Abstract
Disseminated infection with organisms of the Mycobacterium avium complex (MAC) is a common complication of AIDS in the United States and other developing countries, but it is rare or absent in sub-Saharan Africa. To assess the comparative likelihood of exposure to MAC in these geographic areas, we used a standard protocol to culture 91 water samples from environmental sites and piped water supply systems in the United States, Finland, Zaire, and Kenya. MAC was isolated from all geographic areas and from 22 of 91 (24%) samples. Isolation rates were 13 of 47 (28%) for environmental samples and 9 of 44 (20%) for water supply samples. Overall isolation rates were 18 of 52 (35%) samples in the United States and Finland, whereas they were 4 of 39 (10%) samples in Zaire and Kenya (P = 0.015). MAC isolation rates from water supply systems were 8 of 25 (32%) samples in the United States and Finland and 1 of 19 (5%) samples in Zaire and Kenya (P = 0.056). MAC was isolated from hospital water in the United States and Finland but not in hospital water in Zaire and Kenya. Serovar determinations showed that six of eight isolates from the United States were serovar 4 or 8. One MAC isolate from Zaire was identified as an "X" mycobacterium. These data suggest that exposure to MAC in water is likely in diverse areas of the world, but that the likelihood of human exposure to the organism in water may be slightly less in sub-Saharan Africa than in developed countries in the Northern Hemisphere.
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- Bolan G., Reingold A. L., Carson L. A., Silcox V. A., Woodley C. L., Hayes P. S., Hightower A. W., McFarland L., Brown J. W., 3rd, Petersen N. J. Infections with Mycobacterium chelonei in patients receiving dialysis and using processed hemodialyzers. J Infect Dis. 1985 Nov;152(5):1013–1019. doi: 10.1093/infdis/152.5.1013. [DOI] [PubMed] [Google Scholar]
- Burns D. N., Wallace R. J., Jr, Schultz M. E., Zhang Y. S., Zubairi S. Q., Pang Y. J., Gibert C. L., Brown B. A., Noel E. S., Gordin F. M. Nosocomial outbreak of respiratory tract colonization with Mycobacterium fortuitum: demonstration of the usefulness of pulsed-field gel electrophoresis in an epidemiologic investigation. Am Rev Respir Dis. 1991 Nov;144(5):1153–1159. doi: 10.1164/ajrccm/144.5.1153. [DOI] [PubMed] [Google Scholar]
- Costrini A. M., Mahler D. A., Gross W. M., Hawkins J. E., Yesner R., D'Esopo N. D. Clinical and roentgenographic features of nosocomial pulmonary disease due to Mycobacterium xenopi. Am Rev Respir Dis. 1981 Jan;123(1):104–109. doi: 10.1164/arrd.1981.123.1.104. [DOI] [PubMed] [Google Scholar]
- Cregan P., Yajko D. M., Ng V. L., Gonzalez P. C., Nassos P. S., Sanders C. A., Hadley W. K. Use of DNA probes to detect Mycobacterium intracellulare and "X" mycobacteria among clinical isolates of Mycobacterium avium complex. J Infect Dis. 1992 Jul;166(1):191–194. doi: 10.1093/infdis/166.1.191. [DOI] [PubMed] [Google Scholar]
- Dawson D. J. Infection with Mycobacterium avium complex in Australian patients with AIDS. Med J Aust. 1990 Oct 15;153(8):466–468. doi: 10.5694/j.1326-5377.1990.tb126152.x. [DOI] [PubMed] [Google Scholar]
- Falkinham J. O., 3rd, Parker B. C., Gruft H. Epidemiology of infection by nontuberculous mycobacteria. I. Geographic distribution in the eastern United States. Am Rev Respir Dis. 1980 Jun;121(6):931–937. doi: 10.1164/arrd.1980.121.6.931. [DOI] [PubMed] [Google Scholar]
