Correlation of quantitative bone marrow and blood cultures in AIDS patients with disseminated Mycobacterium avium complex infection.
The relationship between Mycobacterium avium complex (MAC) infection of blood and bone marrow was studied in human immunodeficiency virus-infected patients before and during treatment. Quantitative cultures were obtained at baseline from 17 persons with newly detected MAC bacteremia. Serial blood cultures were obtained, and a second bone marrow sample was obtained at 4 or 8 weeks. At baseline, the median MAC load in bone marrow core samples was 3 log10 higher than in blood. Bone marrow MAC loads ranged widely (866-847,315 cfu/g), and no significant correlation was found between MAC load in blood and that in bone marrow core samples. MAC loads in bilateral bone marrow biopsy samples from 7 subjects were highly correlated. MAC loads declined in blood and bone marrow at similar rates during therapy, but blood was sterilized before bone marrow. Length of survival was inversely associated with initial bone marrow core MAC load but not with blood MAC load. Initiation of treatment when tissue MAC load is low may increase the likelihood of favorable clinical outcome.
Hafner
R
R
Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892-7624, USA. rhafner@niaid.nih.gov
Inderlied
C B
CB
Peterson
D M
DM
Wright
D J
DJ
Standiford
H C
HC
Drusano
G
G
Muth
K
K
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000382:microbiology*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000382:microbiology; D001706:Biopsy; D001769:Blood / Q000382:microbiology*; D001853:Bone Marrow / Q000382:microbiology*; D017291:Clarithromycin / Q000627:therapeutic use; D015169:Colony Count, Microbial; D003470:Culture Media; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015269:Mycobacterium avium Complex / Q000302:isolation & purification*; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy / Q000382:microbiology*; D012367:RNA, Viral / Q000097:blood
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D003470:Culture Media; D012367:RNA, Viral; D004977:Ethambutol; D017291:Clarithromycin