Ruf B, Schürmann D, Brehmer W, Mauch H, Pohle H D
II. Medizinische Klinik, Klinikum Rudolf Virchow (Wedding), Freie Universität Berlin.
Klin Wochenschr. 1989 Jul 17;67(14):717-22. doi: 10.1007/BF01721290.
The importance of blood cultures in diagnosing disseminated mycobacteriosis in AIDS patients was evaluated. Blood samples were screened for mycobacteria by culture and microscopic techniques. Mycobacteremia was proven in 20/136 (14.7%) AIDS patients, the agent being M. avium-M. intracellulare (MAI) in 16 cases and M. tuberculosis in four cases. The rate of cases with positive blood samples in disseminated MAI infection was 59.3% (16/27 cases) and in disseminated tuberculosis 57.1% (4/7 cases). To detect mycobacteria buffy-coat was slightly superior to lysated cell pellets, obtained by a lysis-centrifugation technique. In 4/16 cases with MAI bacteremia, the agent was proven by positive blood smears for acid-fast bacilli only; in these four patients MAI was demonstrated at other body sites. These results illustrate the diagnostic role of blood culture and its use in early diagnosis of disseminated mycobacteriosis, with microscopic examination of blood smears being an important adjunct.
评估了血培养在诊断艾滋病患者播散性分枝杆菌病中的重要性。通过培养和显微镜技术对血样进行分枝杆菌筛查。在136例艾滋病患者中有20例（14.7%）血行播散性分枝杆菌感染得到证实，其中16例病原体为鸟分枝杆菌-胞内分枝杆菌（MAI），4例为结核分枝杆菌。播散性MAI感染血样阳性率为59.3%（27例中的16例），播散性结核病血样阳性率为57.1%（7例中的4例）。检测分枝杆菌时，血沉棕黄层略优于通过裂解离心技术获得的裂解细胞沉淀。在16例MAI菌血症患者中的4例，仅通过抗酸杆菌血涂片阳性证实病原体；在这4例患者的其他身体部位也发现了MAI。这些结果说明了血培养的诊断作用及其在播散性分枝杆菌病早期诊断中的应用，血涂片显微镜检查是一项重要的辅助手段。