- George K. L., Falkinham J. O., 3rd Selective medium for the isolation and enumeration of Mycobacterium avium-intracellulare and M. scrofulaceum. Can J Microbiol. 1986 Jan;32(1):10–14. doi: 10.1139/m86-003. [DOI] [PubMed] [Google Scholar]
- George K. L., Parker B. C., Gruft H., Falkinham J. O., 3rd Epidemiology of infection by nontuberculous mycobacteria. II. Growth and survival in natural waters. Am Rev Respir Dis. 1980 Jul;122(1):89–94. doi: 10.1164/arrd.1980.122.1.89. [DOI] [PubMed] [Google Scholar]
- Goslee S., Wolinsky E. Water as a source of potentially pathogenic mycobacteria. Am Rev Respir Dis. 1976 Mar;113(3):287–292. doi: 10.1164/arrd.1976.113.3.287. [DOI] [PubMed] [Google Scholar]
- 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]
- Iivanainen E. K., Martikainen P. J., Vänänen P. K., Katila M. L. Environmental factors affecting the occurrence of mycobacteria in brook waters. Appl Environ Microbiol. 1993 Feb;59(2):398–404. doi: 10.1128/aem.59.2.398-404.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Inderlied C. B., Kemper C. A., Bermudez L. E. The Mycobacterium avium complex. Clin Microbiol Rev. 1993 Jul;6(3):266–310. doi: 10.1128/cmr.6.3.266. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kirschner R. A., Jr, Parker B. C., Falkinham J. O., 3rd Epidemiology of infection by nontuberculous mycobacteria. Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum in acid, brown-water swamps of the southeastern United States and their association with environmental variables. Am Rev Respir Dis. 1992 Feb;145(2 Pt 1):271–275. doi: 10.1164/ajrccm/145.2_Pt_1.271. [DOI] [PubMed] [Google Scholar]
- Lockwood W. W., Friedman C., Bus N., Pierson C., Gaynes R. An outbreak of Mycobacterium terrae in clinical specimens associated with a hospital potable water supply. Am Rev Respir Dis. 1989 Dec;140(6):1614–1617. doi: 10.1164/ajrccm/140.6.1614. [DOI] [PubMed] [Google Scholar]
- Lowry P. W., Jarvis W. R., Oberle A. D., Bland L. A., Silberman R., Bocchini J. A., Jr, Dean H. D., Swenson J. M., Wallace R. J., Jr Mycobacterium chelonae causing otitis media in an ear-nose-and-throat practice. N Engl J Med. 1988 Oct 13;319(15):978–982. doi: 10.1056/NEJM198810133191504. [DOI] [PubMed] [Google Scholar]
- Morrissey A. B., Aisu T. O., Falkinham J. O., 3rd, Eriki P. P., Ellner J. J., Daniel T. M. Absence of Mycobacterium avium complex disease in patients with AIDS in Uganda. J Acquir Immune Defic Syndr. 1992;5(5):477–478. [PubMed] [Google Scholar]
- Nightingale S. D., Byrd L. T., Southern P. M., Jockusch J. D., Cal S. X., Wynne B. A. Incidence of Mycobacterium avium-intracellulare complex bacteremia in human immunodeficiency virus-positive patients. J Infect Dis. 1992 Jun;165(6):1082–1085. doi: 10.1093/infdis/165.6.1082. [DOI] [PubMed] [Google Scholar]
- Petrini B., Svahn A., Julander I., Källenius G., Ostlund L. Prevalence of mycobacterium avium complex infection in AIDS patients. Scand J Infect Dis. 1991;23(4):511–512. doi: 10.3109/00365549109075104. [DOI] [PubMed] [Google Scholar]
- Stanford J. L., Paul R. C. A preliminary report on some studies of environmental mycobacteria. Ann Soc Belg Med Trop. 1973;53(4):389–393. [PubMed] [Google Scholar]
- du Moulin G. C., Stottmeier K. D., Pelletier P. A., Tsang A. Y., Hedley-Whyte J. Concentration of Mycobacterium avium by hospital hot water systems. JAMA. 1988 Sep 16;260(11):1599–1601. doi: 10.1001/jama.260.11.1599. [DOI] [PubMed] [Google Scholar]