The incidence of nontuberculous mycobacteria (NTM) pulmonary diseases in HIVnegative patients was studied prospectively from January 1, 2001 to December 31, 2003 by 32 sentinel sites distributed throughout France.In total, 262 patients who yielded NTM isolates from respiratory clinical specimens, met the bacteriological, radiological and clinical criteria established by the American Thoracic Society for NTM respiratory disease. Among the 262 NTM isolates, 234 were slow-growing mycobacteria (125 Mycobacterium avium-intracellulare complex (MAC), 66 M. xenopi, 34 M. kansasii) and 28 were rapidly growing mycobacteria (25 M. abscessus complex). In the Paris area, M. xenopi was the most frequently isolated species, followed by MAC.Most patients (.50%), except those with M. kansasii, had underlying predisposing factors such as pre-existing pulmonary disease or immune deficiency. Asthenia, weight loss, chronic cough and dyspnoea were the most common clinical symptoms. The classical radiological appearance of NTM infections was indistinguishable from that observed in patients with pulmonary tuberculosis.In summary, the incidence of nontuberculous mycobacteria pulmonary infections in HIVnegative patients was estimated at 0.74, 0.73 and 0.72 cases per 100,000 inhabitants in

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Mycobacterium tuberculosis is a major cause of morbidity and mortality worldwide and is becoming a greater concern due to the development of multidrug-resistant strains. M. tuberculosis can contaminate rooms, medical equipment, and research laboratories and has the propensity to be highly resistant to decontamination. The aim of this study was to determine the efficacy of room disinfection with a dry mist of hydrogen peroxide (DMHP) in a biosafety level 3 laboratory in the event of contamination with M. tuberculosis. The biological indicators (BIs) were comprised of presterilized cotton tissues on which amounts of about 10 7 CFU/ml of M. tuberculosis H37Ra were dried. The device (Sterinis; Gloster Sante Europe) provided a DMHP of 5% hydrogen peroxide during 25 min. Three experiments were performed. The viable bacteria were reduced by values of more than 5 log 10 , and no colony grew from any BI. In conclusion, DMHP shows promise as an effective and safe alternative to the currently used formaldehyde.Tuberculosis is a major public health problem, particularly with the development of multidrug-resistant strains (22). It was declared to be a global emergency by the World Health Organization (WHO) in 1993. Mycobacterium tuberculosis bacteria are most likely transmitted by aerosols and so can easily contaminate rooms in health care facilities or research laboratories. Moreover, these bacteria present high intrinsic resistance to disinfection and fumigation processes and possess effective defense mechanisms against oxidative stress (4, 5). Their resistance to disinfectants has been considered intermediate between those of other vegetative bacteria and spores. The components of the cell wall that are responsible for this high level of resistance are unknown, but both mycolic acids and arabinogalactan appear to be involved (3,20).Chemical liquids and vapors are mainly used as decontaminating agents. Traditional room fumigation has been conducted by using formaldehyde or ethylene oxide gas. These methods have been given up due to their toxicity and carcinogenicity. In June 2004, the International Agency for Research on Cancer (IARC) classified formaldehyde as carcinogenic for humans (6,12). It has been recommended in France since September 2006 that this substance not be used for room decontamination, and its production was definitively stopped in January 2007. Thus, research laboratories and hospitals must find other solutions for decontamination; H 2 O 2 provides an alternative to formaldehyde fumigation because of its biological efficacy against various microorganisms (7,8,11,13,17) and its safety (hydrogen peroxide readily decomposes to form water and oxygen).Hydrogen peroxide has already been recommended for the disinfection of a large variety of materials, including dental instruments (18) and bronchoscopes (2). The use of H 2 O 2 vapor (VHP) for the biodecontamination of biological safety cabinets (BSCs), rooms in health care facilities (8), ambulances (1), pharmaceutical facilities, and laboratories (10, 14, 15, ...

The incidence of Mycobacterium avium complex (MAC) pulmonary disease in HIVnegative patients was studied prospectively from

The Amplicor Mycobacterium tuberculosis test is a new PCR assay for the direct detection of Mycobacterium tuberculosis from clinical samples. A multicenter study that included six laboratories was done to evaluate the Amplicor test in comparison with direct microscopy and culture (solid or radiometric media), and the culture method was used as the ''gold standard.'' A total of 2,073 specimens, i.e., 1,749 respiratory specimens and 324 other specimens, were tested. A total of 184 cultures yielded M. tuberculosis. Of these 184 cultures, 77 (42%) were smear negative and 23 (12.5%) concerned extrapulmonary specimens. The sensitivity of the Amplicor test for all of the specimens and for extrapulmonary, smear-positive, and smear-negative specimens was 86, 83, 94.5, and 74%, respectively. The sensitivity of direct microscopy in comparison with that of culture was 58%. A total of 95% of patients with culture-proven tuberculosis were diagnosed by the Amplicor test, whereas direct microscopy detected mycobacteria in only 72% of these patients. The Amplicor test exhibited a high degree of specificity (98%). The assay was very rapid and easy to perform.