Cost effective idenification of Mycobacteria isolated from blood.

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

Cost effective idenification of Mycobacteria isolated from blood.

Abstr Annu Meet Am Soc Microbiol. 1991 May 5-9;91:148 (abstract no. U-35). Unique Identifier : AIDSLINE ASM91/0070292
Kaminski DA; Weymouth LA; Casiano-Colon AE; Univ. of Rochester Med. Ctr., Rochester, NY.

Abstract: Mycobacterium avium complex (MAC) is a common cause of disseminated infection and mycobacteremia in AIDS patients. A total of 994 blood specimens in Dupont Isolator tubes were received in our laboratory for mycobacterial culture during one year (8/89-7/90). 127 cultures (12.8%) from 26 patients were positive for mycobacteria. We examined mycobacterial culture results from these 26 patients during the one year period to identify methods of modifying laboratory procedures in a cost effective manner. From the 26 mycobacteremic patients, acid fast bacilli (AFB) were isolated from 51% (127/250) of blood and 51% (75/146) of other specimen types. 88% (23/26) of blood isolates were identified as MAC. The other 3 patient isolates were: 1 M. tuberculosis, 1 M. kansasii, and 1 dual infection with both M. tuberculosis and a slow-growing atypical mycobacterium currently being identified at CDC. The mixed blood infection was easily recognized by differences in colony morphology on the primary media. After the first blood culture in which MAC was isolated, a total of 148 subsequent blood cultures were received from the 23 MAC bacteremic patients (median 6 per patient; range 0-23 per patient). These were submitted over a median of 80 days (range 0-321) after the first MAC positive blood culture. 62% of these subsequent blood cultures (92/148) were positive; all isolates were identified as MAC. Once MAC has been isolated from one blood culture, there is a high probability that a mycobacterium isolated from subsequent blood cultures in the same patient will also be MAC. For subsequent AFB blood isolates in MAC bacteremic patients, our current abbreviated identification scheme (acid fast smear, colony morphology, and 2 key biochemical tests) saves technical time and reagents. Further abbreviation (smear and colony morphology only) and a final report of presumptive MAC would save additional technical costs and decrease reporting time by at least 10-14 days.

Keywords: Blood/*MICROBIOLOGY Human Microbiological Techniques/ECONOMICS Mycobacterium avium Complex/*ISOLATION & PURIF ABSTRACT
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