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Non-tuberculous mycobacteria I: one year clinical isolates identification in Tertiary Hospital Aids Reference Center, Rio de Janeiro, Brazil, in pre highly active antiretroviral therapy era
Ferreira, Rosa Maria Carvalho;Saad, Maria Helena Féres;Silva, Marlei Gomes da;Fonseca, Leila de Souza;
Memórias do Instituto Oswaldo Cruz , 2002, DOI: 10.1590/S0074-02762002000500024
Abstract: the aim of this study was to determine the prevalence of non-tuberculous mycobacteria (ntm) isolates at university hospital, reference center for aids in rio de janeiro, brazil, during one year. we used standard biochemical tests for species identification and is1245 pcr amplification was applied as a mycobacterium avium specific identification marker. four hundred and four specimens from 233 patients yielded acid-fast bacilli growth. m. tuberculosis was identified in 85% of the patients and ntm in 15%. ntm disseminated infection was a common event correlated with human immunodeficiency virus (hiv) infected patients and only in hiv negative patients the source of ntm was non sterile site. m. avium complex (mac) was biochemically identified in 57.8% (49/83) of ntm isolates, most of them from sterile sites (75.5%), and in 94% (46/49) the is 1245 marker specific for m. avium was present. twenty ntm strains showed a mac biochemical pattern with the exception of a urease-positive (99% of mac are urease-negative), however is1245 was detected in 96% of the strains leading to their identification as m. avium. in this group differences in ntm source was not significant. the second most frequently isolated ntm was identified as m. scrofulaceum (7.2%), followed by m. terrae (3.6%), m. gordonae (2.4%), m. chelonae (1.2%), m. fortuitum (1.2%) and one strain which could not be identified. all were is1245 negative except for one strain identified as m. scrofulaceum. it is interesting to note that non-sterile sites were the major source of these isolates (92.8%). our finding indicated that m. avium is still the major atypical species among in the mac isolates recovered from brazilian aids patients without highty active antiretroviral therapy schema. some discrepancies were seen between the identification methods and further investigations must be done to better characterize ntm isolates using other phenotypic and genotypic methods.
Non-tuberculous mycobacteria I: one year clinical isolates identification in Tertiary Hospital Aids Reference Center, Rio de Janeiro, Brazil, in pre highly active antiretroviral therapy era  [cached]
Ferreira Rosa Maria Carvalho,Saad Maria Helena Féres,Silva Marlei Gomes da,Fonseca Leila de Souza
Memórias do Instituto Oswaldo Cruz , 2002,
Abstract: The aim of this study was to determine the prevalence of non-tuberculous mycobacteria (NTM) isolates at University Hospital, Reference Center for Aids in Rio de Janeiro, Brazil, during one year. We used standard biochemical tests for species identification and IS1245 PCR amplification was applied as a Mycobacterium avium specific identification marker. Four hundred and four specimens from 233 patients yielded acid-fast bacilli growth. M. tuberculosis was identified in 85% of the patients and NTM in 15%. NTM disseminated infection was a common event correlated with human immunodeficiency virus (HIV) infected patients and only in HIV negative patients the source of NTM was non sterile site. M. avium complex (MAC) was biochemically identified in 57.8% (49/83) of NTM isolates, most of them from sterile sites (75.5%), and in 94% (46/49) the IS 1245 marker specific for M. avium was present. Twenty NTM strains showed a MAC biochemical pattern with the exception of a urease-positive (99% of MAC are urease-negative), however IS1245 was detected in 96% of the strains leading to their identification as M. avium. In this group differences in NTM source was not significant. The second most frequently isolated NTM was identified as M. scrofulaceum (7.2%), followed by M. terrae (3.6%), M. gordonae (2.4%), M. chelonae (1.2%), M. fortuitum (1.2%) and one strain which could not be identified. All were IS1245 negative except for one strain identified as M. scrofulaceum. It is interesting to note that non-sterile sites were the major source of these isolates (92.8%). Our finding indicated that M. avium is still the major atypical species among in the MAC isolates recovered from Brazilian Aids patients without highty active antiretroviral therapy schema. Some discrepancies were seen between the identification methods and further investigations must be done to better characterize NTM isolates using other phenotypic and genotypic methods.
