Bacteremia Due to Mycobacterium avium-intracellulare in the Acquired Immunodeficiency Syndrome

Abstract

The presence of Mycobacterium avium-intracellulare has frequently been demonstrated in tissue specimens from patients with the acquired immunodeficiency syndrome. The importance of this mycobacterium as a cause of constitutional symptoms and organ dysfunction has been unclear, however, because of the sparse inflammatory response evoked and the frequent concurrence of other pathogenic organisms. We detected M. avium-intracellulare in blood samples from eight patients with the acquired immunodeficiency syndrome, seven of whom had a previously recognized M. avium-intracellulare infection. Blood cultures were positive on 1 to 14 occasions over 135 days using the Dupont isolator system or the Bactec 12B medium system. Cultures were positive within 14 to 51 or 7 to 14 days with the respective techniques. The ability to rapidly isolate M. avium-intracellulare from blood may provide a useful diagnostic technique for detecting disseminated mycobacterial disease in patients with the acquired immunodeficiency syndrome as well as in other patient populations. This technique may also be useful for assessing the efficacy of drug therapy.

Quantitative aspects of septicemia

“…The lysis-centrifugation method recovered significantly more fungi than conventional broth, radiometric broth, or biphasic brain heart infusion bottles. The superiority of the lysis-centrifugation method for the recovery of mycobacteria (30,45), especially Mycobacterium avium-M. intracellulare complex (31,43,44,58,104), Cryptococcus neoformans (5,6), and Histoplasma capsulatum (5,100), from blood has been useful in diagnosis of these infections in immunocompromised patients. Enhanced isolation of staphylococci and members of the family Enterobacteriaceae was also found in several studies (6,33,34,38,39,46,63).…”

Isolation and Identification of Nontuberculous Mycobacteria From Water and Soil in Central India

“…[2] Secondly, NTM can cause mycobacteriosis in immunocompromised patients especially those with AIDS and present as disseminated disease. [3] Isolation of NTM from the environment reveals the epidemiological distribution in a particular region, which is useful in interpreting the efficacy of BCG or to know the species that might lead to disease in AIDS patients in that area. So far, only two studies, one each from South [4] and North India [5] have documented isolation of NTM in the environment.…”

Mycobacterial Infections in AIDS

“…but this is a gross underestimate due to incomplete diagnosis and reporting. When sought, the diagnosis can be made ante mortem in one-quarter or more, and post mortem in one-half of patients (3,5,6,42). Disseminated M avium complex arises late in the course of HIV disease, typically preceded by at least one other AIDS-defining condition (43).…”