This study was done to determine the occurrence of mycobacteria in the bloodstreams of patients with fever and advanced AIDS in a Brazilian hospital. We also verified the capability of an automated method for recovering these bacteria. During a period of 19 months, 254 patients with AIDS were evaluated. Blood cultures were generally submitted in pairs and drawn separately. Blood cultures were processed by the BACTEC 460TB System (Becton Dickinson Microbiology Systems, Sparks, MD), using the Bactec 13A media (Becton Dickinson Microbiology Systems, Sparks, MD). Of the 530 vials submitted, 77 (14.5%) from 41 (16%) patients were positive. Mycobacterium avium complex was recovered from 45 (58.4%) of the 77 positive vials, corresponding to 22 (53.6%) patients with positive blood cultures. The average time to detect Mycobacterium avium complex was 15 days. Mycobacterium tuberculosis was recovered from 26 (33.8%) of the 77 positive vials, corresponding to 15 (36.6%) patients with positive blood cultures, with an average detection time of 24 days. Other species of mycobacteria were recovered from 6 (7.8%) of the 77 vials, corresponding to 4 (9.8%) patients. M.avium complex was fairly prevalent (8.7%) in severely ill patients with AIDS in our hospital. M. tuberculosis was also an important (6.0%) agent of systemic bacterial infections in these patients. The rapid diagnosis of mycobacteremia was possible with the implementation of this automated technology.

Mais de 500.000 casos novos de malária foram notificados no Brasil, em 1992. P.falciparum and P.vivax são as espécies responsáveis por 99,3% dos casos. O diagnóstico precoce é indispensável para início do tratamento adequado. Neste trabalho, apresentamos os resultados do método tradicional para detecção de plasmódios, gota espessa, e os resultados de métodos alternativos estudados: imunofluorescência indireta com anticorpo policlonal anti-P.falciparum e QBC-método, em grupos populacionais bem definidos. A análise dos resultados foi feita em relação à presença ou ausênsia de sintomas clínicos de malária. Também, diferentes classes de imunoglobulinas anti-P.falciparum foram quantificadas para auxiliar na análise global dos resultados, principalmente nos resultados discrepantes. Nós concluímos que os métodos alternativos são mais sensíveis do que a gota espessa e que a associação das informações epidemiológicas, clínicas e laboratoriais é necessária para definir a presença de malária.

In Brazil, more than 500,000 new cases of malaria were notified in 1992. Plasmodium falciparum and P.vivax are the responsible species for 99.3% of the cases. For adequate treatment, precoce diagnosis is necessary. In this work, we present the results of the traditional Plasmodia detection method, thick blood film (TBF), and the results of alternative methods: Immunofluorescence assay (IFA) with polyclonal antibody and Quantitative Buffy Coat method (QBC)® in a well defined population groups. The analysis were done in relation to the presence or absence of malaria clinical symptoms. Also different classes of immunoglobulins anti-P.falciparum were quantified for the global analysis of the results, mainly in the discrepant results. We concluded that alternative methods are more sensitive than TBF and that the association of epidemiological, clinical and laboratory findings is necessary to define the presence of malaria.