Clinical and Epidemiologic Features of Infection With Mycobacterium genavense

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Abstract
Objectives: To characterize clinical and epidemiologic features of infections withMycobacterium genavense. Design: Case series and case-control studies. Patients withM genavensewere compared with two control groups: CD4 controls were matched on the basis of CD4 counts, andMycobacterium avium-intracellularecomplex controls had disseminated infection withM avium-intracellularecomplex. Results: Fifty-four patients with disseminated infections caused byM genavensewere 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 genavensewas 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 ofM 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 withM genavensewas similar to the survival ofM avium-intracellularecomplex 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 withM genavensemay 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 withM avium-intracellulare complex. (Arch Intern Med. 1995;155:400-404)