Culture of Mycobacterium tuberculosis from non-fixed sputum smears.

Smears prepared from sputum species were kept in the dark at 4 degrees C or at 20-25 degrees C. Cultures for mycobacteria were carried out on these smears 0, 4, 8, and 15 days later and the results compared with those of cultures made from the sputum specimen on the day of collection. The percentage of negative cultures from originally positive specimens was high, and use of the method is not considered advisable. There is an additional risk of infection for laboratory staff when handling unfixed smears.

Mycobacteria in HIV-infected patients in Buenos Aires.

SETTING: F. J. Muñiz Hospital and Department of Phthisiopneumonology, in Buenos Aires. OBJECTIVE: To analyze bacteriological findings concerning tuberculosis and other mycobacteriosis, in association with HIV infection and AIDS. DESIGN: From June 1985 to December 1991, 2521 samples from 1259 HIV-seropositive and AIDS patients were analyzed: 1133 samples were of bronchopulmonary origin and the remaining 1388 of extrapulmonary origin. Drug susceptibility tests were performed using the proportions method. RESULTS: Mycobacterial disease was confirmed by culture in 240 of the 1259 HIV/AIDS patients (19%). Mycobacterium tuberculosis was isolated in 223 of these cases (92.9%) and M. bovis in two, while M. avium-complex (MAC) strains were identified as the cause of disease in 14 patients (5.8%). In only one case was disease due to M. kansasii. Blood cultures were positive in 21.2% of these 240 cases. Resistance of M. tuberculosis to antituberculosis drugs was found in 9.4% of the 223 isolates. In only one case was multidrug resistance detected, in a patient who had received previous treatment. CONCLUSION: Smear examination, although less sensitive than in HIV-negative patients, was still a simple and reliable tool for the rapid diagnosis of mycobacterial disease. Blood culture aided in the successful diagnosis of about half of the cases of disseminated tuberculosis and of all cases of MAC disease. An alarming spread of tuberculosis was detected among a group of HIV-positive prisoners, and the possible emergence of multidrug resistance should be anticipated.

PIP: An increase in human immunodeficiency virus (HIV)-associated mycobacterial tuberculosis has led to a reversal of an earlier trend in Argentina toward a decline in the incidence of tuberculosis. A bacteriologic study conducted at the Muniz Hospital in Buenos Aires June 1985-December 1991 confirmed the reliability of smear examination for the rapid diagnosis of mycobacterial disease. 2521 samples were obtained from 1259 HIV-infected individuals during the study period and mycobacterial disease was confirmed by culture in 240 cases (19%). The smears were positive in 59.0% of the 122 pulmonary cases, 22.0% of the 72 extrapulmonary cases, and 56.5% of the 46 pulmonary-extrapulmonary cases. Blood cultures were positive in 21.2% of the 240 cases. In patients with pulmonary localization, acquired immunodeficiency syndrome (AIDS) was diagnosed between a few months to two years after the onset of tuberculosis; those with the two other localizations had already advanced to AIDS at the time of blood smear. Resistance to one or more antitubercular drugs was found in 9.4% of cases.

Non tuberculous mycobacterioses in Buenos Aires.

Se estudiaron 5182 cultivos positivos para micobacterias obtenidos durante los anos 1977 y 1978 en el Laboratorio de la Catedra de Tisioneumonologia y del Hospital Muniz de Buenos Aires: 5120 de ellos eran M. tuberculosis y 62 micobacterias no tuberculosas. Los cultivos provenian de 3130 pacientes, de ellos 3120 tenian enfermedad producida por M. tuberculosis y 10 casos de otras micobacteriosis: 9 de localizacion pulmonar y uno de un granuloma cutaneo. En 5 de los casos pulmonares el agente causante pertenecia al complejo M. avium-intracellulare-scrofulaceum y en los otros 4 a la especie M. kansasii. Del granuloma cutaneo se aislo M. marinum. Esto representa un porcentaje de 0,32% de micobacteriosis no tuberculosas, sobre el total de los casos de tuberculosis diagnosticados. Los criterios seguidos para considerar una microbacteria "atipica" o no tuberculosa como agente causante de enfermedad fueron: obtencion de mas de un cultivo del paciente, salvo cuando la micobacteria fuera la unica cultivada de una biopsia de tejidos con lesiones granulomatosas; enfermedad comprobada; resistencia inicial a varias drogas antituberculosas, especialmente al PAS, coincidente con una evolucion lenta y dificil de la enfermedad

Enfermedad producida por micobacterias no tuberculosas en Buenos Aires, Argentina / Diseases caused by nontuberculous mycobacteria in Buenos Aires, Argentina

Se presentan los resultados de un estudio sobre la prevalencia de micobacterias no tuberculosas realizado en 4 894 pacientes de los cuales se extrajeron 8 006 cultivos estudiados durante cuatro anos (19771980)