Nontuberculous mycobacteria (NTM) are emerging pathogens increasingly associated with chronic pulmonary disease. The purpose of the study was to determine the prevalence of NTM infections in NW Greece. A total of 57 NTM strains isolated from consecutive patients were analyzed during 2000–2005 period. All the isolates were identified using a reverse hybridization molecular assay (GenoType Mycobacteria, Hain Lifescience, Germany). The isolated species were: 30 M. gordonae, 6 M. avium, 8 M. fortuitum, 6 M. chelonae, 3 M. marinum, 2 M. xenopi, 2 M. celatum and 1 M. peregninum. M. gordonae isolates were considered as environmental contamination. The remaining, except all strains of M. chelonae and M. marinum, were repeatedly isolated from respiratory specimens. M. chelonae strains were isolated from corneal scrapings and M. marinum strains were isolated from skin lesions. All patients were HIV-negative and the majority had chronic respiratory disease. NTM isolates were considered as pathogenic and patients received appropriate treatment.

To evaluate the experience of a clinical microbiology laboratory with a DNA amplification assay for routine detection of Mycobacterium tuberculosis, the Cobas Amplicor Mycobacterium tuberculosis (MTB) polymerase chain reaction (PCR) assay (Roche Diagnostics Systems, USA) was performed on 7,722 respiratory and 1,451 nonrespiratory specimens collected from 3,321 patients. The results were compared with those of culture in conventional Lowenstein-Jensen medium, culture in the MB/BacT system (Organon Teknika, France), and clinical investigations. A total of 240 of the 254 respiratory specimens culture positive for Mycobacterium tuberculosis were also positive in the PCR assay. Of the 7,300 culture-negative specimens, 45 (0.6%) were positive in the PCR. After detailed interpretation, the overall sensitivity, specificity, and positive and negative predictive values of the PCR assay were 84.5, 99.8, 94.1, and 99.4%, respectively, for respiratory specimens. The PCR assay was more sensitive for smear-positive respiratory specimens (97.1%) than for smear-negative respiratory specimens (48.6%). Of the 18 culture-positive (smear-negative) nonrespiratory specimens, 9 were positive in the PCR. None of the 1,384 culture-negative nonrespiratory specimens were positive in the PCR. The inhibition rates detected by the internal control of the test were 2.2% for respiratory specimens and 3.4% for nonrespiratory specimens. After resolving the discrepancies, the overall sensitivity, specificity, and positive and negative predictive values of the PCR assay were 82.5, 99.8, 94.3, and 99.4%, respectively, when compared to the results of diagnostic culture. In conclusion, the use of the Cobas Amplicor MTB-PCR assay might enable clinical microbiology laboratories with considerable previous experience in molecular biology testing to perform PCR and confirm tuberculosis infection immediately, leading to improved patient management.

The case of an otherwise well 9-y-old boy with fever, papular rash, jaundice and impaired liver function is presented. Streptococcus mitis sensitive to penicillin grew in blood culture. The boy had an excellent outcome. The clinical spectrum of viridans streptococci may be wider than currently anticipated, and Streptococcus mitis may cause septicaemia and hepatitis in immunocompetent individuals.

The case of an 11-year-old boy suffering from pulmonary hydatid disease with rupture and bacterial superinfection is presented. After 3 courses of chemotherapy with albendazole the boy recovered fully, uneventfully and without relapse. Conservative management should always be considered before surgical intervention in children with echinococcosis, even when complications have occurred.