[Disseminated Mycobacterium genavense infection in patients with HIV infection. Description of 5 cases and review of the literature].
BACKGROUND
Five cases of disseminated infection by Mycobacterium genavense in patients with HIV infection are reported with a review of the literature.


METHODS
A description of the clinical, epidemiologic and therapeutic characteristics of five cases are presented. The initial isolation of the microorganism was performed in Bactec 13A from blood and bone marrow aspirates. Subcultures were made in different media and the growth characteristics evaluated. Sensitivity to NAP was determined by radiometric techniques and gas chromatography allowed a possible identification. Definitive identification was based on PCR amplification of the gene which codifies the 65kDa protein and the posterior restriction of the amplified fragments by using BstEII and HaeIII.


RESULTS
All five patients were males with HIV infection and a lymphocyte count of less than 25 cells/mm3 with an non-specific clinical picture similar to that produced by M. avium complex (MAC). Empiric antiMAC treatment was administered in four of the patients with good clinical response. All five strains were sensitive to NAP. The greatest growth rate was obtained in the subcultures with acid pH in liquid medium. Gas chromatography was very similar to that of M. simiae. Amplification of the gene which codifies the 65 kDa protein and posterior restriction with BstEII resulted in 2 fragments of 325 and 125 bp, while restriction with HaeIII resulted in two fragments of 140 and 105 bp.


CONCLUSIONS
Mycobacterium genavense represents 9% of the disseminated infections by mycobacteria in AIDS patients. The clinical manifestations, empiric treatment and response is similar to that of infection by M. avium complex. Growth is favored by acid pH in liquid medium. Susceptibility to NAP leads to possible identification which should be confirmed by molecular techniques.
Rodríguez
P
P
Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, Barcelona.
March
F
F
Garrigó
M
M
Moreno
C
C
Barrio
J
J
Gurguí
M
M
Sambeat
M A
MA
Coll
P
P
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001426:Bacterial Proteins; D018834:Chaperonin 60; D018833:Chaperonins / Q000235:genetics; D017809:Fatal Outcome; D006801:Humans; D006910:Hydroxypropiophenone / Q000031:analogs & derivatives / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D009170:Nontuberculous Mycobacteria / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D015995:Prevalence
D000995:Antitubercular Agents; D001426:Bacterial Proteins; D018834:Chaperonin 60; C074119:heat-shock protein 65, Mycobacterium; D006910:Hydroxypropiophenone; C017561:4-nitro-alpha-acetylamino-beta-hydroxypropiophenone; D018833:Chaperonins
Infección diseminada por Mycobacterium genavense en pacientes con infección por HIV. Descripción de 5 casos y revisión de la literatura.