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PP-61
LABORATORY MICROBIOLOGY CONTRIBUTION TO Mycobacterium spp.
DIAGNOSIS IN THREE DISTRICT COUNCILS OF SETúBAL
(PORTUGAL), AN AREA WITH HIGH MYCOBACTERIAL INFECTION PREVALENCE.
José Diogo, Ana Rodrigues, Isabel Nascimento, Elisabete Sardinha, Ana Raposo, Rita Figueira, Isabel Monge, Kátia Silva,
Maria José Gil, Susana Rodrigues.
Laboratory Microbiology, Hospital Garcia de Orta (Almada)
The purpose of this work is to evaluate the incidence of Mycobacterium spp. infection in three district councils of Setubal
(Almada, Seixal and Sesimbra) with a high prevalence of this disease, superior to the average in Portugal. The number
of patients with mycobacterial infection and positive mycobacteriological study in Laboratório de Microbiologia (LM),
Serviço de Patologia Clínica, Hospital Garcia de Orta, E. P. E. (HGO) between 1993 and 2008 were evaluated.
Each biological sample was processed as follows: 1) for acid-fast stain with Kinyoun’s carbolfuchsin and microscopic observation
with a 100x immersion oil objective; 2) inoculation in Lowenstein-Jensen medium with aerobic incubation at
37ºC and/or inoculation in Middlebrock 7H9 and incubation in MGIT System (Bactec®); and 3) species identification and
first line antimycobacterial susceptibility testing.
In these sixteen years, LM processed more than 25000 biological products, 3813 were positive and isolated from biological
products of 1704 patients.
The age, gender, positive samples for BAAR and number of cases of tuberculosis (including variation per year) in Almada,
Seixal and Sesimbra was determinated. A relation was established between the disease localization (pleuro-pulmonar,
extra-pulmonar and disseminated) by clinical and microbiological criteria. The mean age of the patients was 40,6 years,
1199 (70.3%) were male and 505 (29,7%) were female.
Species identification (since 2004) was: 664 (84,1%) M. tuberculosis, 67 (8,5%) M. gordonae, 20 (2,5%) M. avium-intracelular
and 39 (4,9%) other mycobacteria.
The first line antimycobacterial resistance was determinated in 649 M. tuberculosis strains. The resistance level was: 116
(17,9%) to streptomycin, 76 (11,7%) to isoniazid, 28 (4,3 %) to rifampicin, 17 (2,6%) to ethambutol and 14 (2,2%) to pyrazinamide.
The multiresistance (simultaneous resistance to isoniazid and rifampicin) was detected in 27 (4,1 %) strains. Six patients
had extensively drug-resistance tuberculosis (XDR-TB). Susceptibility pattern variation per year was also evaluated.
European Society of Mycobacteriology | 30 th Annual Congress | July 2009 | Porto - Portugal
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