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bacterial agents isolated from cerebrospinal fluid of patients with acquired immunodeficiency syndrome (aids) and neurological complications.cerebrospinal fluid (csf) samples from 2083 patients with acquired immunodeficiency syndrome (aids) and neurological complications were bacteriologically examined during a period of 7 years (1984-1990). the percentage of patients who had at least one bacterial agent cultured from the csf was 6.2%. mycobacterium tuberculosis was the most frequently isolated agent (4.3%), followed by mycobacterium avium complex or mac (0.7%), pseudomonas spp (0.5%), enterobacter spp (0.4%), and staphylococcus aure ...19947569621
pharmacokinetics of clarithromycin and zidovudine in patients with aids.the interrelationships between the pharmacokinetics of zidovudine alone and of zidovudine plus clarithromycin were evaluated with 18 volunteers with aids who had no infection with mycobacterium avium complex or clinical evidence of gastroenteritis. patients received 200 mg of zidovudine orally every 8 h on days 1 to 4 and 1,000 mg of clarithromycin every 12 h, given 2 h apart from zidovudine, on days 2 to 4. concentrations of zidovudine in plasma were measured at steady state both prior to (phas ...19957574530
clinical significance of nontuberculous mycobacteria isolates in a canadian tertiary care center.to determine the epidemiology and clinical features of disease due to nontuberculous mycobacteria (ntm) in our institution, we reviewed the medical records of all patients from whom ntm isolates were recovered from 1988 to 1990 to extract selected clinical and laboratory data. on the basis of the likelihood of infection, patients were classified as having definite, probable, or unlikely ntm disease as defined by published guidelines. of 80 patients who met the inclusion criteria, 17 had definite ...19957578721
localized soft-tissue infections with mycobacterium avium/mycobacterium intracellulare complex in immunocompetent patients: granulomatous tenosynovitis of the hand or wrist.in immunocompetent patients, mycobacterium avium/mycobacterium intracellulare complex (mac) has been associated with pulmonary infection in adults, cervical lymphadenitis in children, and disseminated infection in children and adults. mac rarely has been recognized as a cause of localized soft-tissue infection in immunocompetent hosts. six cases of granulomatous tenosynovitis due to mac are reported; five cases occurred after local surgical procedures, trauma, or corticosteroid injection. in fou ...19957578762
clinical manifestations and implications of coinfection with mycobacterium kansasii and human immunodeficiency virus type 1.we conducted a retrospective study to further elucidate the clinical presentations and prognosis of disease due to mycobacterium kansasii in patients infected with human immunodeficiency virus (hiv). forty-nine hiv-infected patients first had m. kansasii isolated at a mean cd4 cell count of 62/mm3 and at a mean interval of 17 months after the diagnosis of aids. seventeen of the 49 patients had disseminated disease caused by m. kansasii. twenty-nine patients had a positive acid-fast smear of sput ...19957578764
identification of mycobacterium intracellulare by a polymerase chain reaction using species-specific primers.the polymerase chain reaction (pcr) is a rapid and specific method used to amplify a certain dna fragment. it is applicable to rapid diagnosis of mycobacterial infections. by use of species-specific primers, it is possible to identify mycobacteria by pcr. in this study, a newly constructed primer was tested for specificity for mycobacterium intracellulare in the pcr.19957579315
allogeneic bmt in a patient with cml and prior disseminated infection by mycobacterium avium complex.a patient with chronic myeloid leukemia (cml) who developed a disseminated infection by mycobacterium avium complex (mac) was successfully treated with rifampin, ethambutol, isoniazid, cycloserin and ciprofloxacin. diagnosis was proven by histologic examination of hepatic biopsy and culture of the liver biopsy material. two years later the patient underwent allogeneic bone marrow transplantation (bmt) from an hla-matched sibling donor. antimycobacterial prophylaxis to mac with ethambutol, cyclos ...19957581120
ribosomal internal transcribed spacer sequences are identical among mycobacterium avium-intracellulare complex isolates from aids patients, but vary among isolates from elderly pulmonary disease patients.sequencing 280 bp of the internal transcribed spacer (its) between the 16s and 23s rrna genes in a collection of 46 clinical isolates of the mycobacterium avium-intracellulare complex (mai complex) identified nine different sequences, grouping these isolates in nine 'its sequevars'. this analysis extends the subdivision within the mai complex to 18 its sequevars and also improves discrimination from other mycobacterial species. evaluation of the sequevar grouping among different clinical sources ...19957582034
clinical isolates of mycobacterium simiae in san antonio, texas. an 11-yr review.during a period of 11 yr (1983-1993) 137 clinical isolates of mycobacterium simiae obtained from 75 patients were identified in a university hospital in san antonio, texas. one hundred twenty-eight isolates (93%) were from a pulmonary source, four (3%) from blood, and five from other sites including skin, urine, lymph node, bone marrow, and brain. of 62 evaluable patients, six (10%) had definite infection, nine (14%) had probable disease, and 48 (76%) were thought to be colonized. during the las ...19957582293
disseminated disease due to mycobacterium avium complex in aids.we retrospectively analysed 46 cases of disseminated infection with mycobacterium avium complex (mac) within a cohort of 702 hiv-infected patients in edinburgh. clinical features were compared with case-matched controls (aids cases without disseminated mac), and survival and progression times were controlled for confounding variables that influence survival. disseminated mac was diagnosed antemortem in 18% of aids patients, and was the aids-defining diagnosis in 6% of all aids cases. concomitant ...19957583075
age-dependent humoral responses of children to mycobacterial antigens.in the united states, disseminated infection with environmental mycobacteria, including the mycobacterium avium complex, is the most common opportunistic bacterial infection seen in aids patients. however, the source and relative degree of exposure to environmental mycobacteria during childhood are unknown. to examine the age-related exposure to mycobacteria, we obtained serum samples from 150 children ranging in age from 6 months to 18 years. each sample was tested against both m. avium (serova ...19957583921
