Le diagnostic microbiologique des infections à mycobactéries atypiques chez les malades atteints de SIDA: Rapport coût-efficacité

Translated title of the contribution: The diagnosis of atypical mycobacteria infections in aids patients: Cost/effectiveness

C. Truffot-Pernot, L. Maury, J. Grosset

Research output: Contribution to journalArticlepeer-review

Abstract

To diagnose systemic infections with atypical mycobacteria, AIDS patients with persistent unexplained fever have had 3 blood and some other specimens (sputum, alveolar lavage fluids, bone marrow or liver biopsies, ...) cultures. The blood samples, drawn on 3 consecutive days without taking into account fever peaks, were collected into isolator tubes (Dupont System) and, after lysis-centrifugation, inoculated onto plain and sodium pyruvate-containing Löwenstein-Jensen medium. From February 1986 to October 1990, 2460 blood samples taken from 709 AIDS patients were cultivated. One hundred and fourty one blood samples (5,7%) from 56 (7,9%) patients yielded atypical mycobacteria. Mycobacterium avium-in-tracellulare was the most frequently isolated species. In addition to positive blood cultures, 37 patients had positive cultures from other specimens : sputum culture was the more frequently positive (30/37 patients, 66% of the samples). In 10 patients, sputum smears were positive for AFB. Among patients with negative blood cultures, 9 were considered as infected with atypical mycobacteria (4 with M. kansasii, 2 with M. xenopi and 3 with M. avium-intracellulare). The responsible organisms were isolated from respiratory samples (7 patients) and liver or lymph-node biopsies (2 patients). Smears were positive for AFB in 6 cases (4 sputa, 1 alveolar lavage fluid, 1 lymph-node biopsy). Blood culture appears to be the most sensitive tool for the diagnosis of infection with atypical mycobacteria in AIDS patients. Because blood culture are negative in some cases, other specimens, especially sputum samples, should also be cultivated.

Translated title of the contributionThe diagnosis of atypical mycobacteria infections in aids patients: Cost/effectiveness
Original languageFrench
Pages (from-to)99-104
Number of pages6
JournalMedecine et Maladies Infectieuses
Volume21
Issue number2
DOIs
StatePublished - Feb 1991

Keywords

  • AIDS
  • Atypical mycobacteria
  • Blood cultures
  • Mycobacterium avium-intracellulare

ASJC Scopus subject areas

  • Infectious Diseases

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