Mycobacterial infections of fowl
Published:
Nov 27, 2017
Keywords:
Mycobacterium spp birds mycobacterial culture Polymerase Chain Reaction
Abstract
The significance of mycobacterial infections of birds may have been decreased considerably by the broad application of modern farming practices, but their study continues to be important with reference to fowl, animal and public health protection. Mycobacterial infections of birds are mainly caused by members of the Mycobacterium avium complex (MAC). This is divided into 28 serotypes that are grouped into species: serotypes 1 to 6, 8 to 11 and serotype 21 consist the M. avium subsp. avium (MA), serotypes 4 and 8 are also referred to as M. avium subsp. hominisuis, whereas serotypes 7, 12 to 20 and 22 to 28 consist the Mycobacterium intracellulare. Serotypes 1 to 3 of MA are the only ones that cause systemic tuberculosis in chickens. M. intracellulare and the rest of the serotypes that consist MA usually cause only focal tuberculous lesions. Recendy, another member of the Mycobacterium species, namely Mycobacterium genavense, has been added to those that can infect fowl. Cases of fowl mycobacteriosis have been reported from practically every place on earth. The disease usually enters a farm by carrier animals that excrete mycobacteria in their feces. The bacteria usually gain entrance into the host through the oral route and rarely through the upper respiratory tract. Sporadic incidences of sudden death, loss of weight and drop of egg production consist evidence of fowl mycobacteriosis in a farm. Clinical symptoms can also result from infection of the intestine, bones, lung or the skin. Tuberculous lesions located in the viscera and more significandy the bone marrow, when revealed during post-mortem examination, consist pathognomonic findings. The diagnostic investigation of mycobacterial infections in the laboratory usually relies on serology, the microscopic examination of fecal smears and culture that continues to consist the method of reference. These are nowadays implemented by specific Molecular Biology methods, the most broadly applied of which is the polymerase chain reaction (PCR). Cultivation of clinical material for the isolation of mycobacteria begins with the decontamination of the sample that aims to neutralize the bacteria that would over grow mycobacteria. The product is then inoculated onto selective media. Those that are commonly incorporated to the cultivation of MAC are Lowenstein-Jensen and Middlebrook 7H11. Incubation is performed in 5-10% carbon dioxide atmosphere for no less than 4-6 weeks. Identification of colonies relies on biochemical tests or PCR that can decrease substantially the time required for a definite result. Identification of MAC by PCR is usually performed by targeting the following genomic regions: 16S rRNA, hsp65, IS 1245 and IS901. For M. genavense, that is genetically very closely related to MA, PCR is usually incorporated for the amplification of a region within the gene that codes 65kDa heat shock protein, proceeded by the digestion of the amplification product with the restriction endonuclease, SaR.
Article Details
- How to Cite
-
FRANGIADAKI (Ε. Γ. ΦΡΑΓΚΙΑΔΑΚΗ) E., IKONOMOPOULOS (Ι. Α. ΟΙΚΟΝΟΜΟΠΟΥΛΟΣ) J., BALASKAS (Χ. ΜΠΑΛΑΣΚΑΣ) C., & GAZOULI (Μ. ΓΑΖΟΥΛΗ) M. (2017). Mycobacterial infections of fowl. Journal of the Hellenic Veterinary Medical Society, 57(2), 127–139. https://doi.org/10.12681/jhvms.15017
- Issue
- Vol. 57 No. 2 (2006)
- Section
- Review Articles
Authors who publish with this journal agree to the following terms:
· Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non-Commercial License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
· Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g. post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
· Authors are permitted and encouraged to post their work online (preferably in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
Downloads
Download data is not yet available.
References
Ananiss-Aghajani E, Jones Κ, Holtzman A, Aronson Τ, Glover Ν, Boian S, Brunk C (1996) Molecular technique for rapid identification of mycobacteria. J Clin Microbiol, 34:98-102.
