MYCOBACTERIUM GENAVENSE IN AIDS PATIENTS, REPORT OF 24 CASES IN ITALYAND REVIEW OF THE LITERATURE

Mycobacterium genavense is a frequently missed agent of disseminated d isease in AIDS patients. The increasing frequency with which such orga nism is being isolated in Italy suggested a comparison of local survey with data reported in literature. Isolates presumed to belong to the species M. genavense were centralized and identified by means of genom ic sequencing and/or HPLC analysis of cell wall mycolic acids; clinica l data were obtained from relevant patients' record and collected usin g a proper questionnaire. In 24 cases in which this organism has been isolated in Italy M. genavense was grown, prevalently from blood, in l iquid medium after an average of six weeks of incubation. In overwhelm ing majority, patients were males, presented other opportunistic disea ses and were characterized by very low CD4+ counts (average 23/mu l); most frequent symptoms were fever, anemia and weight loss. All but two patients, who died before the mycobacterial infection was diagnosed, were treated with at least three drugs; the mean survival was close to one year. A review of literature reports revealed a wide overlapping of clinical and microbiological features.