[Identification of mycobacteria under routine clinical conditions]. / Artbestimmung von Mykobakterien unter Routinebedingungen.

A simplified system for identification of mycobacteria in routine is presented and discussed. By this way costs for staff and material can be reduced.

[Lung diseases caused by non-tuberculous mycobacteria in East Germany and Hungary]. / Lungenerkrankungen durch nichttuberkulöse Mykobakterien in der DDR und in Ungarn.

Despite the decrease of new cases of pulmonary tuberculosis also between 1982 and 1986 an increase in nontuberculous mycobacteriosis can be seen especially in the GDR and also in Hungary. In 1986 the ratio of recognized lung diseases caused by nontuberculous mycobacteria to all newly diagnosed bacillary cases was 4.1% in the GDR and 2.2% in Hungary. In Hungary, M. xenopi was the most important potential pathogenic species of nontuberculous mycobacteria during the whole period, followed by M. kansasii. In the GDR at the beginning most cases of nontuberculous mycobacteriosis were caused by M. kansasii later, M. xenopi was most frequent. Most of the patients with nontuberculous mycobacteriosis were men older than 50 years of age.

[The identification of mycobacteria during 22 years]. / Ergebnisse der Identifizierung von Mykobakterien während 22 Jahren.

During 22 years 14,711 strains of mycobacteria were identified. Most of them were isolated from humans, a smaller part came from animals and the environment. The constancy respectively the variability of the features were analyzed for the most frequently isolated species: M. tuberculosis, M. bovis, M. kansasii, M. gordonae, M. terrae-complex, M. xenopi, M. fortuitum and M. chelonae. Based on the results a further rationalisation of species identification in routine work would be possible.

[Incidence of primary and secondary resistance of M. tuberculosis in East Germany in 1983 in hospitalized patients]. / Häufigkeit primärer und sekundärer Resistenz von M. tuberculosis in der DDR bei im Jahre 1983 stationär behandelten Patienten.

The frequency of primary drug resistance in patients treated in hospital because of tuberculosis of the lung in 1983 was 2.3% (21 patients). Among them there were 5 patients (0.6%) with resistance to both INH and SM and 1 patient with a fourfold resistance. The frequency of secondary drug resistance was 20% (29 patients), among them a good third showed resistance to two or more drugs. Comparing to 1980 a decrease by half of patients treated repeatedly and also of the number of patients with secondary resistance can be recognized. Both the low share of primary drug resistance and the decrease of patients with repeated treatment indicate an effective therapy of tuberculosis in the GDR during the last years.

[Incidence and significance of lung diseases caused by tuberculosis bacteria and atypical mycobacteria in East Germany]. / Häufigkeit und Bedeutung von Lungenkrankheiten durch Tuberkelbakterien und atypische Mykobakterien in der DDR.

The number of new cases of pulmonary mycobacterial diseases registered in the GDR was 1,574 in the year 1982, 1,525 in 1983, and 1,404, as a preliminary result, in 1984. That is an incidence rate per 100,000 population of 9.4, 9.1, and 8.4, respectively. In 1982 Mycobacterium bovis was isolated in 4.6% of all newly diagnosed pulmonary cases, and in 1983 and 1984 a certain decrease became evident, namely to 3.5 and 3.1%, respectively. The number of patients with recognized diseases caused by nontuberculous mycobacteria was 20 in 1982 and 33 in 1983, which equals 1.3 and 2.2%, respectively, of the newly diagnosed bacillary cases. In causing a mycobacteriosis M. kansasii is the most important potential pathogenic species of nontuberculous mycobacteria, followed by M. xenopi. Nine tenths of the patients with mycobacteriosis were men. About eighty per cent of the male patients were older than 50 years. The absolute number of newly diagnosed lung diseases caused by nontuberculous mycobacteria in the GDR was nearly the same during the last years: there were 20 to 33 patients per year.

[Effectiveness of a fast culture method for mycobacteria as a therapeutic control and within the scope of diagnosis]. / Leistungsfähigkeit der Schnellanzüchtung von Mykobakterien als Therapiekontrolle und im Rahmen der Diagnostik.

