title: Differential virulence of Mycobacterium avium strains isolated from HIV-infected patients with disseminated M. avium complex disease.
abstract: The role that colonization with Mycobacterium avium plays in the development of disseminated disease is unclear. In this study, we determined whether all M. avium strains isolated from the portals of M. avium infection are capable of crossing the mucosal border and causing infection. The patients in this study were enrolled in AIDS Clinical Trial Group protocol 341. The patients were divided into 3 groups; 2 groups differed in their immunological and clinical risk for M. avium disease. A third group (n=22 patients) had culture-documented disseminated M. avium complex disease at the time of entry in the study. Eight of 22 patients had M. avium isolated from both a colonized site and blood or bone marrow specimens. All 8 patients had distinct M. avium strains; 2 patients had a polyclonal infection. The virulence properties of 13 strains were determined, including invasion of gastrointestinal cells and replication in macrophages. There were significant differences in the virulence properties, and these differences may provide insight into the interplay between microbial pathogenesis and host defense.
authors.affiliation: Department of Pathology and Laboratory Medicine, Childrens Hospital Los Angeles and University of Southern California, Los Angeles, California 90027, USA.
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Ohkusu
authors.forename: Luiz E
authors.initials: LE
authors.lastname: Bermudez
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Nash
authors.forename: Rob Roy
authors.initials: RR
authors.lastname: MacGregor
authors.forename: Clark B
authors.initials: CB
authors.lastname: Inderlied
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D015269:Mycobacterium avium Complex / Q000472:pathogenicity*; D015270:Mycobacterium avium-intracellulare Infection / Q000276:immunology / Q000382:microbiology*; D012150:Polymorphism, Restriction Fragment Length; D014774:Virulence