Detection of Mycoplasma fermentons in broncho-alveolar lavage fluid specimens from AIDS patients with lower respiratory tract infection

Abstract

Objective To investigate the role of Mycoplasma fermentons in lower respiratory tract disease of HIV-positive patients. Methods A polymerase chain reaction (PCR) assay was used to detect M. fermentons in broncho-alveolar lavage (BAL) fluid and peripheral blood mononuclear cells (PBMCs) collected from 78 hospitalized HIV-positive patients with lower respiratory tract disease (the index group). BAL specimens were also assessed from two control groups; 25 HIV-positive patients without respiratory symptoms and 46 patients with a respiratory illness who did not have risk factors for HIV. Results Seventy-one (91%) of the 78 patients who comprised the index group had AIDS. Sixty-one patients provided BAL and PBMC specimens; 16 provided a BAL specimen and one only a PBMC specimen; 15 (25°/o) of the 61 patients had M. fermentons positive BAL fluid, of whom 10 (67%) also had a positive PBMC specimen. In contrast, of the 46 patients who had a negative BAL fluid, only three (6.4°/o) had a positive PBMC sample (P<0.00001 Fisher's exact test). Overall, 21 (27%) of 77 patients had M. fermentons positive BAL fluid. Of these positive patients, 16 also had another microorganism in the BAL fluid and for five patients M. fermentons was detected alone. Compared with patients in the index group, none of the 46 BAL fluid specimens from patients at low risk of HIV infection was M. fermentons positive (P< 0.001, %2 15.13). Two (8%) of the 25 HIV-positive patients without respiratory symptoms had a M. fermentons positive BAL fluid, positiviry that was also statistically different from the index group (P= 0.045, %2 4.01). Conclusions M. fermentons frequently invades the lower respiratory tract of AIDS patients as an opportunist and may cause disease in some. © 2000 British HIV Association.