treatment of localized mycobacterium avium complex infection with clofazimine and doxycycline in a cat.mycobacterium avium complex infection resulted in a granuloma that developed at the base of the left ear in a cat. the lesion caused vestibular dysfunction and facial palsy on the left side and protruded into the oral cavity on that side. the cat was treated successfully, with resolution of the lesion and elimination of the organism, by use of combined administration of clofazimine and doxycycline. adverse effects of the clofazimine treatment included temporary reddish-orange discoloration of th ...19957591945
in-vitro activity of oxazolidinones against mycobacterium avium complex.options for treating disseminated mycobacterium avium complex (mac) disease have improved. however, efficacy is not always certain, resistance is common and rapidly bactericidal agents would improve efficacy and prevent resistance. certain oxazolidinones were tested against mac strains and inhibited growth at expected serum concentrations or lower. activity correlated with hydrophobicity and one agent was bactericidal at concentrations two to five times greater than the mic.19957592181
gene replacement through homologous recombination in mycobacterium intracellulare.mycobacterium intracellulare is a slow-growing pathogenic mycobacterium closely related to mycobacterium avium. in contrast to mycobacterium tuberculosis and mycobacterium bovis bcg, m. intracellulare has received little attention as a model species for studies of mycobacterial molecular biology and genetics. this study shows that m. intracellulare 1403 (atcc 35761) can be transformed by electroporation with high frequencies (up to 10(6) transformants per microgram of dna), using plasmids pyt937 ...19957592373
interaction with human immunodeficiency virus type 1 modulates innate effector functions of human monocytes.the effect of human immunodeficiency virus (hiv) type 1 on human mononuclear phagocyte effector functions in response to infection with bacteria of the mycobacterium avium-intracellular complex (mac) was investigated. the results showed that interaction of hiv-1 or its constituents with cd4 expressed in the monocyte membrane led to substantial impairment of monocyte capacity to restrict the intracellular growth of mac. this was accompanied by substantially decreased production of tumor necrosis ...19957594725
identification of mycobacterium avium complex isolated in eastern and central japan by using dna probes.an attempt was made to identify mycobacterium avium and mycobacterium intracellulare in the m. avium intracellulare complex (mac) isolated in the tohoku (38 strains) and tokai (30 strains) districts of japan by using dna probes which are specific for m. avium, m. intracellulare and m. tuberculosis complex, respectively. the incidence of m. avium infection (82%) by far exceeded that of m. intracellulare infection in the tohoku district of eastern japan. in the tokai district of central japan, the ...19957597695
[epidemiology of non-tuberculous mycobacteriosis (ntm) in japan].an epidemiologic study of ntm was conducted by the mycobacteriosis research group of the japanese national chest hospital. the case cards of patients with ntm disease from 97 sanatoriums were studied. the total number of ntm patients newly admitted to these sanatoriums was 3,057 in the 8 years from 1985 to 1992. the number of ntm patients increased each year, and the prevalence was estimated at 2.99 per 10(5) population in 1992, which was double what it had been in 1985. in contrast, the rate of ...19947602834
the role of bronchoscopy in the diagnosis and treatment of pulmonary disease in hiv-infected patients.pulmonary disease is the most common reason for presentation and the major cause of death in hiv-infected patients. there has been an evolution in the optimal approach to the investigation of a pulmonary infiltrate in hiv-infected patients since the introduction of induced sputum for the diagnosis of pneumocystis carinii pneumonia (pcp).19957605295
[uveitis associated with rifabutin treatment. apropos of 3 patients].disseminated mycobacterium-avium complex (mac) infection develops in most patients with aids. we report three cases of anterior uveitis with vitritis in aids patients treated by the combination of rifabutin, clarithromycin and ethambutol for mac bacteremia. uveitis secondary to the introduction of rifabutin treatment is suggested.19957609395
effect of transportation and acid neutralization on recovery of mycobacteria from processed specimens.because of the increasing incidence of tuberculosis, more rapid detection of mycobacteria has become an important issue. realizing that not every clinical laboratory has a rapid detection system for growing mycobacteria, this study was conducted to examine the feasibility of submitting sediments of processed specimens to a reference laboratory for further testing in a radiometric system. using n-acetyl-l-cysteine-naoh solution, 247 respiratory specimens were processed at a diagnostic laboratory. ...19957611184
two markers, is901-is902 and p40, identified by pcr and by using monoclonal antibodies in mycobacterium avium strains.the occurrence of two markers, a newly identified 40-kda protein (p40) and the insertion sequence is901-is902, in strains of mycobacterium avium subspp. was evaluated. analysis of 184 type and field strains of the m. avium complex from human, animal, and environmental sources by pcr specific to is901 and by a monoclonal antibody specific to p40 demonstrated the presence of the two molecular markers in all of the m. avium subsp. silvaticum strains examined and also in a number of m. avium subsp. ...19957615703
identification of mycobacterium tuberculosis and m. avium complex directly from smear-positive sputum specimens and bactec 12b cultures by high-performance liquid chromatography with fluorescence detection and computer-driven pattern recognition models.a high-performance liquid chromatography method that utilized fluorescence detection (hplc-fl) of mycolic acid 6,7-dimethoxycoumarin esters was developed to identify mycobacterium tuberculosis (mtb) and m. avium complex (mac) directly from fluorochrome stain smear-positive sputum specimens and young bactec 12b cultures. hplc-fl chromatograms from a training set that included 202 smear-positive clinical sputum specimens and 343 mycobacterial cultures were used to construct a calibrated peak-namin ...19957615740