Pathology of AIDS-Study from a Neuropsychiatric Centre from South India
Vani Santosh,Yasha T. C,Panda K. M,Das S
Annals of Indian Academy of Neurology , 1998,
Abstract: The pathomorphological features noted in 47 cases of HIV/AIDS studied on autopsy (39 cases) and surgical biopsy material (8 cases) over a period of 8.5 years are described here. The serum samples of all cases and 26/29 CSF samples tested were positive for anti HIV antibodies. Majority of patients were young adult males in the age group 25-35 years. History of high risk behaviour was available in 59.6% cases. 38/39 autopsied cases succumbed to various opportunistic infections. Infection by a single pathogen was noted in 76.3% cases and due to multiple infectious agents in 23.7%. The commonest opportunistic infection was cryptococcosis (59%) followed by toxoplasma encephalities (28.2%) and tuberculous meningitis (25.6%). The others included meningococcal meningitis, herpes simplex, cytomegalovirus and acanthamoeba encephalitis noted in one case each. Features meningococcal meningitis, herpes simplex, cytomegalovirus and acanthamoeba encephalitis noted in one case each. Features of HIV leucoencephalitis was noted in one autopsy and tow brain biopsy specimens. Complete body necropsy carried out in 11/39 cases revealed disseminated cryptococcosis in 5, tuberculosis in 4 and features of HIV related changes of lymphoreticular organs in 3 cases. Pneumocystis carinil pneumonia was noted in 2 patients along with cryptococcosis. Diagnostic lymph node biopsy in 3 patients revealed tuberculous lymphadenitis in 2 and infection by non-tuberculous mycobacteria in one. Evidence of IIIV associated neuropathy was noted in 3 cases. In the present series, the incidence of cryptococcal meningitis was very high compared to neurotuberculosis as reported from other clinical and one autopsy series from other parts of India. Similarly, the incidence of toxoplasma encephalitis was also higher. The type of laboratory support and the experience of the pathologist play a crucial role in accurate identification of the pathogens. Therefore, a high index of clinical suspicion and a proper diagnostic approach to HIV/AIDS patients is required in developing countries to identify various pathological lesions.
Usefulness of the detection of Toxoplasma gondii antigens in AIDS patients
Fachado, Alberto;Fonte, Luis;Alberti, Esteban;Hadad, Pablo;Fonseca, Lisset;Machin, Rodolfo;Finlay, Carlos;
Revista do Instituto de Medicina Tropical de S?o Paulo , 1994, DOI: 10.1590/S0036-46651994000600009
Abstract: toxoplasmic encephalitis (te) is a mayor cause of central nervous system infection in patients with acquired immunodeficiency syndrome (aids). toxoplasma antibodies were detected in 56 of 79 patients with aids (71%), in the present study. fourteen out of 57 seropositive patients developed tf (25%) and had toxoplasma gondii antigen detected in their urine. for this, most of them received an effective therapy, with the subsequent disappearance of the symptoms and discontinuity of excretion of the t. gondii antigens. our results suggest that the monitoring of t. gondii antigen in the urine of aids patients may be useful to decide on the proper time for therapy, as well as to avoid the beginning of neurologic signs in these patients.
Frequency of tuberculous and non-tuberculous mycobacteria in HIV infected patients from Bogota, Colombia
Martha I Murcia-Aranguren, Jorge E Gómez-Marin, Fernando S Alvarado, José G Bustillo, Ellen de Mendivelson, Bertha Gómez, Clara I León, William A Triana, Erwing A Vargas, Edgar Rodríguez
BMC Infectious Diseases , 2001, DOI: 10.1186/1471-2334-1-21
Abstract: Patients who attended the three major HIV/AIDS healthcare centres in Bogota were prospectively studied over a six month period. A total of 286 patients were enrolled, 20% of them were hospitalized at some point during the study. Sixty four percent (64%) were classified as stage C, 25% as stage B, and 11% as stage A (CDC staging system, 1993). A total of 1,622 clinical samples (mostly paired samples of blood, sputum, stool, and urine) were processed for acid-fast bacilli (AFB) stain and culture.Overall 43 of 1,622 cultures (2.6%) were positive for mycobacteria. Twenty-two sputum samples were positive. Four patients were diagnosed with M. tuberculosis (1.4%). All isolates of M. tuberculosis were sensitive to common anti-tuberculous drugs. M. avium was isolated in thirteen patients (4.5%), but only in three of them the cultures originated from blood. The other isolates were obtained from stool, urine or sputum samples. In three cases, direct AFB smears of blood were positive. Two patients presented simultaneously with M. tuberculosis and M. avium.Non-tuberculous Mycobacterium