[Haemophilus influenzae pulmonary infection in patients infected with the human immunodeficiency virus]. / Infección pulmonar por Haemophilus influenzae en pacientes infectados por el virus de la inmunodeficiencia humana.

BACKGROUND: Haemophilus influenzae has frequently been identified as the etiologic agent in pneumonias of patients with the human immunodeficiency virus (HIV) infection. The experience of the authors is reviewed and the significance of isolating this microorganism in respiratory samples commented upon. METHODS: The clinical, radiological and microbiological data of patients with HIV infection in whom H. influenzae was identified in blood, lung tissue, or samples of the lower respiratory tract obtained by fibrobronchoscopy were retrospectively evaluated. RESULTS: Twenty cases were diagnosed with 75% presenting bilateral lung infiltration. In 70% the isolation sample was that of bronchoalveolar lavage. In 40% of the total another microorganism was identified in coinfection with H. influenzae, of which Mycobacterium tuberculosis was the most frequent. Thirty-five percent of the cases presented antecedents of one or several previous pulmonary infections. H. influenzae infection was not observed with either concomitant or previous infections in 20% of the patients. CONCLUSIONS: A high frequency of pneumonias by Haemophilus influenzae with bilateral radiologic presentation have been found. H. influenzae is frequently demonstrated as in coinfection with other agents. The role that this microorganism has in pulmonary infection of patients with HIV infection is not clearly defined.

[Pulmonary disease caused by opportunistic environmental mycobacteria. Review of 35 cases]. / Enfermedad pulmonar por micobacterias ambientales oportunistas. Revisión de 35 casos.

The clinical characteristics, radiologic findings, and therapeutic response in 35 cases of pulmonary disease induced by opportunistic environmental mycobacteria collected during a period of 4 years are reported. These cases included 21 infections by Mycobacterium kansasii, 10 by M. xenopi, and 4 by M. avium. The cases reported constituted the 6% of all mycobacterial infections of the lung observed in our institution. The mean age of the patients was 56 years and 83% of them were male. The presence of previous pulmonary involvement was rather frequent, specially the existence of chronic limitation of the air flow (CLAF) (91%) and previous tuberculosis (29%). The clinical symptoms were almost nonspecific and they could frequently be misinterpreted as an intercurrent infection in cases of CLAF. The radiologic findings could not be distinguished from an infection by M. tuberculosis. The clinical course with pharmacologic first line therapy (93% of cases) was satisfactory in 28 patients in whom follow-up controls are available.

In vitro activity of clofazimine against rapidly growing nonchromogenic mycobacteria.

The in vitro activity of clofazimine against 80 isolates of rapidly growing nonchromogenic mycobacteria was studied by an agar dilution method. The drug inhibited 96% of strains tested at concentrations less than or equal to 1 microgram/ml, and it appears to be an agent of potential efficacy against Mycobacterium fortuitum and M. chelonae.

Prospective study on the etiology of community-acquired pneumonia in children and adults in Spain.

The cause of primary pneumonia was diagnosed in 157 of 198 children and 165 of 207 adults seen as inpatients or outpatients in a 12-month period. In children Mycoplasma pneumoniae and pneumococcus were identified in 79 and 29 cases respectively. Twenty-nine of 53 cases of viral infection in children were caused by respiratory syncytial virus, two-thirds of the cases occurring in children under three years of age. No children died of pneumonia. In adults pneumococcus was the most common pathogen, accounting for 81 cases. The overall mortality in adults was 7.7%. A high mortality was found in patients with Haemophilus influenzae and other gram-negative bacilli infections, and in elderly patients with pneumococcal pneumonia. Coagglutination was more sensitive than counterimmunoelectrophoresis for the detection of pneumococcal antigen in respiratory samples (p less than 0.001). Counterimmunoelectrophoresis was the only useful technique for detection of pneumococcal antigen in urine specimens, concentration, overnight storage at 4 degrees C and specific staining significantly increasing positivity (p less than 0.001).

[Usefulness of the API ZYM system for the identification of Legionella sp]. / Utilidad del sistema API ZYM en la identificación de Legionella sp.

BACKGROUND: The identification of Legionella genus is usually difficult, time consuming, and expensive. We decided to study the usefulness of API-ZYM system (Biomerieux) for Legionella species identification. METHODS: A total of 96 strains (82 from Legionella genus and 14 from other bacterial genus) were included. We studied 19 different enzyme activities and we proceed following the manufacturers directions, with an incubation time for galleries of 4 hours at 37 degrees C. RESULTS: Seventeen out of the 19 enzyme activities were uniformly positive or negative for Legionella sp. Thus, the sensitivity of these activities was 100% in identifying Legionella sp. Valine and cystine-arylamidase gave variable reactions for Legionella sp. strains. When the results of these enzyme test were compared to those of the control strains (Haemophilus influenzae, Pseudomonas aeruginosa) we observed that alkaline phosphatase, esterase, esterase-lipase, acid phosphatase and naphthol-AS-BI-phosphohydrolase in one side and esterase, esterase-lipase and leucin-arylamidase in the other side were able to differentiate Legionella sp. strains from P. aeruginosa and H. influenzae, respectively. CONCLUSION: API SYM system is a simple, accurate and reproducible method for the identification of Legionella sp.