The most common bacterial infection identified in patients with AIDS is caused by Mycobacterium avium complex (MAC) bacilli. To rapidly and specifically detect MAC infections, polymerase chain reaction (PCR) protocols were developed. These protocols utilize PCR primers derived from unique sequences within the mycobacterial 16s RnA genes. Bacterial titration experiments have indicated that 1 - 10 nontuberculosis bacilli can be detected in vitro using these PCR protocols. Thusfar, we have had limited success in adapting these PCR protocols for the detection of MAC bacilli in serum from AIDS patients. We are currently evaluating whether serum inhibitory factors or the low concentrations of bacilli in the sera have caused the inconsistent results. Because of these difficulties, we have been adapting our PCR protocols to utilize alternative clinical specimens. In collaboration with investigators at the National Zoo, we have shown, utilizing our PCR protocols, that MAC bacilli can be rapidly detected in the feces of birds with M. avium disease. It is possible that similar protocols may be useful for the easy and rapid identification MAC infections in AIDS patients.
