Chest
Clinical InvestigationsTuberculosisIncreasing Incidence of Mycobacterium xenopi at Bellevue Hospital: An Emerging Pathogen or a Product of Improved Laboratory Methods?
Section snippets
Materials and Methods
A list of all patients with positive culture results for Mxenopi from January 1, 1975, to October 1995, and two or morepositive culture results from November 1995 to January 1998 wasobtained from the mycobacteriology laboratory records of BellevueHospital. Medical records were reviewed for age, gender, ethnicity,chest radiograph, pathology specimens, HIV status, and clinical course.
Sputum samples using a nebulized saline solution induction technique orBAL samples were obtained. Specimens were
Results
During period 1 (January 1975 to October 1995), we identified 81patients (61 male and 20 female) with at least one M xenopiisolate. Specimens were recovered from sputum alone (60 cases), BAL (20cases), and blood and sputum (1 case). Twenty-nine cultures of Mxenopi were isolated prior to 1991, 12 from 1991 through 1993, and40 from January 1994 to September 1995. Of the 81 patients, 33 wereAfrican American, 26 were Hispanic, 16 were white, and 6 were Asian,reflecting the ethnic distribution at
Discussion
We have observed a dramatic increase in M xenopiisolates in the Bellevue Hospital mycobacteriology laboratory, from 29isolates over a 15-year period to 381 isolates over a recent 3-yearperiod. This dramatic increase was coincident with the institution ofmore-sensitive culture techniques in our mycobacteriology laboratory.Despite these 422 patients' isolates, we identified only threepatients with clinical M xenopi pulmonary disease. Two ofthese patients had severe COPD, and the third patient had
ACKNOWLEDGMENT
The authors thank Drs. Claudia Plottel, KarenHoover, and Fred Bevelacqua for sharing information on their patients;the New York City mycobacteriology laboratory for sharing its dataconcerning the changing isolate profiles; and Jessie A. Pierre foreditorial assistance.
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Supported by National Institutes of Health grant No. M01RR00096.