterium smegmatis were included as controls. Although all the reference strains were eliminated in 30 min of exposure to 2% GA, we observed the recovery of all M. massiliense clinical isolates even after 10h of exposure. This study suggests that failures in high-level disinfection and the high tolerance of these M. massiliense clinical strains to the 2% GA were strongly associated to the magnitude of the outbreak.
2006年8月至2007年2月期间，在巴西里约热内卢州，视频腹腔镜检查后发生了大规模的快速生长分枝杆菌（RGM）感染疫情，主要与最近描述的马赛分枝杆菌菌种有关。所有确诊和可能病例报告均描述了在手术前使用2%戊二醛（2% GA）对医疗器械进行30分钟的高水平消毒。我们调查了疫情期间分离出的马赛分枝杆菌菌株在接触商业消毒剂30分钟、1小时、6小时和10小时后对高水平消毒的敏感性。官方分枝杆菌杀菌试验的参考菌株，如脓肿分枝杆菌、牛分枝杆菌、龟分枝杆菌、新金色分枝杆菌和耻垢分枝杆菌作为对照。尽管所有参考菌株在接触2% GA 30分钟后均被消灭，但我们观察到所有马赛分枝杆菌临床分离株即使在接触10小时后仍能复苏。这项研究表明，高水平消毒失败以及这些马赛分枝杆菌临床菌株对2% GA的高耐受性与疫情的规模密切相关。
