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Revista do Instituto de Medicina Tropical de São Paulo

On-line version ISSN 1678-9946

Rev. Inst. Med. trop. S. Paulo vol.37 no.5 São Paulo Sept./Oct. 1995

http://dx.doi.org/10.1590/S0036-46651995000500001 

MICROBIOLOGY

 

Mycobacterium avium complex (MAC) isolated from AIDS patients and the criteria required for its implication in disease

 

Complexo Mycobacterium avium (MAC) isolado de pacientes com AIDS e os critérios exigidos para sua implicação em doença

 

 

David Jamil HadadI; Maria Cecília de Almeida PalharesII; Anna Luiza Nunes PlaccoIII; Carmem Silvia Bruniera DominguesIV; Adauto Castelo FilhoV; Lucilaine FerrazoliVI; Sueli Yoko Mizuka UekiVI; Maria Alice da Silva TellesVI; Maria Conceição MartinsVI; Moisés PalaciVI

IHolder of Master's degree in Infectious and Parasitic Diseases, Escola Paulista de Medicina (EPM), and infectologist physician at the AIDS Reference and Training Center (CRTA)
IIHead of the CRTA laboratory
IIIHolder of a degree in Biomedicine, CRTA laboratory
IVResponsible for the AIDS Epidemiologic Alert Center (CVE) of the Health Secretariat of the State of São Paulo
VAssociate Professor, Discipline in Infectious and Parasitic Diseases, EPM
VIScientific researcher, Sector of Mycobacteria, Adolfo Lutz Institute

Correspondence to

 

 


SUMMARY

Before the AIDS pandemia, the Mycobacterium avium complex (MAC) was responsible in most cases for the pneumopathies that attack patients with basic chronic pulmonary diseases such as emphysema and chronic bronchitis36. In 1981, with the advent of the acquired immunodeficiency syndrome (AIDS), MAC started to represent one of the most frequent bacterial diseases among AIDS patients, with the disseminated form of the disease being the major clinical manifestation of the infection8. Between January 1989 and February 1991, the Section of Mycobacteria of the Adolfo Lutz Institute, São Paulo, isolated MAC from 103 patients by culturing different sterile and no-sterile processed specimens collected from 2304 patients seen at the AIDS Reference and Training Center and/or Emilio Ribas Infectology Institute. Disseminated disease was diagnosed in 29 of those patients on the basis of MAC isolation from blood and/or bone marrow aspirate. The other 74 patients were divided into categories highly (5), moderately (26) and little suggestive of disease (43) according to the criteria of DAVIDSON (1989)10. The various criteria for MAC isolation from sterile and non-sterile specimens are discussed.

Keywords: Mycobacterium avium complex (MAC); Acquired immunodeficiency syndrome (AIDS); Diagnostic criteria.


RESUMO

Anterior a pandemia de AIDS, o Complexo Mycobacterium avium (MAC) era responsável pela maioria das vezes, por pneumopatias acometendo pacientes com doença pulmonar crônica de base como enfisema e bronquite crônica36. Em 1981, com o advento da síndrome de imunodeficiência adquirida (SIDA), o MAC passou a representar uma das doenças bacterianas mais frequentes em pacientes com esta síndrome, sendo a doença disseminada a principal forma de manifestação clínica da infecção8.
Entre Janeiro de 1989 e Fevereiro de 1991, no Setor de Micobactérias do Instituto Adolfo Lutz em São Paulo, o MAC foi isolado de 103 pacientes a partir do cultivo de diferentes espécimes estéreis e não estéreis processados, coletados de 2.304 pacientes atendidos no Centro de Referência e Treinamento AIDS e/ou Instituto de Infectologia Emilio Ribas. A doença disseminada foi diagnosticada em 29 destes, com base no isolamento do MAC a partir do sangue e/ou aspirado de medula óssea. Os outros 74 pacientes foram agrupados nas categorias altamente (5), moderadamente (26) e pouco sugestiva de doença (43) de acordo com os postulados de DAVIDSON (1989)10. Os diferentes critérios para valorizar o seu isolamento de espécimes estéreis e não estéreis são discutidos.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

ACKNOWLEDGEMENTS

We are grateful to Prof. Dr. Gildo Del Negro from "Disciplina de Moléstias Infecciosas da Faculdade de Medicina da Universidade de São Paulo" for his critical review of the manuscript.

 

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Correspondence to:
David Jamil Hadad
Rua Antonio Carlos 122
01309-010, São Paulo, SP, Brasil

Recebido para publicação em 12/04/1995
Aceito para publicação em 15/09/1995

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