VIDRL Mycobacterium Reference Laboratory
Quarterly Surveillance Report - September - December 2005

*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
Sept
28
10
22
577
627
Oct
20
7
29
529
578
Nov
21
9
23
471
515
Dec
11
4
27
480
518
Referred Specimens 
Sept
34
16
37
71
Oct
35
24
72
107
Nov
23
16
66
89
Dec
30
19
60
90
85
           
Total
202
205
336
2057
2595

 

 

 

Site details of M. tuberculosis isolates and resistant isolates by month

 
Sept
Oct
Nov
Dec
Site
 
Pulmonary
15
14
10
8
Extrapulmonary
11
17
19
11
         
Extrapulmonary Site Details

Lymph node (x4),
Pleural fluid (x2)
,Pelvic tissue,
Neck mass,
Chest lump,
Buttock,
Vertebral tissue

Lymph node (x8),
Neck lump,
Pleural fluid,
Pleural bx,
Psoas abscess,
Elbow asp,
Fallopian tube,
Lung,
Chest aspirate

 Lymph node (x8), Neck pus,
Peritoneal fluid,
Ascitic fluid,
Abdominal wall,
Neck fluid,
Spinal tissue,
Brain tissue,
Paraspinal mass,
Chest pus,
Neck aspirate 		Lymph node (x8), Pleural fluid,
Urine,
Peritoneal biopsy
Resistance

1x resistance to Isoniazid & Streptomycin1x resistance to Rifampicin

1x resistance to Isoniazid 3x intermediate resistance to Isoniazid

1x resistance to Isoniazid, Rifampicin, Pyrazinamide & Streptomycin 1x resistance to Isoniazid & Streptomycin1x resistance to Isoniazid

1x resistance to Isoniazid & Streptomycin1x resistance to Isoniazid

 

Direct Amplification (PCR)

 
Sept
Oct
Nov
Dec
Fresh Specimens

 

 

 

 
Positive - Culture positive

6

12 (10 pts)

15 (6 pts)

3 (2 pts)
Positive - Culture negative

4 (3 pts)

-

-

3 (2 pt, 2x old Tb)
Negative - Culture positive

2

1

-

2
Negative

50

73

84

87
Total

62

86

99

95
Paraffin Embedded Specimens
Positive (MTBC)

4 (3 pts)

-

-

2
Negative (MTBC)

3

2

4

2
Total

7

2

4

4

 

Comments

M.abscessus was isolated from pulmonary specimens of seven individuals, 3 males and 4 females. One male has had the organism isolated on several occasions since 1998.

M.bovis BCG was recovered from two patients, one male infant and one 19 year old female. Both were associated with BCG vaccinations.

M.chelonae was isolated from corneal scrapings of a 46 year old male and from a leg of a 68 year old female.

M.fortuitum was recovered from various sites of six patients, 2 males and 4 females. Sites included umbilical tissue, ascitic fluid, a neck lump, groin and leg abscesses.

M.kansasii was isolated from respiratory specimens of three patients, 2 elderly males and one 20 year old female.

M.marinum was recovered from the hands of two males. One patient gave a history of injury from a tropical fish tank.

M.ulcerans PCR was requested on 209 specimens. There were 54 positive results (two from paraffin embedded tissue) from 27 patients. This represents 22 new patients, 11 were associated with Pt. Lonsdale while the others came from various locations.

Molecular methods were used to identify or confirm identification of 55 isolates, of which 43 were mycobacterial species including 4 M.intracellulare, 2 M.simiae, 2 M.szulgai and one each of M.heckeshornense, M.marinum and M shimoidei.

Mycobacterium generic PCR was performed on 40 specimens including 9 paraffin embedded tissues. M.chelonae was identified from a leg, M.marinum from tendon tissue, M. heckeshornense from a finger, M. avium from a lymph node, M.intracellulare, M. shimoidei, M.szulgai and M.xenopi were isolated from pulmonary specimens. A novel mycobacterial species was identified from a cat and M.fortuitum was detected from paraffin sections from a groin abscess.