Int Conf AIDS. 1996 Jul 7-12;11(2):24 (abstract no. We.B.302). Unique
Objective: To describe the characteristics of mycobacterial infection
among inner city hospital patients between 1986 -1995. Methods: We
reviewed records from the mycobacteriology laboratory and autopsy files
of all patients with mycobacterial infection based on positive Fite or
Ziehl-Neelsen stains, culture or both. Results: A total of 805 patients
was identified on the basis of a positive stain, culture or both; 554
were men(68.8%) and 251 women(31.2%) with a median age of 43.5 years.
There were 780 blacks, 11 caucasians, 11 hispanics and 3 indians. Of
these, 449(55.8%) were seropositive, 151 seronegative and 205 of unknown
HIV status. Species identification was possible for isolates from 710
patients(88.2%). M. avium complex (MAC) accounted for 290, M.
tuberculosis (MTb) for 250, M. kansasi (MK) for 96, M. fortuitum MF) 28,
M. chelonei (MC) 13 and others 33. A total of 51 patients had specimens
that yielded no growth despite positive smears. The annual incidence
rate of mycobacteriosis remained fairly uniform until 1993 when an
upward trend began but is now levelling off. Between 1986-92 MTb was the
predominant mycobacterial species isolated annually but MAC surpassed
MTb as the predominant organism isolated from patients between 1993-95.
Mycobacteria were more commonly isolated from sputum 58%(467), blood
11.4%(92) and broncho-alveolar lavage specimens 9.7%(78). Of 202 MTb
isolates tested, 12.4% were resistant to INH, 7.2% were resistant to
rifampin and 8.4% to ethambutol. The most common mycobacterial species
identified among HIV seropositive patients were MAC (247), MTb and MK
each from 61 patients, versus MTb (90), MK(16) and MAC(12) among HIV
seronegative patients. Clinical specimens from 5 patients, all HIV
seropositive,revealed concomitant infection with two species of
mycobacteria. Mycobacteria (8 MTb, 2 MK) were isolated from
cerebrospinal fluid in 10 patients, five of whom were HIV seropositive.
Conclusions: In contrast to the recent experience at other institutions
serving minority inner city patients we did not observe an increasing
trend for MTb in general or among HIV seropositive patients. We also did
not find an increase in multidrug resistant MTb strains.
*HIV Infections/COMPLICATIONS *Mycobacterium/ISOLATION & PURIF