use of restriction fragment length polymorphism as a genetic marker for typing mycobacterium avium strains.restriction fragment length polymorphism (rflp) was used to study 75 clinical isolates identified as mycobacterium avium. two repetitive insertion sequences, is1311 and is900, were used as dna probes. although less than 25% of isolates showed rflp patterns with is900, all strains gave banding patterns with is1311. m. avium strains isolated from patients with aids exhibited marked polymorphism with both probes.19957615764
bacteriologically confirmed non-tuberculous mycobacterial lymphadenitis in south east england: a recent increase in the number of cases.the annual numbers of cases of non-tuberculous mycobacterial lymphadenitis in south east england has increased over the period 1973 to 1993, most notably during the last few years. the most frequent cause is the mycobacterium avium complex, followed by m malmoense. the reason for the increase is unknown but it could be due to an increased awareness in mycobacterial disease, an external factor such as pollution, or both.19957618936
pulmonary disease due to infection by mycobacterium avium complex in patients with aids.we reviewed the clinical, radiographic, and histologic features of nine patients with aids and pulmonary disease due to mycobacterium avium complex (mac). pulmonary mac disease was defined by (1) the isolation of mac from two or more lower respiratory tract specimens or from a single lung biopsy sample, (2) an infiltrate revealed by chest radiography, and (3) the absence of other identified pulmonary pathogens or malignancies. pulmonary mac disease was present in five (2.5%) of 200 patients with ...19957619998
an epidemiologic analysis of mycobacterium avium complex disease in homosexual men infected with human immunodeficiency virus type 1.cofactors associated with the mycobacterium avium complex (mac) disease and its prognosis in incident cases of aids in homosexuals were studied. we compared 51 men in whom mac disease developed as the initial aids-defining illness (termed aids illness hereafter); 157 men who had mac disease subsequent to another aids illness; and 884 men who had only non-mac aids illnesses. mac disease was the initially diagnosed aids illness more often in baltimore (6.9%) and los angeles (5.6%) than in chicago ...19957620006
primary mycobacterium avium complex septic arthritis in a patient with aids. 19957620043
[a clinical experience of dna probe method for identifying mycobacterium avium and mycobacterium intracellulare].in japan the number of patient infected with m. avium complex (mac) has been increasing in contrast to a decrease of pulmonary tuberculosis. dna probe method enabled us be able to differentiate an isolated mac into m. avium and m. intracellulare. from 1991 to 1992, we performed an investigation to apply this new technique of the dna probe method on 52 patients of atypical mycobacteriosis diagnosed as infected with mac by the ordinary method at the higashi nagoya national hospital. the group cons ...19957630072
clarithromycin therapy for mycobacterium avium complex bacteremia. 19957632282
selective utilization of dna probes for identification of mycobacterium species on the basis of cord formation in primary bactec 12b cultures.primary bactec 12b cultures with serpentine cords observed in kinyoun-stained smears were tested with a probe for mycobacterium tuberculosis complex, while cultures without cords were tested with a probe for m. avium complex. the sensitivity, specificity, and positive and negative predictive values of cording for the presumptive identification of m. tuberculosis were 95, 95, 90, and 98%, respectively. with experience, the selection of a probe for testing of primary bactec 12b cultures on the bas ...19957650183
the efficacy of the disinfection of bronchoscopes contaminated in vitro with mycobacterium tuberculosis and mycobacterium avium-intracellulare in sputum: a comparison of sactimed-i-sinald and glutaraldehyde.the efficacy of sactimed-i-sinald and glutaraldehyde was tested against clinical isolates of mycobacterium tuberculosis (mtb) and mycobacterium avium-intracellulare (mai). an in-use method demonstrated that over 10 disinfection cycles, using an auto-disinfector and a contact time of 60 min, mtb was eradicated in 10 out of 10 cycles with sactimed-i-sinald and five out of 10 cycles for glutaraldehyde. for mai, sactimed-i-sinald showed a 5 log reduction at a 60 min contact time, which was not seen ...19957658005
activities of clarithromycin, azithromycin, and ofloxacin in combination with liposomal or unencapsulated granulocyte-macrophage colony-stimulating factor against intramacrophage mycobacterium avium-mycobacterium intracellulare.the effects of ofloxacin, clarithromycin, and azithromycin in combination with granulocyte-macrophage colony-stimulating factor (gm-csf) against mycobacterium avium-mycobacterium intracellulare (mai) were evaluated in an in vitro human macrophage infection model. treatment of mai-infected macrophages with gm-csf alone induced a maximal killing effect at 1000 u/ml, and the potency was increased 100-fold by encapsulating the cytokine within liposomes. antibiotics were applied at concentrations clo ...19957658075
pentoxifylline impairs macrophage defense against mycobacterium avium complex.pentoxifylline, a tumor necrosis factor-alpha (tnf) inhibitor, is being tested as a treatment adjunct in human immunodeficiency virus (hiv)-infected patients. however, tnf is important in cellular defense. the effect of pentoxifylline on mycobacterium avium complex (mac) growth in exogenously infected macrophages was compared with the effect of dexamethasone. pentoxifylline, in a concentration that decreased mac-induced tnf by 48.1%, enhanced mac growth by 1.9- to 19.6-fold and 1.82- to 4.46-fol ...19957658084
atypical mycobacterial disease findings at autopsy in a cohort of 350 aids patients in milan, italy. 19957658095
prophylaxis of mycobacterium avium complex infections in aids. 19957659325
