Skip to main content
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1993 May;31(5):1385–1387. doi: 10.1128/jcm.31.5.1385-1387.1993

Mycobacteria in stool specimens: the nonvalue of smears for predicting culture results.

A Morris 1, L B Reller 1, M Salfinger 1, K Jackson 1, A Sievers 1, B Dwyer 1
PMCID: PMC262947  PMID: 8501249

Abstract

A previous recommendation suggests that stool be cultured for mycobacteria only if the smear is positive. We have correlated smear and culture results of 2,176 stool specimens submitted for mycobacterial culture. The sensitivity, specificity, and positive and negative predictive values for smears to predict culture results are 34, 99, 90, and 87%, respectively. We recommend that the stool smear not be used as a screening technique to decide which specimens from at-risk patients should be cultured because it lacks the necessary sensitivity.

Full text

PDF
1385

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Böttger E. C., Teske A., Kirschner P., Bost S., Chang H. R., Beer V., Hirschel B. Disseminated "Mycobacterium genavense" infection in patients with AIDS. Lancet. 1992 Jul 11;340(8811):76–80. doi: 10.1016/0140-6736(92)90397-l. [DOI] [PubMed] [Google Scholar]
  2. Dautzenberg B., Truffot C., Legris S., Meyohas M. C., Berlie H. C., Mercat A., Chevret S., Grosset J. Activity of clarithromycin against Mycobacterium avium infection in patients with the acquired immune deficiency syndrome. A controlled clinical trial. Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):564–569. doi: 10.1164/ajrccm/144.3_Pt_1.564. [DOI] [PubMed] [Google Scholar]
  3. Diagnosis and treatment of disease caused by nontuberculous mycobacteria. Am Rev Respir Dis. 1990 Oct;142(4):940–953. doi: 10.1164/ajrccm/142.4.940. [DOI] [PubMed] [Google Scholar]
  4. Ellner J. J., Goldberger M. J., Parenti D. M. Mycobacterium avium infection and AIDS: a therapeutic dilemma in rapid evolution. J Infect Dis. 1991 Jun;163(6):1326–1335. doi: 10.1093/infdis/163.6.1326. [DOI] [PubMed] [Google Scholar]
  5. Heifets L. B., Iseman M. D. Individualized therapy versus standard regimens in the treatment of Mycobacterium avium infections. Am Rev Respir Dis. 1991 Jul;144(1):1–2. doi: 10.1164/ajrccm/144.1.1. [DOI] [PubMed] [Google Scholar]
  6. Horsburgh C. R., Jr, Havlik J. A., Ellis D. A., Kennedy E., Fann S. A., Dubois R. E., Thompson S. E. Survival of patients with acquired immune deficiency syndrome and disseminated Mycobacterium avium complex infection with and without antimycobacterial chemotherapy. Am Rev Respir Dis. 1991 Sep;144(3 Pt 1):557–559. doi: 10.1164/ajrccm/144.3_Pt_1.557. [DOI] [PubMed] [Google Scholar]
  7. Horsburgh C. R., Jr Mycobacterium avium complex infection in the acquired immunodeficiency syndrome. N Engl J Med. 1991 May 9;324(19):1332–1338. doi: 10.1056/NEJM199105093241906. [DOI] [PubMed] [Google Scholar]
  8. Hoy J., Mijch A., Sandland M., Grayson L., Lucas R., Dwyer B. Quadruple-drug therapy for Mycobacterium avium-intracellulare bacteremia in AIDS patients. J Infect Dis. 1990 Apr;161(4):801–805. doi: 10.1093/infdis/161.4.801. [DOI] [PubMed] [Google Scholar]
  9. Jackson K., Sievers A., Ross B. C., Dwyer B. Isolation of a fastidious Mycobacterium species from two AIDS patients. J Clin Microbiol. 1992 Nov;30(11):2934–2937. doi: 10.1128/jcm.30.11.2934-2937.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Jacobson M. A., Hopewell P. C., Yajko D. M., Hadley W. K., Lazarus E., Mohanty P. K., Modin G. W., Feigal D. W., Cusick P. S., Sande M. A. Natural history of disseminated Mycobacterium avium complex infection in AIDS. J Infect Dis. 1991 Nov;164(5):994–998. doi: 10.1093/infdis/164.5.994. [DOI] [PubMed] [Google Scholar]
  11. Kemper C. A., Meng T. C., Nussbaum J., Chiu J., Feigal D. F., Bartok A. E., Leedom J. M., Tilles J. G., Deresinski S. C., McCutchan J. A. Treatment of Mycobacterium avium complex bacteremia in AIDS with a four-drug oral regimen. Rifampin, ethambutol, clofazimine, and ciprofloxacin. The California Collaborative Treatment Group. Ann Intern Med. 1992 Mar 15;116(6):466–472. doi: 10.7326/0003-4819-116-6-466. [DOI] [PubMed] [Google Scholar]
  12. Kiehn T. E., Cammarata R. Laboratory diagnosis of mycobacterial infections in patients with acquired immunodeficiency syndrome. J Clin Microbiol. 1986 Nov;24(5):708–711. doi: 10.1128/jcm.24.5.708-711.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Kiehn T. E., Edwards F. F., Brannon P., Tsang A. Y., Maio M., Gold J. W., Whimbey E., Wong B., McClatchy J. K., Armstrong D. Infections caused by Mycobacterium avium complex in immunocompromised patients: diagnosis by blood culture and fecal examination, antimicrobial susceptibility tests, and morphological and seroagglutination characteristics. J Clin Microbiol. 1985 Feb;21(2):168–173. doi: 10.1128/jcm.21.2.168-173.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Portaels F., Larsson L., Smeets P. Isolation of mycobacteria from healthy persons' stools. Int J Lepr Other Mycobact Dis. 1988 Sep;56(3):468–471. [PubMed] [Google Scholar]
  15. Wallace R. J., Jr, Glassroth J., O'Brien R. A plea for clinical trials to resolve the issue of optimal therapy in the treatment of Mycobacterium avium infection. Am Rev Respir Dis. 1991 Jul;144(1):3–4. doi: 10.1164/ajrccm/144.1.3. [DOI] [PubMed] [Google Scholar]
  16. Young L. S., Wiviott L., Wu M., Kolonoski P., Bolan R., Inderlied C. B. Azithromycin for treatment of Mycobacterium avium-intracellulare complex infection in patients with AIDS. Lancet. 1991 Nov 2;338(8775):1107–1109. doi: 10.1016/0140-6736(91)91965-w. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES