ISOLATION OF MYCOBACTERIUM-AVIUM COMPLEX FROM WATER IN THE UNITED-STATES, FINLAND, ZAIRE, AND KENYA

Disseminated infection with organisms of the Mycobacterium avium compl ex (MAC) is a common complication of AIDS in the United States and oth er developing countries, but it is rare or absent in sub-Saharan Afric a. To assess the comparative likelihood of exposure to MAC in these ge ographic areas, we used a standard protocol to culture 91 water sample s from environmental sites and piped water supply systems in the Unite d States, Finland, Zaire, and Kenya. MAC was isolated from all geograp hic areas and from 22 of 91 (24%) samples. Isolation rates were 13 of 47 (28%) for environmental samples and 9 of 44 (20%) for water supply samples. Overall isolation rates were 18 of 52 (35%) samples in the Un ited States and Finland, whereas they were 4 of 39 (10%) samples in Za ire and Kenya (P = 0.015). MAC isolation rates from water supply syste ms were 9 of 25 (32%) samples in the United States and Finland and 1 o f 19 (5%) samples in Zaire and Kenya (P = 0.056). MAC was isolated fro m hospital water in the United States and Finland but not in hospital water in Zaire and Kenya. Serovar determinations showed that six of ei ght isolates from the United States were serovar 4 or 8. One MAC isola te from Zaire was identified as an ''X'' mycobacterium. These data sug gest that exposure to MAC in water is likely in diverse areas of the w orld, but that the likelihood of human exposure to the organism in wat er may be slightly less in sub-Saharan Africa than in developed countr ies in the Northern Hemisphere.