aerosolized interferon gamma for mycobacterium avium-complex lung disease.it has recently been shown that human alveolar macrophages can be selectively activated without systemic effect by the use of aerosolized interferon-gamma (ifn gamma), a cytokine that enhances macrophage oxidative and antimicrobial activity. we report the case of a 38-yr-old man negative for human immunodeficiency virus (hiv), with silicosis and advanced cavitary lung disease due to mycobacterium avium intracellulare (mai), who failed to improve despite 3 yr of continuous medical therapy with th ...19957663788
determination of mics for mycobacterium avium-m. intracellulare complex in liquid medium by a colorimetric method.we investigated the potential of a rapid colorimetric microassay based on the reduction of dimethylthiazol-diphenyltetrazolium bromide (mtt) for determining the growth of mycobacterium avium-m. intracellulare complex (mac) and mics of clofazimine, resorcinomycin a, and the quinolone pd 127391 against mac. the reduction of mtt was directly proportional to the number of viable bacteria. a comparison of the mtt reduction test with the [3h]glycerol uptake assay showed the former to possess higher an ...19957665657
algorithm for use of nucleic acid probes for identifying mycobacterium tuberculosis from bactec 12b bottles.nucleic acid probes (gen-probe, san diego, calif.) can be used to identify mycobacteria in bactec 12b broth cultures prior to detection of growth on solid media. we developed an algorithm that can be used to make an initial choice of a probe (either mycobacterium tuberculosis complex [mtb] or m. avium complex [mac]) for use in testing respiratory specimens. the algorithm was based on both the fluorochrome smear result of the concentrated specimen and the time from inoculation until the bactec 12 ...19957665676
symptomatic mycobacterium avium complex infection of the central nervous system. a case report and review of the literature.mycobacterium avium complex infections rarely involve the central nervous system, even in patients with widely disseminated disease. we report a case of disseminated m. avium complex infection presenting with central nervous system symptoms in a patient with hodgkin's disease. neurologic findings included disorientation, nuchal rigidity, seizures, an extensor plantar response, cerebrospinal fluid studies consistent with meningitis, and eventually, coma and death. organisms of the m. avium comple ...19957668942
[tuberculosis agent: biological characteristics and difficulties of microbiological diagnosis].the natural occurrence of various mycobacteria and high morbidity rates due to mycobacteria-induced diseases among patients with immunodeficiency requires its precise diagnostic techniques. numerous recent researches in tuberculosis microbiology discuss the impact of mycobacterial cell structural and functional changes on the occurrence of pulmonary disease. mycobacteria isolated from the areas under special radiation control have been found to have a varying virulence. the spread of altered myc ...19957670332
[microbiological diagnosis of tuberculosis]. 19957670333
[nontubercular mycobacteria in the gastric juice]. 19957671776
further structural definition of a new family of glycopeptidolipids from mycobacterium xenopi.the highly antigenic surface glycolipids of serovars of the mycobacterium avium complex are glycopeptidolipids of the general structure [formula: see text] however, it has recently been shown [rivière, m., & puzo, g. (1991) j. biol. chem. 266, 9057-9063; rivière, m., & puzo, g. (1992) biochemistry 31, 3575-3580] that the characteristic glycopeptidolipid of a strain of mycobacterium xenopi is of the structure [formula: see text] [monosaccharide, 3-o-ch3-6-deoxy-alpha-l-talopyranose; tetrasacchari ...19937678195
mycobacterium avium-m. intracellulare binds to the integrin receptor alpha v beta 3 on human monocytes and monocyte-derived macrophages.mycobacterium avium-m. intracellulare is an intracellular pathogen responsible for the highest incidence of disseminated bacterial infection in patients with aids. treatment of the infection is difficult and has been of limited efficacy. attachment of the organism to macrophages is a critical early step in the establishment of the disease. in the present study, we isolated and identified a receptor that mediates attachment of m. avium-m. intracellulare to human peripheral blood monocytes and mon ...19937678588
efficacy of granulocyte colony-stimulating factor and ru-40555 in combination with clarithromycin against mycobacterium avium complex infection in c57bl/6 mice.we compared the activities of two different biological-response modifiers with that of clarithromycin against mycobacterium avium complex infection in c57bl/6 mice. mice were pretreated daily with clarithromycin (50 mg/kg of body weight subcutaneously [s.c.]), ru-40555 (100 mg/kg s.c.), or granulocyte colony-stimulating factor (g-csf) at low dose (15 micrograms/kg intraperitoneally [i.p.]) or high dose (300 micrograms/kg i.p.) 3 days before intravenous challenge with 2.5 x 10(7) cfu of the mo-1 ...19937684213
negative images of mycobacteria in aspiration biopsy smears from the lymph node of a patient with acquired immunodeficiency syndrome (aids): report of a case and a review of the literature.negative images of acid-fast bacilli were observed in diff-quik-stained smears of lymph node aspirates from a patient with acquired immunodeficiency syndrome (aids) and disseminated mycobacterium avium-intracellulare infection. the significance of this finding in relation to the diagnosis and treatment of this infection is discussed and the literature pertaining to this observation is reviewed.19937686095
incorporation of 5-fluorouracil into rna by mycobacterium avium complex strain lm1.the incorporation of 5-fluorouracil (fura) into rna of mycobacterium avium complex strain lm1 was evaluated. cells were labeled with either [14c]fura or [3h]uracil and the ribonucleosides were analyzed by high-performance liquid chromatography. the identification of the ribonucleosides was facilitated by the use of an isocratic system that provided unambiguous identification of the rna pyrimidine components. uracil was incorporated into rna as uridine, but an equal amount was converted to cytidi ...19937689417
rapid detection and identification of mycobacterium avium by amplification of 16s rrna sequences.an assay that is based on the amplification of 16s rrna sequences and that was initially developed to detect mycobacterium paratuberculosis in cattle was used to test 20 serotypes of the mycobacterium avium complex (mac) and atypical mycobacterial species not belonging to mac. only serotypes 1 to 6 and 8 to 11, designated m. avium, were detected by the assay, indicating that it can be used for the rapid detection and identification of m. avium. the results of the assay for clinical samples from ...19937691877
