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February 27, 1995

Clinical and Epidemiologic Features of Infection With Mycobacterium genavense

Author Affiliations

From the Division of Infectious Diseases, Hôpital Cantonal Universitaire, Geneva, Switzerland (Drs Pechère, Emler, and Hirschel and Mr Gabriel), Universitätsspital Zurich (Switzerland) (Dr Opravil), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (Dr Chave), Inselspital Bern (Switzerland) (Dr von Overbeck), and University of Iowa, Iowa City (Dr Clark); Department of Medicine, University of Washington, Seattle (Dr Wald); Public Health Administration and Disease Control, Denver, Colo (Dr Bessesen); Clinical Pathology, Fairfield Hospital, Melbourne, Australia (Dr Sievers); Institut für Medizinische Mikrobiologie, Medizinische Hoschschule, Hannover, Germany (Drs Hein, Kirschner, and Böttger); and Bacteriology and Virology Laboratory, Ospedale di Careggi, Firenze, Italy (Mr Tortoli).

Arch Intern Med. 1995;155(4):400-404. doi:10.1001/archinte.1995.00430040074009

Objectives:  To characterize clinical and epidemiologic features of infections with Mycobacterium genavense.

Design:  Case series and case-control studies. Patients with M genavense were compared with two control groups: CD4 controls were matched on the basis of CD4 counts, and Mycobacterium avium-intracellularecomplex controls had disseminated infection with M avium-intracellulare complex.

Results:  Fifty-four patients with disseminated infections caused by M genavense were found, from Europe (37), North America (15), and Australia (two). All were infected with human immunodeficiency virus. The median CD4 count was 0.016× 109/L (16/mm3) (range, 0.001 to 0.082×109/L. Eighty-seven percent had fever and weight loss, 44% had diarrhea, 43% had splenomegaly, 39% had hepatomegaly, and 72% had anemia. In Swiss university hospitals, M genavense was responsible for 12.8% of nontuberculous disseminated mycobacterial infections in patients with human immunodeficiency virus from 1990 to 1992. The median survival was 190 days after the first isolation of M genavense. Among the patients who had been treated with at least two antimycobacterial drugs for 1 month or more, median survival was 263 days (95% confidence interval, 144 to 382 days), compared with 81 days (95% confidence interval, 73 to 89 days) for those not treated (P=.0009). Survival in patients with M genavense was similar to the survival of M avium-intracellulare complex controls. However, patients with similar CD4 counts (CD4 controls) survived longer (median, 342 days; 95% confidence interval, 269 to 415 days; P<.0003).

Conclusions:  Infection with M genavense may be responsible for more than 10% of disseminated nontuberculous mycobacterial infections in patients with human immunodeficiency virus infection. Its clinical presentation and response to treatment are similar to those of infection with M avium-intracellulare complex.(Arch Intern Med. 1995;155:400-404)

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