VIDRL Mycobacterium Reference Laboratory
Quarterly Surveillance Report - Fourth Quarter 2001
*Due to the slow growing
nature of Mycobacteria spp. this report will always be presented with
a one period delay to maintain accuracy
Specimen Analysis
|
Most
specimens (both primary & referred) and isolates are from Victorian
patients. The majority of non-Victorian patients originate in the Northern
Territory & the Solomon Islands
|
| Primary Specimens | |||||
|
M.
tb isolates
|
New
Victorian M tb isolates
|
Non
M. tb isolates
|
Negatives
|
Total
|
|
| October |
20
|
6
|
15
|
470
|
505
|
| November |
5
|
4
|
11
|
394
|
410
|
| December |
22
|
6
|
15
|
380
|
417
|
| Referred Specimens | |||||
| October |
37
|
14
|
46
|
83
|
|
| November |
32
|
22
|
51
|
83
|
|
| December |
23
|
7
|
35
|
25
|
|
| Total |
139
|
59
|
173
|
1244
|
1556
|
Site details of M. tuberculosis isolates and resistant isolates by month
|
October
|
November
|
December
|
|
| Site | |||
| Pulmonary |
10
|
15
|
7
|
| Extrapulmonary |
10
|
11
|
6
|
| Extrapulmonary Site Details |
Lymph node (x5) , |
Lymph
Node (x3), Urine (x2), Bronch. wash (x1), Neck bx. (x2), Bone (x1), Foot (x1) |
Lymph
Node (x4), Neck mass (x1), Parietal pleura (x1) |
| Resistance | 3x
resistance to Isoniazid, 1x resistance to Isoniazid & Streptomycin |
3x
resistance to Isoniazid, 1x resistance to Isoniazid & Streptomycin |
Direct Amplification (MTD)
|
October
|
November
|
December
|
|
| Positive |
2
|
-
|
1
|
| Negative |
50
|
50
|
23
|
| Positive - culture negative |
1
|
1
|
-
|
| Inhibition - culture positive |
1
|
1
|
1
|
| Total |
54
|
52
|
24
|
Comments
M. bovis BCG
Isolated from two patients. One isolate was pus from a vaccination site and
the other was from an axillary abscess.
M. kansasii
Isolated from sputum of an elderly male and from tissue specimens, (right hand
& right index finger) from two other men.
M. ulcerans
M. ulcerans PCR was requested from 15 specimens. There were three positive results,
two from the same patient (arm biopsy & eyelid tissue). One patient had
the organism isolated from culture and culture results from the other patient
are pending. M. ulcerans was also identified from a referred isolate where no
PCR was performed
Molecular identifying techniques were used to identify or confirm identification of 31 isolates, including one of M. intracellulare and one of M. interjectum. The last organism was detected in a mixed culture where M. tuberculosis was also isolated. M. interjectum was isolated from this patient on three different occasions, each one a month or more apart.
Mycobacterium generic PCR was performed on 25 specimens, 14 of which were paraffin embedded. M. tuberculosis complex DNA was detected in one paraffin embedded lung tissue where culture was never requested.
M. avium complex DNA was detected in three specimens. Two of these were from
the same patient and M. abscessus DNA was also detected. These results were
subsequently confirmed by culture.