methenamine silver positivity of the mycobacterium avium-intracellulare complex. 19937693828
clarithromycin, dapsone, and a combination of both used to treat or prevent disseminated mycobacterium avium infection in beige mice.bacteremic infection caused by organisms of the mycobacterium avium complex (mac) is common in patients with aids. we evaluated both clarithromycin and dapsone alone and in combination for the treatment and prevention of disseminated mac disease in beige mice. in the therapeutic model, c57bl/6 beige mice were infected intravenously with strain 101 of mac (serovar 1). after 1 week postinfection, mice were given clarithromycin (200 mg/kg of body weight per day) and dapsone (15 mg/kg of body weight ...19947695252
immunobiology of mycobacterium avium infection.infection caused by organisms of the mycobacterium avium complex is diagnosed in 50% to 60% of aids patients with the advanced stage of disease. mycobacterium avium is an environmental bacterium that gains access to the host through both the gastrointestinal tract and the respiratory tract. after crossing the mucosal barrier mycobacterium avium disseminates, infecting chiefly mononuclear phagocytes of the reticuloendothelial system. a number of cells of the immune system such as cd4+ t cells, na ...19947698113
mycobacterium avium complex: advances in therapy.disseminated mycobacterium avium complex (mac) is one of the most common opportunistic infections in aids patients and is increasingly recognized as a significant pathogen in chronic pulmonary disease in nonimmunocompromised patients. important progress in therapy has occurred over the last several years. in aids patients, multidrug therapy has been shown to be beneficial in terms of reducing circulating bacteremia and improving clinical symptoms. clarithromycin and azithromycin, two broad-spect ...19947698117
mycobacterium genavense: an emerging pathogen.disseminated mycobacterial infection, often due to mycobacterium avium complex, occurs frequently in patients with aids. more recently, a newly identified mycobacterium, mycobacterium genavense, has been repeatedly isolated from aids patients. mycobacterium genavense has unusual fastidious growth requirements and shows poor and variable growth in vitro. molecular biology techniques are necessary for accurate diagnosis of infection and have established mycobacterium genavense to be a definite cau ...19947698119
pulmonary infections caused by less frequently encountered slow-growing environmental mycobacteria.pulmonary mycobacteriosis is usually caused by mycobacterium tuberculosis or mycobacterium avium complex. there are, however, other slow-growing mycobacteria that can cause pulmonary infection. mycobacterium kansasii, mycobacterium malmoense, mycobacterium xenopi, mycobacterium szulgai and mycobacterium simiae typically infect middle-aged to elderly persons with preexisting lung disease. differentiation of infection with these five mycobacteria from infection with mycobacterium tuberculosis, by ...19947698120
antimycobacterial susceptibility testing: present practices and future trends.along with the worldwide renewed interest in tuberculosis, the high incidence of non-tuberculous disease in hiv-infected patients and the continuing problem of disease caused by rapidly growing mycobacteria, there has been a renewed interest in mycobacterial susceptibility testing. this renewed interest stems from the needs both to provide accurate, reliable and timely susceptibility test information for the management of patients infected with these mycobacteria and to identify new and more eff ...19947698124
isolation of the newly described species mycobacterium celatum from aids patients.mycobacterium celatum is a recently described species which, on the basis of conventional tests, may be misidentified as mycobacterium xenopi or as belonging to the mycobacterium avium complex. only genomic sequencing or high-performance liquid chromatography of cell wall mycolic acids can presently allow a correct identification of this mycobacterium. two cases of infection due to m. celatum, in aids patients, are described here. the quantitative susceptibility pattern of the isolates to a wide ...19957699029
cervical lymphadenitis due to mycobacteria other than tuberculosis--an emerging problem in children?therapy with antituberculosis drugs is not indicated in patients with isolated cervical lymph node infection due to mycobacteria other than tuberculosis (mott); resectional surgery is the treatment of choice in these cases. the reason for this study was a striking increase in the incidence of this disease in children referred to the university hospital in aachen. in the period from 1987 to 1990, we saw only 1 case of nontuberculous mycobacterial cervical lymphadenitis among 77 cultured specimens ...19957700608
liposomes in the treatment of infections.the use of liposomes in the treatment of severe infections is under investigation. classical liposomes which localize in cells of the mononuclear phagocyte system (mps) can be exploited in two ways. first for targeting of macrophage modulators such as muramyl peptides or ifn-gamma, to stimulate the cells of the mps to maximal blood clearance capacity. this enhanced nonspecific anti-infectious resistance is important as in immunocompromised patients micro-organisms frequently appear in the blood ...19947704480
clarithromycin in the treatment of mycobacterium avium lung infections in patients without aids. clarithromycin study group of france.mycobacterium avium complex infections, common in patients with aids as either pulmonary or disseminated disease, are infrequent in patients without aids. participants were 45 hiv-negative patients with lung disease and positive sputum cultures for m avium; 10 had documented immunocompromise, and 24 had preexisting lung disease. clarithromycin dosage was 500 to 2,000 mg daily (mean +/- sd = 1,633 +/- 432 mg). the drug was administered either alone (n = 14) or in combination with rifampin (n = 8) ...19957705112
the prevalence and clinical significance of pulmonary infection due to non-tuberculous mycobacteria in hong kong.an unexpected increase in positive sputum cultures of non-tuberculous mycobacteria (ntm) was noted in hong kong in 1990 compared to previous years, in contrast to a steady decline in the number of positive cultures of mycobacterium tuberculosis. a retrospective case note study was therefore undertaken to ascertain the clinical importance of the rise in ntm isolates. a representative sample of 183 of the 675 patients with ntm isolates from sputum during 1990 was identified. cases were assigned to ...19957708977
