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Epidemiological and clinical aspects of mycobacterial infections

  • Special Addendum
  • Diagnosis and therapy of mycobacterial infections
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Summary

The incidence of tuberculosis in the developed countries has recently started to rise again due to increased migration, a higher rate of direct transmission ofMycobacterium tuberculosis, and co-infection with HIV. The impact of the latter on the pathogenesis and presentation of tuberculosis is summarised. Important measures to prevent the further spread of tuberculosis include rapid diagnosis, prompt isolation of infectious patients, adequate control of treatment compliance, as well as surveillance of local resistance patterns. Disease due to theMycobacterium avium complex is more frequent among HIV-infected patients in Central Europe than tuberculosis, and its development in the presence of immune deficiency seems to be mainly the result of a new infection with this ubiquitous microorganism rather than the reactivation of a previously acquired infection. It has a significant impact on mortality. The diagnosis ofMycobacterium avium complex infection requires a high degree of conjecture because most of the symptoms are non-specific, such as fever, night sweats, weight loss and anaemia. Promptly initiated treatment significantly prolongs the survival time of those affected by comparison with untreated patients.

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References

  1. Ledergerber, B., von Overbeck, J., Egger, M., Lüthy, R., the Swiss HIV Cohort Study (SHCS) The Swiss HIV cohort study: rationale, organization and selected baseline characteristics. Soz. Präventivmed. 39 (1994) 387–394.

    Google Scholar 

  2. Raviglione, M. C., Sudre, P., Rieder, H. L., Spinaci, S., Kochi, A. Secular trends of tuberculosis in western Europe. Bull. World Health Organ. 71 (1993) 297–306.

    PubMed  Google Scholar 

  3. Sudre, P., ten Dam, G., Kochi, A. Tuberculosis: a global overview of the situation today. Bull. World Health Organ. 70 (1992) 149–159.

    PubMed  Google Scholar 

  4. Rieder, H. L., Cauthen, G. M., Bloch, A. B., Cole, C. H., Holtzman, D., Snider, D. E., Jr., Bigler, W. J., Witte, J. J. Tuberculosis and acquired immunodeficiency syndrome — Florida. Arch. Intern. Med. 149 (1989) 1268–1273.

    PubMed  Google Scholar 

  5. Centers for Disease Control Management of persons exposed to multidrug-resistant tuberculosis. MMWR Morb. Mortal. Wkly. Rep. 41 (1992) 61–71.

    Google Scholar 

  6. Barnes, P. F., Bloch, A. B., Davidson, P. T., Snider, D. E., Jr. Tuberculosis in patients with human immunodeficiency virus infection. N. Engl. J. Med. 324 (1991) 1644–1650.

    PubMed  Google Scholar 

  7. Genewein, A., Telenti, A., Bernasconi, C., Mordasini, C., Weiss, S., Maurer, A. M., Rieder, H. L., Schopfer, K., Bodmer, T. Molecular approach to identifying route of transmission of tuberculosis in the community. Lancet 342 (1993) 841–844.

    PubMed  Google Scholar 

  8. Peloquin, C. A., MacPhee, A. A., Berning, S. E. Malabsorption of antimycobacterial medications. N. Engl. J. Med. 329 (1993) 1122–1123.

    PubMed  Google Scholar 

  9. Bloch, A. B., Cauthen, G. M., Onorato, I. M., Dansbury, K. G., Kelly, G. D., Driver, C. R., Snider, D. E., Jr. Nationwide survey of drugresistant tuberculosis in the United States. JAMA 271 (1994) 665–671.

    PubMed  Google Scholar 

  10. Raviglione, M. C., Snider, D. E., Jr., Kochi, A. Global epidemiology of tuberculosis. Morbidity and mortality of a worldwide epidemic. JAMA 273 (1995) 220–226.

    PubMed  Google Scholar 

  11. Pfyffer, G. E. Tuberkulose: Diagnostik und Resistenzhäufigkeit 1991/92. Schweiz. Rundsch. Med. (Prax.) 82 (1993) 1090–1094.