infections are frequent in HIV infected patients in Bogota. The diagnostic sensitivity for infection with tuberculous and non-tuberculous mycobacteria can be increased when diverse body fluids are processed from each patient.Mycobacterium infections are frequent opportunistic pathogens associated with the acquired immunodeficiency syndrome (AIDS). Its relative virulence and potential for person-to-person transmission distinguishes Mycobacterium tuberculosis. Persons infected with the human immunodeficiency virus (HIV) are particularly susceptible to tuberculosis, either by the reactivation of latent infection or by a primary infection with rapid progression to active disease [1-4]. The annual incidence rate of tuberculosis in Colombia during 1998 was 19.6 per 100,000 persons [5], but rates 1,000-fold higher have been reported in some HIV-seropositive populations [6-14]. In addition, disseminated i
Non-tuberculous mycobacteria isolated from slaughter pigs in Mubende district, Uganda
Adrian Muwonge, Clovice Kankya, Tone B Johansen, Berit Dj?nne, Jacques Godfroid, Demelash Biffa, Vigdis Edvardsen, Eystein Skjerve
BMC Veterinary Research , 2012, DOI: 10.1186/1746-6148-8-52
Abstract: A total of 363 lymph nodes were collected and cultured for the presence of mycobacteria. Isolates were identified by 16S rDNA gene sequencing. A questionnaire survey was administered to identify production related factors associated with infection prevalence. Data were assembled and analysed using descriptive statistics and mixed effects logistic regression analysis.Mycobacteria were detected in 39 % (143/363) of the examined lymph nodes, 63 % (59/93) of lymph nodes with gross lesions typical of mycobacteriosis and 31% (84/270) of lymph nodes with no visible lesions. Nineteen per cent of the isolated mycobacteria were identified as Mycobacterium (M) avium, of these 78% and 22% were M. avium sub sp. Hominissuis and avium respectively. Other mycobacterial species included M. senuense (16%), M. terrae (7%) and M. asiaticum (6%). This study found free range systems (OR?=?3.0; P?=?0.034) and use of water from valley dams (OR?=?2.0; P?=?0.049) as factors associated with high prevalence of mycobacteria in slaughter pigs.This study demonstrated a high prevalence of NTM infections among slaughter pigs in Mubende district of Uganda. M. avium was the most prevalent of all NTM isolated and identified. Free range system of pig management and valley dam water were the most significant factors associated with NTM prevalence in Mubende district. These findings could be of a major public health concern given that it is in a predominantly pork consuming population with 18% HIV/AIDS prevalence. Therefore, stringent post-mortem inspection at the slaughter houses is of paramount importance to reduce human exposure.Non-tuberculous mycobacteria (NTM) are the most prevalent type of mycobacteria. Unlike members of the Mycobacterium tuberculosis complex (MTC) that are highly pathogenic, the majority of NTM have been regarded as non-pathogenic. This opinion is now changing as more NTM have been associated with several human diseases [1]. NTM naturally occur in the environment, especially wate
HIV co-infection with tuberculous and non-tuberculous mycobacteria in western Kenya: challenges in the diagnosis and management
HDN Nyamogoba, G Mbuthia, S Mining, G Kikuvi, R Kikuvi, S Mpoke, D Menya, PG Waiyaki
African Health Sciences , 2012,
Abstract: Background: Tuberculosis (TB) and HIV co-infections have a global prevalence with devastating morbidity and massive mortality, Sub-Saharan Africa being the worst hit. Objectives: To evaluate the prevalence of TB-HIV co-infection and demonstrate the confusion caused by NTM and HIV/AIDS co-infection in TB diagnosis and treatment in western Kenya. Methods: In a cross-sectional study carried out at 10 hospitals in western Kenya, sputa from consenting 872 TB suspects underwent microscopy, and culture on Lowenstein-Jensen and Mycobacteria Growth Index Tube media. Isolates were identified using the Hain’s GenoType Mycobacterium CM and GenoType Mycobacterium AS kits. A total of 695 participants were screened for HIV using Uni-GoldTM test and positives confirmed with the enzyme linked immunosorbent assay. Results: A total of 346 (39.7%) participants were diagnosed with TB. Out of the 346 TB cases, 263 (76%) were tested for HIV infection and 110 (41.8%) of these were sero-positive (co-infected). The female to male TB-HIV co-infection prevalence ratio (PR) was 1.35. This study reports isolation of non-tuberculous mycobacteria from TB suspects at a rate of 1.7%. Conclusion: A high TB-HIV co-infection rate was observed in this study. The NTM disease could be misdiagnosed and treated as TB in western Kenya.