[disseminated mycobacterium avium complex infections in aids. apropos of 100 cases. groupe d'epidémiologie clinique du sida en aquitaine].the improvement of survival of aids patients allowed the emergence of disseminated mycobacterium avium complex infections (d.mac). here we report the experience of the group of "epidémiologie clinique du sida en aquitaine (gecsa)" about 100 patients. there were no differences according to sex, age and route of acquisition of hiv. clinical and biological characteristics of the infections were not specific. the mean tcd4+ lymphocytes count was 18/mm3. the diagnostic was generally established by sy ...19957709100
[mycobacterium avium complex]. 19957709113
[aids in denmark. 2. survival after the diagnosis of aids. danish study group for hiv infection].the survival pattern was studied for 687 danish aids patients (93% of notified cases in the study period) who were diagnosed with aids during the period from 1980 to 1990. the median survival was 17 months. factors significantly associated with a shortened survival were transfusion-acquired hiv infection, age > 40 years, year of diagnosis before 1987, and the presence of either disseminated infection with mycobacterium avium-complex, cytomegalovirus chorioretinitis or malignant lymphoma at time ...19957709483
experimental drugs and combination therapy.the worldwide increase in tuberculosis, the additional problem of increasing multiple drug resistance (mdr) and the primary resistance of mycobacterium avium requires new strategies in drug development and in therapy. the reason for development of mdr is manifold. one important factor is the change in cell wall construction which limits the penetration of the drug to the target receptor. this is supported by the observation that within a class of tuberculostatic drugs (identical mode of action) ...19947713572
a novel insertion element from mycobacterium avium, is1245, is a specific target for analysis of strain relatedness.the insertion sequence is1245 is a novel mycobacterial repetitive element identified in mycobacterium avium. it encodes a transposase which exhibits a 64% amino acid similarity with is1081, an insertion element present in the m. tuberculosis complex. the host range of is1245 appears limited to m. avium as this element was not identified in m. intracellulare or in any other of 18 mycobacteria species tested. when is1245 was used for restriction fragment length polymorphism (rflp) analysis, human ...19957714183
therapeutic effect of krm-1648 with various antimicrobials against mycobacterium avium complex infection in mice.a new benzoxazinorifamycin, krm-1648 (krm), was studied for its therapeutic efficacy in combination with other antimicrobials against mycobacterium avium complex infections in mice. when m. intracellulare-infected (intravenously) mice were given krm, clarithromycin (cam), sparfloxacin (spfx), or ethambutol (eb) each alone or in combination, by gavage, once daily 6 times per week (streptomycin [sm] was given subcutaneously twice per week) from day 1, krm + cam exhibited combined efficacy in terms ...19957718848
enhancement of antibiotic susceptibility and suppression of mycobacterium avium complex growth by poloxamer 331.the resistance of mycobacterium avium complex (mac) to antibiotics is thought to be enhanced by its outer glycolipid layer, which protects the organisms from antibiotics and host defense mechanisms. we hypothesized that surfactants which disrupt the lipid barrier might be of therapeutic value. we evaluated the ability of 10 poloxamer surfactants to inhibit the growth of mac organisms and to potentiate antimycobacterial drug activity in broth culture using a radiometric assay. very large, small, ...19957726511
isolation of nontuberculous, non-avium mycobacteria from patients infected with human immunodeficiency virus.mycobacterium avium serovars account for 97% of typeable m. avium complex (mac) organisms causing infection in patients with aids. we reviewed 216 consecutive cultures that yielded nontuberculous mycobacteria (ntm) from 212 patients. only the first isolate of each species of ntm recovered from each patient was analyzed in the study. among the 92 patients infected with the human immunodeficiency virus, 96 ntm organisms were identified; m. avium was recovered from 50 (77%) of the 65 ntm-positive c ...19957727674
rapid detection of tuberculous and non-tuberculous mycobacteria by microscopic observation of growth on middlebrook 7h11 agar.the rate of recovery and time to the detection of mycobacteria in clinical specimens were measured in traditional egg-based media cultures and on middlebrook 7h11 agar plate cultures using microcolony detection. in the 5438 specimens processed, a total of 293 (5.4%) clinically relevant mycobacterial isolates were detected (mycobacterium tuberculosis, n = 231; mycobacterium avium complex, n = 60; mycobacterium kansasii, n = 2). of these, 227 (77%) and 237 (81%) isolates were detected on lowenstei ...19957729457
lack of rifabutin resistance with prophylaxis for disseminated mycobacterium avium complex. 19947734014
clinical pharmacokinetics of rifabutin.the clinical effectiveness of rifabutin for prophylaxis of disseminated mycobacterium avium complex infection has recently been demonstrated in hiv-positive patients with low cd4 counts. rifabutin is a newly marketed, semisynthetic antimycobacterial agent similar to rifampicin (rifampin) in structure and activity. however, rifabutin has important pharmacokinetic differences compared with rifampicin. rifabutin has relatively low oral bioavailability; about 20% after single dose administration. wi ...19957736687
dapsone/pyrimethamine may prevent mycobacterial disease in immunosuppressed patients infected with the human immunodeficiency virus.dapsone exhibits activity against mycobacterium tuberculosis and mycobacterium avium complex (mac) in vitro. we retrospectively examined the incidence of mycobacterial diseases within a randomized prospective trial of prophylaxis for pneumocystis carinii pneumonia and toxoplasmosis. of 501 participants who had not previously had a mycobacterial disease, 274 received dapsone/pyrimethamine (200/75 mg once weekly) and 227 received aerosolized pentamidine (300 mg once every 4 weeks). the median cd4 ...19957742423
