title: Skin testing with Mycobacterium avium sensitin to identify infection with M. avium complex in patients with cystic fibrosis.
abstract: We sought to determine if patients with cystic fibrosis and sputum cultures positive for Mycobacterium avium complex (MAC) have delayed-type hypersensitivity to an M. avium sensitin. Seventeen (33%) of 51 selected patients had MAC isolated from at least one sputum culture. Skin tests with purified protein derivative and M. avium sensitin demonstrated that five (10%) of 51 patients were anergic, and anergy was correlated with use of systemic steroids. Sixteen (35%) of 46 nonanergic patients had M. avium-dominant skin test reactions. Twelve (75%) of these 16 patients with cultures positive for MAC had M. avium-dominant skin tests; the specificity of skin testing was 87%. These data suggest that most patients with cystic fibrosis and sputum cultures positive for MAC have infection rather than colonization with MAC. Skin testing with M. avium sensitin is a sensitive and specific method for screening these infections.
authors.affiliation: Infectious Disease Section, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
authors.forename: R
authors.initials: R
authors.lastname: Pinto-Powell
authors.forename: K N
authors.initials: KN
authors.lastname: Olivier
authors.forename: B J
authors.initials: BJ
authors.lastname: Marsh
authors.forename: S
authors.initials: S
authors.lastname: Donaldson
authors.forename: H W
authors.initials: HW
authors.lastname: Parker
authors.forename: W
authors.initials: W
authors.lastname: Boyle
authors.forename: M
authors.initials: M
authors.lastname: Knowles
authors.forename: M
authors.initials: M
authors.lastname: Magnusson
authors.forename: C F
authors.initials: CF
authors.lastname: von Reyn
mesh_terms: D000293:Adolescent; D000328:Adult; D000941:Antigens / Q000276:immunology*; D000942:Antigens, Bacterial / Q000276:immunology*; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications / Q000276:immunology / Q000382:microbiology*; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology; D007428:Intradermal Tests; D008297:Male; D015269:Mycobacterium avium Complex / Q000302:isolation & purification*; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications / Q000276:immunology / Q000382:microbiology*; D009894:Opportunistic Infections / Q000150:complications / Q000276:immunology / Q000382:microbiology*; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology; D014373:Tuberculin / Q000276:immunology
chemical_list: D000941:Antigens; D000942:Antigens, Bacterial; D014373:Tuberculin; C012031:sensitin