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Mycobacterium gordonae: A Treatable Disease in HIV-Positive Patients – Discussion (1)

Mycobacterium gordonae: A Treatable Disease in HIV-Positive Patients - Discussion (1)Mycobacterium gordonae has been called tap water bacillus or M aquae and is commonly found in soil (gardeners may have a higher risk), nonpasteurized fresh milk, and water. In humans it can be found in sputum, gastric fluid, and urine as a saprophyte or colonizer. Nosocomial outbreaks (tap water, ice machine, bronchoscopies, laboratory contamination) have been reported.
Even within the group of MOTTs, it is regarded as one of the least pathogenic organisms. Disease is unusual, although there are case reports of HIV-negative patients with keratitis, skin nodules, prosthetic aortic valve endocarditis, peritoneal infection, meningitis secondary to a ventriculoatrial shunt with dissemination, synovial infection, hepatoperi-toneal infection, lung infiltrates, lung nodules,- or cavitation. Additional patients were reviewed in a recent report with similar results. None of our HIV-negative patients had evident disease and treatment was not required; this is in accordance with two previous publications.
The organism can be an opportunistic pathogen in HIV-positive patients as reflected in the three patients that have been described previously (Table 3).

Table 3 -HIV-Positive Patients With Possible or Documented Disease Because of Mycobacterium gordonae

Patient Specimen Treatment SensitivityResistance Outcome Comment ReferenceNo.
41/M/IVDU Sputum, lx>ne marrow I,EMB,ANSA,S,CLO, 10 mo Died Isolation from sterile source 33
52/М/bisexual Bronchoalveolarlavage I,R,EMB,PZA,12 mo Resolved Nonprotected lavage 34
36/MflVDU Peritoneal fluid (with dialysis) I,R,EMB,AMI (PZA), 6 mo EMB,R,ETH,

K/I,PAS

Resolved Associated with invasive procedure 19
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