comparison of multiple drug therapy regimens for hiv-related disseminated mycobacterium avium complex disease.in june 1993, the united states public health service (usphs) made recommendations for treatment of disseminated mycobacterium avium complex (mac) in patients infected with the human immunodeficiency syndrome (hiv). it was suggested that every treatment regimen include either azithromycin or clarithromycin plus one or more of the following drugs: ethambutol, clofazimine, rifabutin, rifampin, ciprofloxacin, or amikacin. this study compares the effect of multiple drug therapy regimens on the survi ...19957749789
mycobacterium avium complex in water, food, and soil samples collected from the environment of hiv-infected individuals.as part of an epidemiologic study of mycobacterium avium complex (mac) infection in san francisco, water, food and soil samples were collected from the home environment of 290 persons with human immunodeficiency virus (hiv) infection and cultured for mycobacteria. isolates recovered from the environment were compared with isolates cultured from study patients. although mycobacteria were recovered from numerous environmental samples, isolates reactive with mac-specific dna probes were recovered f ...19957749796
diarrheogenic bacterial enteritis in acquired immune deficiency syndrome: a light and electron microscopy study of 52 cases.diarrhea, the etiology of which often is obscure, is a major complication of human immunodeficiency virus (hiv) disease. diarrheogenic bacterial infections (eg, enteropathogenic escherichia coli) are diagnosed traditionally by stool analysis rather than by examination of endoscopic biopsy specimens. although e coli rarely have been associated with diarrhea in hiv/acquired immunodeficiency syndrome (aids) patients, neither have they routinely been sought. endoscopic ileal and colorectal biopsy sp ...19957750932
use of a multiplex pcr to detect and identify mycobacterium avium and m. intracellulare in blood culture fluids of aids patients.the presence of mycobacteria in blood culture fluids (bactec) of aids patients with positive growth indices (gis, > 20 u) was investigated by using a multiplex pcr to detect and identify members of the genus mycobacterium, m. avium, m. intracellulare, and m. tuberculosis. three different methods of extracting mycobacterial dna from blood culture fluid were compared for use with the multiplex pcr. mycobacterial cells were pelleted from a small aliquot of blood culture fluid by centrifugation, and ...19957751375
culture of intestinal biopsy specimens and stool culture for detection of bacterial enteropathogens in patients infected with human immunodeficiency virus. the berlin diarrhea/wasting syndrome study group.the diagnostic yields of stool cultures and biopsy specimens for the detection of enteric bacterial pathogens in 213 human immunodeficiency virus-infected patients were compared. forty-five percent (19 of 42) of the pathogens were detected exclusively by stool culture, 2% (1 of 42) of the isolates were detected exclusively by culture of biopsy specimens, and 53% (22 of 42) were detected by both methods. repeated stool cultures remain the most important means of diagnosing enteric bacterial patho ...19957751389
optimum recovery of mycobacterium avium complex from blood specimens of human immunodeficiency virus-positive patients by using small volumes of isolator concentrate inoculated into bactec 12b bottles. 19957751399
mycobacterium avium: a potentially treatable cause of pericardial effusions.we present a patient with a very large pericardial effusion due to disseminated mycobacterium avium complex (mac) infection with associated bacteraemia and gastroenteritis. he was hiv antibody-positive with a cd4+ lymphocyte count of 10 x 10(6)/l. he complained of fevers, diarrhoea and dyspnoea and an echocardiogram showed a pericardial effusion. chest x-ray showed progressive enlargement of the cardiac silhouette over a 3-month period. the effusion was drained surgically and antimycobacterial t ...19957751668
mycobacterium avium complex (mac) osteomyelitis and septic arthritis in an immunocompetent host.we describe a case of mycobacterium avium complex (mac) osteomyelitis and septic arthritis in an immunocompetent man. infection was derived from a chainsaw injury sustained on the lateral aspect of the ankle 13 years earlier, and had spread through the bone, joint and soft tissue emerging at the medial aspect. this was successfully treated with surgical debridement, drainage, arthrodesis and 18 months of chemotherapy consisting of clarithromycin, rifampicin, ethambutol, and ciprofloxacin with an ...19957751669
impact of clarithromycin and azithromycin on patterns of treatment and survival among aids patients with disseminated mycobacterium avium complex.to determine the impact of the introduction of clarithromycin and azithromycin on the treatment and survival of patients with aids and disseminated mycobacterium avium complex (dmac).19957755914
disseminated mycobacterium scrofulaceum infection: a potentially treatable complication of aids.disseminated mycobacterium scrofulaceum infection has rarely been reported (only 8 cases to date), and no case of infection associated with aids has been reported in detail. we report a case of disseminated m. scrofulaceum infection in an aids patient that presented as chronic ulcerative and nodular skin lesions with probable cavitary lung involvement. we discuss reported cases of dissminated m. scrofulaceum infection and features of human immunodeficiency virus (hiv)-associated disease due to m ...19957756474
comparative in-vitro activity of bay y 3118, a new quinolone, and ciprofloxacin against mycobacterium tuberculosis and mycobacterium avium complex. 19957759400
specificity of diagnostic pcr amplification for m. avium using the probe pmav22.we characterized the serovar specificity of the probe pmav22 using atcc isolates. primers from this sequence amplified dna from serovars 1-6, 8-10, and atcc strain 19075 but did not amplify mais serovars 7, 11, 12, 14, 17-20. this confirmed that the m. avium probe pmav22 is specific for m. avium, not m. intracellulare.19957760864
mycobacterium avium-intracellulare from patients with and without aids compared by pyrolysis mass spectrometry.isolates of mycobacterium avium-intracellulare complex (mai) from aids and non-aids patients were compared by pyrolysis mass spectrometry (pyms). those from aids patients were more closely related to each other than those from non-aids patients which were significantly more disparate.19937763448