A rapid method for culturing mycobacteria using a liquid medium and a rotating incubator was applied in routine examinations parallel with the conventional methods. As therapy control the rapid method appeared unsuitable, for the cultures are checked by microscopy and during therapy there is a period in which mycobacteria are visible but not multiplying. Within the diagnostics results are available somewhat earlier but the efficiency of the rapid culture is less than with the method in general use.

[Incidence of phagotypes of Mycobacterium tuberculosis in Czechoslovakia and East Germany and of Mycobacterium bovis in Czechoslovakia and Argentina]. / Untersuchungen über das Vorkommen von Phagotypen des Mycobacterium tuberculosis in der CSSR und der DDR sowie des Mycobacterium bovis in der CSSR und Argentinien.

The following study gives review of the results of the phagetyping of M. tuberculosis strains in different localities of Czechoslovakia and German Democratic Republic (165 strains from Czechoslovakia and 102 strains from GDR) and the comparison of the occurrence of phage subgroups of M. bovis strains in two different localities of Czechoslovakia (62 strains) and Argentina (93 strains). The results of the phagetyping of the Czechoslovak M. tuberculosis strains show that this group comprises all the 6 phage subgroups and agree very well in subgroups Ax, A2, B and C with the M. tuberculosis strains from GDR. Both groups of strains differ in subgroups A2 (9) and D. The results with the fresh isolated Argentinian M. bovis strains show that this group has only subgroups Ax and D in comparison with the old laboratory strains of M. bovis which have subgroups Ax, A2(9), and D. The phagetyping of the M. tuberculosis and M. bovis strains was undertaken with the help of 11 international mycobacterial phages. The use of mycobacterial phages in 1 RTD (Routine Test Dilution) and 10 RTD concentrations (in contrary to the 1 RTD and concentrated phage suspensions used previously) decreased the number of the "unspecific" reactions.

[The role of Mycobacterium bovis in epidemiology of tuberculosis]. / Die Bedeutung von Mycobacterium bovis in der Tuberkuloseepidemiologie.

After a short review of opinions concerning the role of Mycobacterium bovis in tuberculosis of men in the past and of earlier findings in German Democratic Republic, the results of species determination of mycobacteria from 5210 patients living in the capital Berlin and in the districts of Frankfurt/oder, Neubrandenberg, Potsdam and Rostock - obtained between 1975 and 1980 -, are presented. In children, tuberculosis has generally practically disappeared, and thus disease due to Mycobacterium bovis too. In adults, the proportion of diseases caused by Mycobacterium bovis did not yet decrease, in spite of eradication of tuberculosis in cattle obtained 10 years ago. In the rural districts, pulmonary tuberculosis in males is caused in between 4.6 and 9% by Mycobacterium bovis (highest value in one age group 15.8%). Obviously, there is a long latent period between termination of exposition and disappearance of disease by Mycobacterium bovis in human beings.

[Pathogenic mycobacteria]. / Pathogene Mykobakterien.

It is well established that mycobacteria other than tubercle bacilli and M. leprae are important human pathogens. At least 15 species comprise all the presently known mycobacterial pathogens of man. Eleven species are potential pathogens because disease production often dependent on special factors of the human host. The comments include some characterization of the mycobacteria, especially of the potential pathogenic species. A summary of important nontuberculous mycobacterial diseases of man is presented.

[Thin-layer chromatography of mycobacterial lipids and its importance for the differentiation and identification of mycobacteria]. / Dünschichtchromatographie der Lipidfraktionen von Mykobakterien und ihre Bedeutung für die Artdifferenzierung.

Methodical prerequisites to the differentiation of mycobacteria using thin-layer chromatography of their lipids described. The results of the identification of 112 strains belonging to 22 different species of Runyon's groups II, and III and IV are presented indicating that the lipid analysis permits the subdivision of mycobacteria into more species than with usual culture and biochemical methods. The technique even permits to differentiate between serotypes. In M. fortuitum strains several characteristic lipid patterns can be clearly distinguished, supporting the old opinion that different species are collected in the M. fortuitum-complex: M. giae, M. perigrinum, M. fortuitum, M, minetti. Three distinct lipid patterns were found in the M. avium strains investigated corresponding to the serotypes 1, 2, and 3. Using lipid analysis with two solvent systems it was possible to differentiate between 13 serotypes of M. intracellulare. In this way 9 species of Runyon's groups II could be identified, too. The serotypes Lunning, Gause and scrofulaceum were found to have characteristic lipid patterns permitting their differentiation by the technique described. Lipid analysis by means of thin-layer chromatography has been demonstrated to be a reliable inexpensive method, very useful for the identification and classification of mycobacteria not only for routine procedures but also for taxonomical problems and epidemiological purposes.

