To determine the frequency of nocardiosis in HIV-positive individuals clinically suspected of having tuberculosis (TB), 140 sputum samples were collected and processed by Gram stain, modified Ziehl-Neelsen staining and by culture on Lowenstein Jensen medium. Four (2.85%) patients were positive for nocardia by microscopy and five (3.6%) had positive culture for Nocardia asterioides. In areas where HIV-associated TB is common, some patients diagnosed as smear-negative pulmonary TB will actually have nocardiosis. Clinicians should be aware of this entity in HIV/immunocompromised patients with respiratory infections who fail to respond to antituberculous treatment.
a b s t r a c tBackground: To describe the socio-demographic profile of HIV patients, who are clinically suspected to have lower respiratory tract infections (LRTI) and to estimate the prevalence and types of mycobacterial, bacterial and fungal pathogens in these patients. Materials and methods: Sputum samples were collected from ninety-four subjects attending at Jimma University Hospital, Ethiopia and examined microbiologically. Results: Ninety-two pathogens were isolated from eighty-nine patients of the total ninety-four patients. Out of all isolates, 45.6% of the isolates constitute bacteria, 38% were Mycobacterium tuberculosis and 16.3% belong to different fungal classes. Mixed infection was identified in two cases. Klebsiella pneumonia and Candida albicans were the most common bacterial and fungal pathogens isolated respectively. Conclusion: This study demonstrates that there is a difference in the incidence rates of bacterial and fungal isolates of this study and of other studies conducted within Africa and outside Africa.
An experimental comparative study was conducted in order to compare the positivity pattern of sputum microscopy using the direct and overnight sedimentation Ziehl-Neelsen (ZN) smears, direct and NaOCl pretreated centrifuged ZN smears and overnight sedimentation and NaOC1 pretreated centrifuged ZN smears methods. We examined 660 sputum smeared slides for the presence of acid-fast bacillus from 220 sputum samples. Compared with the direct microscopy method, positivity increased by 91.1% after centrifugation (P < 0.001, chi(2) = 18.27) and by 71.1% after overnight sedimentation (P < 0.001, chi(2) = 11.61). No statistical significant difference was observed between the results of two different concentration techniques (P > 0.05, chi(2) = 0.789). The application of overnight sedimentation (in a laboratory without electricity) and/or the centrifugation technique could make a positive impact on the effectiveness of national tuberculosis control programmes.
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