    Google Scholar 

  12. Brudney, K., Dobkin, J. Resurgent tuberculosis in New York City. Human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs. Am. Rev. Respir. Dis. 144 (1991) 745–749.

    PubMed  Google Scholar 

  13. Horsburgh, C. R., Jr., Selik, R. M. The epidemiology of disseminated nontuberculous mycobacterial infection in the acquired immunodeficiency syndrome (AIDS). Am. Rev. Respir. Dis. 139 (1989) 4–7.

    PubMed  Google Scholar 

  14. Raszka, W. V., Jr., Skillman, L. P., McEvoy, P. L., Robb, M. L. Isolation of nontuberculous, non-avium mycobacteria from patients infected with human immunodeficiency virus. Clin. Infect. Dis. 20 (1995) 73–76.

    PubMed  Google Scholar 

  15. Jenkins, S., Hillman, R., Barnes, N., Goh, B.: Mycobacterial disease in HIV positive patients in east London. Fourth European Conference on Clinical Aspects and Treatment of HIV Infection, Milan, Italy. (1994) abstract P347.

  16. Opravil, M., Pechère, M., Lazzarin, A., Heald, A., Rüttimann, S., Iten, A., Furrer, H., Oertle, D., Praz, G., Vuitton, D. A., Hirschel, B., Lüthy, R. Dapsone/pyrimethamine may prevent mycobacterial disease in immunosuppressed patients infected with the human immunodeficiency virus. Clin. Infect. Dis. 20 (1995) 244–249.

    PubMed  Google Scholar 

  17. von Reyn, C. F., Barber, T. W., Arbeit, R. D., Sox, C. H., O'Connor, G. T., Brindle, R. J., Gilks, C. F., Hakkarainen, K., Ranki, A., Bartholomew, C., Edwards, J., Tosteson, A. N. A., Magnusson, M. Evidence of previous infection withMycobacterium avium-Mycobacterium intracellulare complex among healthy subjects: an international study of dominant mycobacterial skin test reactions. J. Infect. Dis. 168 (1993) 1553–1558.

    PubMed  Google Scholar 

  18. Wayne, L. G., Young, L. S., Bertram, M. Absence of mycobacterial antibody in patients with acquired immune deficiency syndrome. Eur. J. Clin. Microbiol. Infect. Dis. 5 (1986) 363–365.

    Google Scholar 

  19. von Reyn, C. F., Maslow, J. N., Barber, T. W., Falkinham, J. O., 3 rd, Arbeit, R. D. Persistent colonisation of potable water as a source ofMycobacterium avium infection in AIDS. Lancet 343 (1994) 1137–1141.

    PubMed  Google Scholar 

  20. Yajko, D. M., Chin, D. P., Gonzalez, P. C., Nassos, P. S., Hopewell, P. C., Reingold, A. L., Horsburgh, C. R., Jr., Yakrus, M. A., Ostroff, S. M., Hadley, W. K. Mycobacterium avium complex in water, food, and soil samples collected from the environment of HIV-infected individuals. J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. 9 (1995) 176–182.

    PubMed  Google Scholar 

  21. Chin, D. P., Hopewell, P. C., Yajko, D. M., Vittinghoff, E., Horsburgh, C. R., Jr., Hadley, W. K., Stone, E. N., Nassos, P. S., Ostroff, S. M., Jacobson, M. A., Matkin, C. C., Reingold, A. L. Mycobacterium avium complex in the respiratory or gastrointestinal tract and the risk ofM. avium complex bacteremia in patients with human immunodeficiency virus infection. J. Infect. Dis. 169 (1994) 289–295.

    PubMed  Google Scholar 

  22. Havlik, J. A., Jr., Metchock, B., Thompson, S. E., Barrett, K., Rimland, D., Horsburgh, C. R., Jr. A prospective evaluation ofMycobacterium avium complex colonization of the respiratory and gastrointestinal tracts of persons with human immunodeficiency virus infection. J. Infect. Dis. 168 (1993) 1045–1048.