Agreement and disagreement between laboratories in species identification of mycobacteria.

Twenty coded strains of the following species: Mycobacterium avium, M. fortuitum, M. gordonae, M. chelonei, M. intracellulare, M. kansasii, M. nonchromogenicum, M. scrofulaceum, M. terrae, M. triviale and M. xenopi, were subjected to identification in a co-operative study undertaken by seven laboratories of four countries (CSSR, GDR, PRP and USSR). Three of these laboratories recognized 18-19 (90-95%) of the strains, three others 15-17 (75-85%) and one laboratory recognized 8 (40%) strains. In the correctly identified species, agreement between the tests used by all participants was evaluated. The highest rates of agreement in positive or negative results (04-100%) were obtained for nitrate reduction, detection of arylsulphatase, urease and nicotinamidase in M. kansasii, M. avium-intracellulare and M. fortuitum.

[Experimental findings after application of Kveim antigen. III. Sensitization of mice with living and killed strains of Mycobacterium avium (author's transl)]. / Experimentelle Befunde nach Applikation von Kveimantigen. III. Sensibilisierung von Mäusen durch lebende und abgetötete Stämme von Mycobacterium avium.

Mice were infected with Mycobacterium avium (serotype I and serotype II). The application of kveim antigen or two kinds of lipid fractions of Mycobacterium avium (serotype I or II) is followed in all cases by typical tissue reactions resembling positive kveim tests. Control animals which only received kveim antigen or lipid fractions of mycobacterium I showed in all cases negative kveim reactions. Sensibilization of mice with killed kinds of Mycobacterium avium I or II leads after application of kveim antigen or lipid fractions (outside and inside lipids of Mycobacterium avium I and II) only in few cases to positive kveim reactions.

[Culture of aerobic gram-negative bacteria on Endo agar and McConkey agar (author's transl)]. / Nachweis gramnegativer Stäbchen auf Endoagar und McConkey-Agar.

Culture of aerobic gram-negative bacteria by means of Endo Agar and McConkey Agar showed some better results in case of McConkey Agar.

[Experimental findings after application of Kveim antigen. II. Sensibilization of mice and guinea pigs by Mycobacterium avium (serotype I) (author's transl)]. / Experimentelle Befunde nach Applikation von Kveimantigen. II. Sensibilisierung von Mäusen und Meerschweinchen durch aviäre Mykobakterien (Serotyp I).

Mice and guinea pigs were sensibilisized by intraperitoneal injection of Mycobacterium avium (serotype I). Three and five weeks later (guinea pigs) and four weeks later (mice) the animals received kveim antigen into the footpads (guinea pigs) and into the perianal fat tissue (mice). Three and five weeks later (guinea pigs) and four weeks later (mice) the exstirpated material was investigated by light microscopy and enzyme histochemistry. Guinea pigs showed three and five weeks after injection of kveim antigen a lot of questionable positive and positive kveim tests and mice a high percentage of granulomatous changes, resembling a positive kveim reaction. With histochemical methods leucinaminopeptidase is a valuable diagnostic aid for detection of granulomatous changes in mice but not so good in guinea pigs.

A co-operative numerical analysis of Mycobacterium gastri, Mycobacterium kansasii and Mycobacterium marinum.

A co-operative taxonomic study has been performed on slowly growing photochromogenic mycobacteria (Runyon Group I) and closely related organisms. Phenetic data on 54 strains, studied in seven laboratories, were collected and analysed by numerical taxonomic methods. Immunological properties and phage susceptibility patterns were analysed independently to establish correlation with numerical classification. Mycobacterium gastri, M. kansasii and M. marinum appeared as distinct well-defined clusters and the serological and phage data supported the resolution of these three species. A table of definitive properties is presented. Two strains each of M. simiae and M. asiaticum formed a loose cluster which was clearly separated from the previously mentioned three species; the small number of strains examined precluded the establishment of a list of definitive properties of these two species. It is concluded that the Runyon Groups, which provided a practical though arbitrary basis for establishment of a series of co-operative studies, have served their purpose and should now be supplanted by classification and nomenclature based on species.

