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Incidence of Mycobacterium avium-intracellulare Complex Bacteremia in Human Immunodeficiency Virus-Positive Patients Stephen D. Nightingale, Linda T. Byrd, Paul M. Southern, Jonathan D. Jockusch, Stanley X. Cal, and Beverley A. Wynne
University of Texas Southwestern Medical School and Parkland Memorial Hospital. Dallas. Texas; Adria Laboratories. Dublin. Ohio
The reported prevalence of disseminated Mycobacterium avium-intrace/lulare complex (MAC) infection in human immunodeficiency virus (HlV)-positive patients varies widely in the medical literature. Disseminated MAC infection is diagnosed in only -- 3%of HlV-positive patients at the time of AIDS diagnosis [1], while it is found in about half of autopsied patients with AIDS [2). It appears that the incidence of disseminated MAC infection in AIDS patients is proportional to the duration and severity of the immunosuppression caused by HIV infection [3-6]; however, this relationship has not yet been well characterized. For this reason, we have prospectively determined the incidence ofMAC bacteremia in our HlV-positive patients.
we followed them from the day of their first AIDS-defining event until either of the following two occurrences, whichever came first: (I) development of MAC bacteremia or (2) enrollment into a experimental protocol that included an antimycobacterial agent; the last known inpatient, emergency, or outpatient contact with the hospital; death; or the study termination date of 30 September 1991. Patients who developed MAC bacteremia were followed from the date the organism was first cultured from their blood until death, enrollment into an Institutional Review Board-approved experimental trial of antimycobacterial therapy, or the study termination date of 30 September 1991. Product-limit total or disease-free survivals and Wilcoxon tests for the dependence of these survivals on covariates were calculated using the SAS procedure LIFETEST (SAS Institute, Cary, NC). Means are given as ± SE.
Methods Since I October 1988 we have routinely cultured lysis-centrifugation blood [7] for mycobacteremia and fungemia from all our HIV-positive patients at the time of their first contact with our hospital. Thereafter. these cultures have been obtained at monthly intervals after a patient's CD4 cell count has fallen to
Incidence of Mycobacterium avium-intracellulare Complex Bacteremia in Human Immunodeficiency Virus-Positive Patients Stephen D. Nightingale, Linda T. Byrd, Paul M. Southern, Jonathan D. Jockusch, Stanley X. Cal, and Beverley A. Wynne
University of Texas Southwestern Medical School and Parkland Memorial Hospital. Dallas. Texas; Adria Laboratories. Dublin. Ohio
The reported prevalence of disseminated Mycobacterium avium-intrace/lulare complex (MAC) infection in human immunodeficiency virus (HlV)-positive patients varies widely in the medical literature. Disseminated MAC infection is diagnosed in only -- 3%of HlV-positive patients at the time of AIDS diagnosis [1], while it is found in about half of autopsied patients with AIDS [2). It appears that the incidence of disseminated MAC infection in AIDS patients is proportional to the duration and severity of the immunosuppression caused by HIV infection [3-6]; however, this relationship has not yet been well characterized. For this reason, we have prospectively determined the incidence ofMAC bacteremia in our HlV-positive patients.
we followed them from the day of their first AIDS-defining event until either of the following two occurrences, whichever came first: (I) development of MAC bacteremia or (2) enrollment into a experimental protocol that included an antimycobacterial agent; the last known inpatient, emergency, or outpatient contact with the hospital; death; or the study termination date of 30 September 1991. Patients who developed MAC bacteremia were followed from the date the organism was first cultured from their blood until death, enrollment into an Institutional Review Board-approved experimental trial of antimycobacterial therapy, or the study termination date of 30 September 1991. Product-limit total or disease-free survivals and Wilcoxon tests for the dependence of these survivals on covariates were calculated using the SAS procedure LIFETEST (SAS Institute, Cary, NC). Means are given as ± SE.
Methods Since I October 1988 we have routinely cultured lysis-centrifugation blood [7] for mycobacteremia and fungemia from all our HIV-positive patients at the time of their first contact with our hospital. Thereafter. these cultures have been obtained at monthly intervals after a patient's CD4 cell count has fallen to