    PubMed  Google Scholar 

  23. Kemper, C. A., Havlir, D., Bartok, A. E., Kane, C., Camp, B., Lane, N., Deresinski, S. C. Transient bacteremia due toMycobacterium avium complex in patients with AIDS. J. Infect. Dis. 170 (1994) 488–493.

    PubMed  Google Scholar 

  24. Torriani, F. J., McCutchan, J. A., Bozzette, S. A., Grafe, M. R., Havlir, D. V. Autopsy findings in AIDS patients withMycobacterium avium complex bacteremia. J. Infect. Dis. 170 (1994) 1601–1605.

    PubMed  Google Scholar 

  25. Chin, D. P., Reingold, A. L., Stone, E. N., Vittinghoff, E., Horsburgh, C. R., Jr., Simon, E. M., Yajko, D. M., Hadley, W. K., Ostroff, S. M., Hopewell, P. C. The impact ofMycobacterium avium complex bacteremia and its treatment on survival of AIDS patients — a prospective study. J. Infect. Dis. 170 (1994) 578–584.

    PubMed  Google Scholar 

  26. Nightingale, S. D., Byrd, L. T., Southern, P. M., Jockusch, J. D., Cal, S. X., Wynne, B. A. Incidence ofMycobacterium avium-intracellulare complex bacteremia in human immunodeficiency virus-positive patients. J. Infect. Dis. 165 (1992) 1082–1085.

    PubMed  Google Scholar 

  27. Gordin, F., Cohn, D., Sullam, P., Schoenfelder, J., Wynne, B., Horsburgh, C. R., Jr., the Rifabutin Study Group: The occurrence ofMycobacterium avium complex bacteremia in a standardized cohort of AIDS patients. 33rd Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, LA, USA. (1993) abstract 1405.

  28. Opravil, M., Hächler, I., Lüthy, R. Incidence and prophylaxis of non-tuberculous mycobacteriosis in HIV-infected patients. AIDS 8 (1994) 563–564.

    PubMed  Google Scholar 

  29. d'Arminio Monforte, A., Vago, L., Lazzarin, A., Boldorini, R., Bini, T., Guzzetti, S., Antinori, S., Moroni, M., Costanzi, G. AIDS-defining diseases in 250 HIV-infected patients: a comparative study of clinical and autopsy diagnoses. AIDS 6 (1992) 1159–1164.

    PubMed  Google Scholar 

  30. Hoover, D. R., Saah, A. J., Bacellar, H., Phair, J., Detels, R., Anderson, R., Kaslow, R. A., for the Multicenter AIDS Cohort Study Clinical manifestations of AIDS in the era ofPneumocystis prophylaxis. N. Engl. J. Med. 329 (1993) 1922–1926.

    PubMed  Google Scholar 

  31. Benson, C. A. Disease due to theMycobacterium avium complex in patients with AIDS: epidemiology and clinical syndrome. Clin. Infect. Dis. 18 Suppl. 3 (1994) S218-S222.

    PubMed  Google Scholar 

  32. Pechère, C., Opravil, M., Wald, A., Chave, J. P., Bessesen, M., Sievers, A., Hein, R., von Overbeck, J., Clark, R. A., Tortoli, E., Emler, S., Kirschner, P., Gabriel, V., Böttger, E. C., Hirschel, B., the Swiss HIV Cohort Study Clinical and epidemiologic features of infection withMycobacterium genavense. Arch. Intern. Med. 155 (1995) 400–404.

    PubMed  Google Scholar 

  33. Straus, W. L., Ostroff, S. M., Jernigan, D. B., Kiehn, T. E., Sordillo, E. M., Armstrong, D., Boone, N., Schneider, N., Kilburn, J. O., Silcox, V. A., LaBombardi, V., Good, R. C. Clinical and epidemiologic characteristics ofMycobacterium haemophilum, an emerging pathogen in immunocompromised patients. Arch. Intern. Med. 120 (1994) 118–125.

    Google Scholar 

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Opravil, M. Epidemiological and clinical aspects of mycobacterial infections. Infection 25, 56–59 (1997). https://doi.org/10.1007/BF02113516

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