Prevalence of IgG and IgM anti-Toxoplasma antibodies in patients with HIV and acquired immunodeficiency syndrome (AIDS)
Galván Ramírez, María de la Luz;Valdez Alvarado, Virginia;Vargas Gutierrez, Gustavo;Jiménez González, Octavio;García Cosio, Carlos;Vielma Sandoval, Marcos;
Revista da Sociedade Brasileira de Medicina Tropical , 1997, DOI: 10.1590/S0037-86821997000600004
Abstract: with the emergence of the human immunodeficiency virus (hiv), in patients with acquired immunodeficiency syndrome (aids), toxoplasma gondii has arisen as an important opportunist pathogenic agent, especcially in the central nervous system, being the most common cause of intracerebral lesions. the incidence of toxoplasma gondii in hiv-infected patients depends principally on the existence of latent toxoplasma parasitosis in the population affected. through the enzyme-linked immunosorbent assay (elisa), igg and igm anti-toxoplasma antibodies were found in 92 patients of which 46 (50.0%) were igg seropositive, and only one case (1.0%) had igm antibodies.of the 92 patients: 53 were hiv seropositives and 39 had aids. the detection and monitoring of anti-toxoplasma antibodies in hiv patients is essential, since in this group there is a high percentage risk of developing cerebral toxoplasmosis, which is the second cause of death in this type of patients.
Prevalence of IgG and IgM anti-Toxoplasma antibodies in patients with HIV and acquired immunodeficiency syndrome (AIDS)
Galván Ramírez María de la Luz,Valdez Alvarado Virginia,Vargas Gutierrez Gustavo,Jiménez González Octavio
Revista da Sociedade Brasileira de Medicina Tropical , 1997,
Abstract: With the emergence of the human immunodeficiency virus (HIV), in patients with acquired immunodeficiency syndrome (AIDS), Toxoplasma gondii has arisen as an important opportunist pathogenic agent, especcially in the central nervous system, being the most common cause of intracerebral lesions. The incidence of Toxoplasma gondii in HIV-infected patients depends principally on the existence of latent Toxoplasma parasitosis in the population affected. Through the enzyme-linked immunosorbent assay (ELISA), IgG and IgM anti-Toxoplasma antibodies were found in 92 patients of which 46 (50.0%) were IgG seropositive, and only one case (1.0%) had IgM antibodies.Of the 92 patients: 53 were HIV seropositives and 39 had AIDS. The detection and monitoring of anti-Toxoplasma antibodies in HIV patients is essential, since in this group there is a high percentage risk of developing cerebral toxoplasmosis, which is the second cause of death in this type of patients.
Isolation of non-tuberculous mycobacteria from pastoral ecosystems of Uganda: Public Health significance
Clovice Kankya, Adrian Muwonge, Berit Dj?nne, Musso Munyeme, John Opuda-Asibo, Eystein Skjerve, James Oloya, Vigdis Edvardsen, Tone B Johansen
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-320
Abstract: A total of 310 samples (soil, water and faecal from cattle and pigs) were examined for mycobacteria. Isolates were identified by the INNO-Lipa test and by 16S rDNA sequencing. Additionally, a questionnaire survey involving 231 pastoralists was conducted during sample collection. Data were analysed using descriptive statistics followed by a multivariable logistic regression analysis.Forty-eight isolates of NTM were detected; 25.3% of soil samples, 11.8% of water and 9.1% from animal faecal samples contained mycobacteria. Soils around water sources were the most contaminated with NTM (29.8%). Of these samples, M. fortuitum-peregrinum complex, M. avium complex, M. gordonae, and M. nonchromogenicum were the most frequently detected mycobacteria. Drinking untreated compared to treated water (OR = 33), use of valley dam versus stream water for drinking and other domestic use (OR = 20), sharing of water sources with wild primates compared to antelopes (OR = 4.6), sharing of water sources with domestic animals (OR = 5.3), and close contact with cattle or other domestic animals (OR = 13.8) were the most plausible risk factors for humans to come in contact with NTM in the environment.The study detected a wide range of potentially pathogenic NTM from the environment around the pastoral communities in Uganda. Drinking untreated water and living in close contact with cattle or other domestic animals may be risk factors associated with the possibility of humans and animals acquiring NTM infections from these ecosystems.Although members of the Mycobacterium tuberculosis complex (MTC) are responsible for the majority of mycobacterial infections worldwide, environmental opportunistic infections due to non-tuberculous mycobacteria (NTM) are increasingly becoming more of a public health challenge [1]. Globally, the picture of NTM infections has drastically changed with the emergence of the HIV/AIDS pandemic, due to the direct consequence of the immunosuppression [2,3]. Synonyms for th
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