1887

Abstract

The aim of this study was to investigate the high level of pulmonary infections and implement a surveillance programme among 43 ventilator-dependent patients, 15 with pulmonary infections, in a hospital long-term respiratory care ward (RCW) in central Taiwan. isolates were obtained from 35 patients in the RCW of hospital A, 6 patients in the RCWs of another three hospitals (B, C and D), and from 4 water sources in two of the hospitals (A and B). Strains were characterized by methods including 65 PCR–RFLP and PFGE. The patients were followed-up by chest X-ray for 1 year. All clinical isolates were type I and II, and belonged to ten distinct clusters of PFGE patterns. Five clinical strains in two hospitals belonged to a single cluster, whilst four clinical strains in the other two hospitals belonged to a single unique cluster. The strains from hospital A fell into nine clusters and were distinct from the strains isolated from the water supply. Patients infected with type I strains showed a significantly more rapid progression of disease. The number of different strains involved suggested either that there had been a polyclonal outbreak or that a high level of endemic infections was present in the RCW of hospital A. This and the lack of homology between the clinical and environmental isolates from hospital A raised the possibility that pulmonary infections may have been spread by the movement of patients between RCWs, a routine practice in Taiwan's integrated delivery system.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.020586-0
2010-10-01
2024-12-09
Loading full text...

Full text loading...

/deliver/fulltext/jmm/59/10/1203.html?itemId=/content/journal/jmm/10.1099/jmm.0.020586-0&mimeType=html&fmt=ahah