[Experimental findings after application of Kveim antigen. I. Sensibilization of guinea pigs by mycobacterium avium (author's transl)]. / Experimentelle Befunde nach Applikation von Kveimantigen. I. Sensibilisierung von Meerschweinchen durch aviäre Mykobakterien.

Guinea pigs were injected intraperitoneally with different types of mycobacterium avium (serotypes 1, 2 and 3). 4 weeks later followed the injection of Kveim antigen into the foodpats. Beside a high rate of non-specific foreign body reactions in all groups, histological pictures resembling a positive Kveim test were found only in the group of animals which received Mycobacterium avium serotype 1.

[Histological findings after application of Kveim antigen in animals (author's transl)]. / Histologische Befunde nach Applikation von Kveimantigen im Tierversuch.

The frequence of local granulomatous changes after injection of kveim antigen and previous sensibilisation (Freund's adjuvant, BCG-vaccine, atypical mycobacteria, implantation of sarcoidotic lymph nodes, human-gamma-globulin of sarcoidotic patients) was investigated in 69 mice and 38 guinea pigs. Granulomata with epitheloid and giant cells, resembling a "positive Kveim reaction" were found in 26% of the mice and 18% of the guinea pigs. Doubtful positive results were observed in 7% of the mice and 5% of the guinea pigs. A high percentage of non-specific foreign body reactions was observed in guinea pigs (82%), relatively scarcely in mice (16%). The most effective method for sensibilisation of the animals is the administration of Mycobacterium avium to guinea pigs or of Kveim antigen with complete Freund's adjuvant and the intraabdominal implantation of sarcoidotic lymph node material to mice.

[Differentiation and identification of mycobacteria by means of thin-layer chromatography of their lipids. III. Application for the classification of scotochromogenic mycobacteria (author's transl)]. / Zur Differenzierung und Identifizierung von Mykobakterien mit Hilfe der Lipid-Dünnschichtchromatographie II. Anwendung bei skotochromogenen Mykobakterien

Experiences with the lipid analysis of scotochromogenic mycobacteria by means of thin-layer chromatography are described. Out of 18 strains of M. scrofulaceum 11 belong to the serotypes Lunning, Gause, and Scrofulaceum. The similarity of the lipid patterns of the M. scrofulaceum strains to the ones of the M. avium-M. intracellulare group supports the contention of some authors that these species are closely related. Lipid analysis of further species of RUNYON's group II (M. xenopi, M. gordonae, M. kansasii var. aurantiacum, M. flavescens, M. acapulcensis, M. paraffinicum, M. thermoresistibile) gives the evidence that a differentiation by means of thin-layer separation is possible in these cases, too. The answer to the question whether these lipid patterns are species specific or not can only be given when a large number of strains of every species will be investigated.

[Differentiation and identification of mycobacteria by means of thin-layer chromatography of their lipids. II. Application for the classification of slowly growing mycobacteria: M. avium and M. intracellulare (author's transl)]. / Zur Differenzierung und Identifizierung von Mykobakterien mit Hilfe der Lipid-Dünnschichtchromatographie. II. Anwendung bei langsam wachsenden Mykobakterien: M. avium und M. intracellulare

Experiences with the thin-layer chromatography of mycobacterial lipids for the differentiation of the species M. avium and M. intracellulare are described. Details of the procedure used have been published in a recent paper. The 61 strains investigated belong to 16 different serotypes. Twenty of the 21 strains of M. avium present three distinct lipid patterns corresponding to the serotypes 1, 2 and 3. One strain had an aberrant lipid pattern suggesting that serotyping was at fault. The results obtained with 40 M. intracellulare strains of the serotypes III, IV, VI, VII, Davis, Watson, Howell, Chance, Boone, Yandle, Wilson, Altman and Arnold show that a differentiation by thin-layer chromatography of their lipids--using two different developing solvents--is possible. In allbut one case there was a complete correspondence between classification by lipid analysis and the results of serological typing. The distinction between M. avium and M intracellulare on the basis of species specific lipid patterns is not possible. This supports the conclusion that M. avium and M. intracellulare appear to be the same species having a number of distinctive serotypes.