A progressive study of mycobacterium isolations in HIV+ patients (1991–2004)

Abstract number: 1135_249

Nikolaou S., Kanavaki S., Skroubellou A., Karabela S., Raftopoulou I., Papavassiliou A., Tamvakis V.

Objectives:  

We studied the mycobacterium isolation frequency and resistance to antituberculous drugs in HIV+ patients, examinated in National Mycobacterium Reference Laboratory of Athens, during the years 1991–2004.

Methods:  

From 1212 HIV+ patients studied, 156 mycobacterium strains were isolated from various clinical sources. Laboratory testing included Ziehl Neelsen strain, cultures performed classically and automatically by the use of Bactec and MGIT systems, detection of M. tuberculosis rRNA in clinical specimens by the Amplified Mycobacterium Tuberculosis Direct Test AMTD (Gen Probe), identification by the nucleic acid hybridization method of Accuprobe (Gen Probe) and Innolipa V2, (Immunogenetics) and finally, susceptibility testing, by the method of proportion on solid medium Löwenstein Jensen and in liquid medium by the use of Bactec and MGIT automated systems Innolipa RTF TB (Immunogenetics) for the detection of rpo B gene was also performed.

Results:  

From 1212 HIV+ patients examinated for TB, 1029 (84.9%) were men and 183 (15.1%) women. Mycobacterium was isolated in 156 (12.8%) patients. In 91 (58.3%) patients M. tuberculosis was isolated, while in 65 (41.7/%) M. avium. In particular, M. tuberculosis was isolated in 77 (58.8%) men and in 14 (56%) women, while M. avium in 54 (41.2%) men and in 11 (44%) women. M. tuberculosis was mainly isolated from lower respiratory tract, urine and CSF, while M. avium from blood and bone marrow. Among the 91 M. tuberculosis isolations, 87 (95,6%) were susceptible to all antituberculous drugs.

Conclusions:  

Mycobacterium isolation frequency in HIV+ patients is progressively decreasing. M. tuberculosis is predominating in comparison to M. avium. In M. tuberculosis isolations not any significant resistance to antituberculous drugs was detected.