long-term safety of ofloxacin and ciprofloxacin in the treatment of mycobacterial infections.ofloxacin and ciprofloxacin are potentially useful agents for treating mycobacterial infections. we retrospectively reviewed 7 years' experience with these agents in 103 patients. ofloxacin was used primarily to treat tuberculosis (tb), dosed to achieve 2-hour postdose serum concentrations of 8-12 micrograms/ml. ciprofloxacin was used primarily to treat mycobacterium avium complex (mac) infection, dosed to achieve 2-hour post-dose serum concentrations of 4-6 micrograms/ml. despite differences in ...19957767552
inflammatory response following intranasal infection with mycobacterium avium complex: role of t-cell subsets and gamma interferon.the role of cd4+ and cd8+ t cells in the response to intranasal infection with a mycobacterium avium complex isolate (mac) was investigated. depletion of cd4+ t cells by injected antibody exacerbated infection in the lung, spleen, and liver. there were decreased numbers of inflammatory cells in the lungs of cd4-depleted mice and a significant decrease in lung cytotoxic activity. the neutrophil response was unaffected, and in cd4-depleted mice, unlike intact infected mice, these cells were found ...19957768610
phage infection, transfection and transformation of mycobacterium avium complex and mycobacterium paratuberculosis.mycobacterium avium complex strains and mycobacterium paratuberculosis are closely related intracellular pathogens affecting humans and animals. m. avium complex infections are a leading cause of morbidity and mortality in aids patients, and m. paratuberculosis is the agent of johne's disease in ruminants. genetic manipulation of these micro-organisms would facilitate the understanding of their pathogenesis, the construction of attenuated vaccine strains and the development of new drugs and trea ...19957773411
intestinal mycobacteria in african aids patients. 19957776794
clarithromycin therapy for mycobacterium avium complex bacteremia. 19957778830
clarithromycin therapy for mycobacterium avium complex bacteremia. 19957778831
potential role of roxithromycin against the mycobacterium avium complex.until the recent experience with azithromycin and clarithromycin, macrolides were not considered to be important agents against mycobacteria. clinical evidence is now growing that the newer 14 and 15 membered macrolide compounds have therapeutic activity against mycobacterium avium, mycobacterium chelonae and mycobacterium leprae. several years ago, when evaluating the activity of roxithromycin using one of the more virulent m. avium in our collection, the authors found that roxithromycin exerte ...19957782113
dapsone as prophylaxis for disseminated mycobacterium avium complex infection. 19957784829
intracellular activities of roxithromycin used alone and in association with other drugs against mycobacterium avium complex in human macrophages.recent reports have shown that roxithromycin possesses significant activity against atypical mycobacteria, including the mycobacterium avium complex (mac), and that its extracellular anti-mac activity is further enhanced in two- or three-drug combinations with ethambutol, rifampin, amikacin, ofloxacin, and clofazimine. in accordance with the above data, the anti-mac potential of roxithromycin used alone and in combination with the above-mentioned antituberculous drugs was screened intracellularl ...19957786006
rifabutin-associated uveitis during prophylaxis for mycobacterium avium complex infection. 19957786206
chylous ascites: ct and ultrasound appearance.an unusual but pathognomonic appearance of chylous ascites was observed on computed tomographic (ct) and ultrasound examinations of the abdomen in a patient with aids and disseminated tuberculosis. the images showed gradual development of fat-fluid level in the peritoneal collection when the patient maintained a recumbent position. the explanation for this phenomenon is provided together with a brief review of pertinent literature.19957787717
production of tnf-alpha, il-6 and tgf-beta, and expression of receptors for tnf-alpha and il-6, during murine mycobacterium avium infection.the mycobacterium avium complex comprises intracellular bacteria associated with disseminated infection in patients with acquired immune deficiency syndrome (aids). immune defects that lead to infection are unknown but cytokines appear to play an important role in the immunomodulation of host defence mechanisms. we evaluated the cytokine profiles seen temporally after murine m. avium infection. spleen cells were obtained from m. avium-infected c57bl/6 mice and uninfected mice at weeks 1, 2, 3, 4 ...19957790028
polyclonal mycobacterium avium infections in patients with aids: variations in antimicrobial susceptibilities of different strains of m. avium isolated from the same patient.broth microdilution mics were determined for pairs of strains isolated from five aids patients with polyclonal mycobacterium avium infection. four (80%) of the five patients were infected simultaneously with strains having different antimicrobial susceptibility patterns. these findings have implications for the interpretation of susceptibility data in m. avium prophylaxis and treatment trials.19957790424
ct features of pulmonary mycobacterium avium complex infection.the purposes of this study were to describe and compare the prevalence of disease features in subjects with mycobacterium avium complex (mac) disease with those of mycobacterium tuberculosis infection (mtb), to compare the abilities of ct and chest radiography to identify the features of mac disease, and to determine if sputum positivity is related to any of the ct features of mac disease.19957790541
selection of clarithromycin-resistant mycobacterium avium complex during combined therapy using the beige mouse model.sixteen weeks of treatment with clarithromycin (clari) alone displayed significant bactericidal activity against mycobacterium avium complex infection in beige mice. only two combined regimens, clari combined with an initial 4 or 8 weeks of amikacin (amika), displayed activity greater than that displayed by clari alone. four other combined regimens, clari combined with ethambutol (emb), rifabutin (rbt), or both emb and rbt during the entire 16 weeks of treatment or with amika administered in an ...19957793860
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