References

  1. Brunello F., Ligozzi M., Cristelli E., Bonora S., Tortoli E., Fontana R. 2001; Identification of 54 mycobacterial species by PCR-restriction fragment length polymorphism analysis of the hsp65 gene. J Clin Microbiol 39:2799–2806 [CrossRef]
    [Google Scholar]
  2. Burns D. N., Wallace R. J. Jr, Schultz M. E., Zhang Y. S., Zubairi S. Q., Pang Y. J., Gibert C. L., Brown B. A., Noel E. S., Gordin F. M. 1991; Nosocomial outbreak of respiratory tract colonization with Mycobacterium fortuitum : demonstration of the usefulness of pulse-field gel electrophoresis in epidemiologic investigation. Am Rev Respir Dis 144:1153–1159 [CrossRef]
    [Google Scholar]
  3. Chang C. C., Lin Y. H., Chang C. F., Yeh K. S., Chiu C. H., Chu C., Chien M. S., Hsu Y. M., Tsai L. S., Chiou C. S. 2005; Epidemiologic relationship between fluoroquinolone-resistant Salmonella enterica serovar Choleraesuis strains isolated from humans and pigs in Taiwan; (1997 to 2002 J Clin Microbiol 43:2798–2804 [CrossRef]
    [Google Scholar]
  4. Devallois A., Goh K. S., Rastogi N. 1997; Rapid identification of mycobacteria to species level by PCR-restriction fragment length polymorphism analysis of the hsp65 gene and proposition of an algorithm to differentiate 34 mycobacterial species. J Clin Microbiol 35:2969–2973
    [Google Scholar]
  5. Falkinham J. O., Norton C. D., LeChevallier M. W. 2001; Factors influencing numbers of Mycobacterium avium , Mycobacterium intracellulare , and other mycobacteria in drinking water distribution systems. Appl Environ Microbiol 67:1225–1231 [CrossRef]
    [Google Scholar]
  6. Fox L. P., Geyer A. S., Husain S., Della-Latte P., Grossman M. E. 2004; Mycobacterium abscessus cellulitis and multifocal abscesses of the breasts in a transsexual from illicit intramammary injections of silicone. J Am Acad Dermatol 50:450–454 [CrossRef]
    [Google Scholar]
  7. Gaafar A., Unzaga M. J., Cisterna R., Clavo F. E., Urra E., Ayarza R., Martín G. 2003; Evaluation of a modified single-enzyme amplified-fragment length polymorphism technique for fingerprinting and differentiating of Mycobacterium kansasii type I isolates. J Clin Microbiol 41:3846–3850 [CrossRef]
    [Google Scholar]
  8. Goldblatt M. R., Ribes J. A. 2002; Mycobacterium mucogenicum isolated from a patient with granulomatous hepatitis. Arch Pathol Lab Med 126:73–75
    [Google Scholar]
  9. Griffith D. E., Aksamit T., Brown-Elliott B. A., Catanzaro A., Daley C., Gordin F., Holland S. M., Horsburgh R., Huitt G. other authors 2007; An official ATS/EDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial disease. Am J Respir Crit Care Med 175:367–416 [CrossRef]
    [Google Scholar]
  10. Kirschner P., Kiekenbeck M., Meissner D., Wolters J., Bottger E. C. 1992; Genetic heterogeneity within Mycobacterium fortuitum complex species: genotypic criteria for identification. J Clin Microbiol 30:2772–2775
    [Google Scholar]
  11. Koh W. J., Kwon O. J., Lee K. S. 2002; Nontuberculous mycobacterial pulmonary diseases in immunocompetent patients. Korean J Radiol 3:145–157 [CrossRef]
    [Google Scholar]
  12. Lin H. C., Zhao L. J. 2002; Integrated delivery systems. Taiwan J Public Health 21:1–8
    [Google Scholar]
  13. Luna V. A., Jernigan D. B., Tice A., Kellner J. D., Roberts M. C. 2000; A novel multiresistant Streptococcus pneumoniae serogroup 19 clone from Washington State identified by pulsed-field gel electrophoresis and restriction fragment length patterns. J Clin Microbiol 38:1575–1580
    [Google Scholar]
  14. Ollar R. A., Connell N. D. 1999 Molecular Mycobacteriology Boca Raton, FL: CRC Press;
    [Google Scholar]
  15. Phillips M. S., von Reyn C. F. 2001; Nosocomial infections due to nontuberculous mycobacteria. Clin Infect Dis 33:1363–1374 [CrossRef]
    [Google Scholar]
  16. Scholze A., Loddenkemper C., Grunbaum M., Moosmayer I., Offermann G., Tepel M. 2005; Cutaneous Mycobacterium abscessus infection after kidney transplantation. Nephrol Dial Transplant 20:1764–1765 [CrossRef]
    [Google Scholar]
  17. Singh S. P., Salamon H., Lahti C. J., Farid-Moyer M., Small P. M. 1999; Use of pulsed-field gel electrophoresis for molecular epidemiologic and population genetic studies of Mycobacterium tuberculosis . J Clin Microbiol 37:1927–1931
    [Google Scholar]
  18. Sloutsky A., Han L. L., Werner B. G. 2004; Practical strategies for performance optimization of the enhanced Gen-Probe Amplified Mycobacterium Tuberculosis Direct Test. J Clin Microbiol 42:1547–1551 [CrossRef]
    [Google Scholar]
  19. Sperner B., Schalch B., Eisgruber H., Stolle A. 1999; Short protocol for pulsed field gel electrophoresis of a variety of Clostridia species. FEMS Immunol Med Microbiol 24:287–292 [CrossRef]
    [Google Scholar]
  20. Taillard C., Greub G., Weber R., Pfyffer G. E., Bodmer T., Zimmerli S., Frei R., Bassetti S., Rohner P. other authors 2003; Clinical implications of Mycobacterium kansasii species heterogeneity: Swiss National Survey. J Clin Microbiol 41:1240–1244 [CrossRef]
    [Google Scholar]
  21. Telenti A., Marchesi F., Balz M., Bally F., Bottger E. C., Bodmer T. 1993; Rapid identification of mycobacteria to the species level by polymerase chain reaction and restriction enzyme analysis. J Clin Microbiol 31:175–178
    [Google Scholar]
  22. Thornton C. G., MacLellan K. M., Brink T. L. Jr, Passen S. 1998; In vitro comparison of NALC-NaOH, Tween 80, and C18-carboxypropylbetaine for processing of specimens for recovery of mycobacteria. J Clin Microbiol 36:3558–3566
    [Google Scholar]
  23. Wallace R. J. Jr, Zhang Y., Brown B. A., Fraser V., Mazurek G. H., Maloney S. 1993; DNA large restriction fragment patterns of sporadic and epidemic nosocomial strains of Mycobacterium chelonae and Mycobacterium abscessus . J Clin Microbiol 31:2697–2701
    [Google Scholar]
  24. Wallace R. J. Jr, Brown B. A., Griffith D. E. 1998; Nosocomial outbreaks/pseudo-outbreaks caused by nontuberculous mycobacteria. Annu Rev Microbiol 52:453–490 [CrossRef]
    [Google Scholar]
  25. Witebsky F. G., Kruczak-Filipov P. 1996; Identification of mycobacteria by conventional methods. Clin Lab Med 16:569–601
    [Google Scholar]
  26. Zelazny A. M., Root J. M., Shea Y. R., Colombo R. E., Shamputa I. C., Stock F., Conlan S., McNulty S., Brown-Elliott B. A. other authors 2009; Cohort study of molecular identification and typing of Mycobacterium abscessus , Mycobacterium massiliense , and Mycobacterium bolletii . J Clin Microbiol 47:1985–1995 [CrossRef]
    [Google Scholar]
  27. Zhang Y., Mann L. B., Wilson R. W., Brown-Elliott B. A., Vincent V., Iinuma Y., Wallace R. J. Jr 2004a; Molecular analysis of Mycobacterium kansasii isolates from the United States. J Clin Microbiol 42:119–125 [CrossRef]
    [Google Scholar]
  28. Zhang Y., Yakrus M. A., Graviss E. A., Williams-Bouyer N., Turenne C., Kabani A., Wallace R. J. Jr 2004b; Pulsed-field gel electrophoresis study of Mycobacterium abscessus isolates previously affected by DNA degradation. J Clin Microbiol 42:5582–5587 [CrossRef]
    [Google Scholar]
/content/journal/jmm/10.1099/jmm.0.020586-0
Loading
/content/journal/jmm/10.1099/jmm.0.020586-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error