VIDRL Mycobacterium Reference Laboratory
Quarterly Surveillance Report - Fourth Quarter 2002
*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 |
35
|
10
|
17
|
459
|
588
|
| November |
7
|
2
|
24
|
494
|
525
|
| December |
27
|
11
|
17
|
452
|
496
|
| Referred Specimens | |||||
| October |
32
|
18
|
56
|
88
|
|
| November |
26
|
14
|
58
|
84
|
|
| December |
25
|
18
|
42
|
67
|
61
|
| Total |
152
|
73
|
214
|
1405
|
1771
|
Site details of M. tuberculosis isolates and resistant isolates by month
|
October
|
November
|
December
|
|
| Site | |||
| Pulmonary |
14
|
7
|
15
|
| Extrapulmonary |
15
|
9
|
13
|
| Extrapulmonary Site Details |
Lymph node (x4), |
Lymph node (x1), Neck asp (x1), Urine (x2), Pectoral cyst (x1), Thoracic paraspinal mass (x1), Perifracheal tiss (x1), Caecum swab (x1) |
Lymph node (x6), Urine (x3), Pleural fluid (x2), Groin asp. (x1), Ascitic |
| Resistance | 1x resistance to Isoniazid, 1x resistance to Isoniazid & Streptomycin |
1x
resistance to Isoniazid & Streptomycin, 1x resistance to Isoniazid, Streptomycin & Rifampicin |
1x
resistance to Isoniazid & Streptomycin |
Direct Amplification (MTD)
|
October
|
November
|
December
|
|
| Fresh Specimens | |||
| Positive |
3
|
-
|
2
|
| Positive - culture negative |
-
|
1
(TB pos in 1995) |
-
|
| Negative - culture positive |
2
|
1
|
-
|
| Negative |
48
|
34
|
29
|
| Total |
53
|
36
|
31
|
| Paraffin Embedded Specimens | |||
| Positive |
2
|
-
|
1
|
| Negative |
10
|
7
|
6
|
| Total |
12
|
7
|
7
|
Comments
M. bovis was isolated from sputum of a 54 year old male residing in the Northern Territory.
M. bovis BCG was recovered from a vaccination site and an axillary lymph node of two vaccinated infants.
M. abscessus which can cause pulmonary disease was isolated from sputum specimens of 4 males aged from 23 to 77. Three had multiple isolations and one has had the organism isolated every year since 1998.
M. fortuitum was isolated from a leg wound of a 47 year old man.
Mycobacterium kansasii was isolated for the first time from respiratory specimens of one elderly female & 2 males. One male had multiple isolations and concurrent infection with M. avium complex.
Mycobacterium marinum was recovered from the upper extremities of 3 female patients aged between 14 & 57. Two patients gave histories of keeping tropical fish.
M.ulcerans PCR was requested on 75 specimens, including 1 specimen from a ringtail possum. There were 13 positive results from 12 different patients. This represented 10 new bases and included the possum and one case from Queensland. The PCR cases from the new cases were confirmed by culture. There were also 3 new M.ulcerans isolations where PCR was not requested, one from a patient in Western Australia. This represents the first isolation of M. ulcerans from that state.
Molecular identification techniques were used to identify or confirm identification of 71 isolates, including M.asiaticum, M.heckeshornense and M. shimoidei from 2 patients each. Overall 20 mycobacterial species were identified as well as 9 Nocardia spp. & 3 Streptomyces spp.
Mycobacterium generic PCR was performed on 24
specimens, including 12 paraffin embedded specimens. M.tuberculosis
was detected in two paraffin embedded specimens and one sputum. M.avium
was identified from a fresh lymph node biopsy.