Mycobacterium tuberculosis bacteremia in patients with and without human immunodeficiency virus infection.
OBJECTIVE
To determine the incidence of Mycobacterium tuberculosis bacteremia in a general hospital and to describe the clinical characteristics, therapy, and outcome of patients with bacteremic tuberculosis.


METHODS
Clinical charts of all patients in whom M tuberculosis was isolated from blood cultures during a 5-year period were reviewed. Mycobacterium tuberculosis was detected by means of a nonradiometric blood culture system.


RESULTS
Of 285 patients with culture-proved tuberculosis in whom blood cultures were obtained, 50 (14%) had M tuberculosis bacteremia. Of 42 patients analyzed, 34 (81%) were infected with human immunodeficiency virus (HIV) and eight (19%) were not infected with HIV. Blood was the only or the first positive specimen in 14 patients (33%). Most HIV-infected patients (79%) were intravenous drug users, and 40 (88%) had clinical and/or radiologic evidence of involvement of one or more organs. Lungs were affected in 71% of the patients. In-hospital mortality was 18% in HIV-infected patients with mycobacteremia. Among eight non-HIV-infected patients, four had an underlying disease, and none was immunosuppressed. Disseminated disease was diagnosed in three patients. Two patients died as a consequence of tuberculosis in this group.


CONCLUSIONS
Mycobacterium tuberculosis bacteremia is common in HIV-infected patients and is possible in nonimmunosuppressed subjects. Blood cultures are helpful in making the diagnosis of tuberculosis and can help establish a diagnosis of disseminated infection.
Bouza
E
E
Department of Clinical Microbiology, Hospital General Gregorio Marañón, Madrid, Spain.
Díaz-López
M D
MD
Moreno
S
S
Bernaldo de Quirós
J C
JC
Vicente
T
T
Berenguer
J
J
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*