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Journal of Clinical Microbiology, April 1998, p. 1046-1049, Vol. 36, No. 4
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Sensitivity of Fluorochrome Microscopy for Detection of Mycobacterium tuberculosis versus Nontuberculous Mycobacteria

Paul W. Wright,1 Richard J. Wallace Jr.,2,3,* Nathan W. Wright,1 Barbara A. Brown,2 and David E. Griffith3,4

Departments of Family Practice,1 Microbiology,2 and Medicine,4 The University of Texas Health Center at Tyler, and the Center for Pulmonary Infectious Disease Control,3 Tyler, Texas

Received 2 July 1997/Returned for modification 11 August 1997/Accepted 2 January 1998

The results for 6,532 consecutive mycobacterial respiratory specimens collected from 1,040 patients from 1993 to 1995 in a Texas hospital were studied to determine the sensitivity of fluorescence microscopy for detection of Mycobacterium tuberculosis and nontuberculous mycobacteria (NTM). Smears were positive for acid-fast bacilli (AFB) in 63% (677 of 1,082) of specimens growing M. tuberculosis and 56% (638 of 1,148) of specimens growing the four most common species of NTM. Smear positivity by species was 58% (446 of 776) for M. avium complex, 51% (154 of 300) for rapidly growing mycobacteria (98% were M. abscessus), 78% (29 of 37) for M. kansasii, and 26% (9 of 35) for M. gordonae. Definite or probable disease by clinical criteria was present in 79% of patients with M. avium complex, 93% of patients with rapidly growing mycobacteria, 100% of patients with M. kansasii, and 0% of patients with M. gordonae. Patients with M. avium complex had a low incidence of AIDS (7%), and approximately 50% of non-AIDS patients had upper-lobe cavitary disease and 50% had nodular bronchiectasis. Only 23 of 6,532 (0.35%) of AFB smears were positive with a negative culture excluding patients on therapy for established mycobacterial disease. These studies suggest that NTM are as likely as M. tuberculosis to be detected by fluorescent microscopy in specimens from patients from areas endemic for NTM lung disease and at low risk for AIDS.

* Corresponding author. Mailing address: Department of Microbiology, The University of Texas Health Center, P.O. Box 2003, Tyler, TX 75710. Phone: (903) 877-7680. Fax: (903) 877-7652. E-mail: Melanie{at}UTHCT.EDU.

Journal of Clinical Microbiology, April 1998, p. 1046-1049, Vol. 36, No. 4
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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