Artopios Β (1992) Poultry Pathology. Aristotle University of Thessaloniki, 329-334.
Ashford DA, Whitney E, Raghunathan P, Cosini Ο (2001) Epidemiology of selected mycobacteria that infect humans and other animals. Rev sci tech Off Int Epiz, 20:325-337.
Ashour Ν (1972) Contribution to the experimental infection of young chickens with Mycobacterium avium. Acta Vet Brno, 41:421-427.
Arstila TP (1996) Τ cells subsets and the activation of γδ Τ cells. In: Vainio O, Imhof BA, editors. Immunology and development biology of the chicken. Berlin, Heidelberg: Springer-Verlag, 71-78.
Bauer J, Andersen AB (1999) Stability of Insertion Sequence IS1245, a marker for differentiation of Mycobacterium avium strains. J Clin Microbiol, 37:442-444.
Beggs ML, Stevanova R, Eisenach KD (2000) Species identification of Mycobacterium avium complex isolates by a variery of molecular techniques. J Clin Microbiol, 38:508-512.
Bercovier H, Vincent V (2001) Mycobacterial infections in domestic and wild animals due to Mycobacterium marinum, M. fortuitum, M. chelonae, M. porcinum, M. farcinogenes, M. smegmatis, M. scrofulaceum, M. xenopi, M. simiae and M. genavense. Rev Sci Tech Off int Epiz, 20:265-290.
Böddinghaus Β, Rogali Τ, Flohr Τ, Blöcker Η, Böttger EC (1990) Detection and identification of Mycobacteria by amplification of rRNA. J Clin Microbiol, 28:1751-1759.
Bojarski J (1968) Occurrence of Mycobacterium in eggs of tuberculin-positive hens. Med Weter, 24:21-23.
Bono M, Jemmi T, Bernasconi C, Burki D, Telenti A, Bodmer Τ (1995) Genotyping of Mycobacterium avium strains recovered from animals and their comparison to human strains. J Clin Microbiol, 61:371-373.
Böttger EC, Hirscheil Β, Coyle MB (1993) Mycobacterium genavense sp. nov. Int J Syst Bacteriol, 43:841-843.
Bougiouklis P, Brellou G, Fragkiadaki E, Iordanidis P, Vlemmas I, Georgopoulou I (2005) Outbreak of avian mycobacteriosis in a flock of two-year-old domestic pigeons (Columba livia f. domestica). Avian Diseases, 49:442-445.
Brown ST, Brett I, Almenoff PL, Lesser M, Terrin M, Teirstein AS (2003) Recovery of cell wall-deficient organisms from blood does not distinguish between patients with sarcoidosis and control patients. Chest, 132:413-417.
Burnham WR, Lennmard-Jones JE, Stanford JL, Bird RG (1978) Mycobacteria as a possible cause of inflammatory bowel disease. The Lancet, 2:693-696.
Calnek BW, Barnes HJ, Beard CW, McDougald LR, Saif YM (1997) Diseases of Poultry, 10th edition. Mosby-Wolfe, 167-178.
Carlson LDC, Wallis CK, Coyle MB (1998) Standardized BACTEC method to measure clarithromycin susceptibility of Mycobacterium genavense. J Clin Microbiol, 36:748-751.
Carricajo A, Fonsale N, Vautrin AC, Aubert G (2001) Evaluation of BacT/Alert 3D liquid culture system for recovery of mycobacteria from clinical specimens using Sodium Dodecyl (Lauryl) Sulfate-NaOH decontamination. J Clin Microbiol, 39:3799-3800.
Carter GR, Wise DJ (2004) Essentials of Veterinary Bacteriology and Mycology- 6th edition, Iowa State Press, 207-213.
Cave DR, Mitchell DN, Kane SP, Brooke BN (1973) Further animal evidence of a transmissible agent in Crohn's disease. Lancet, 17:1120-1122.
Chamberlin W, Graham DY, Hulten K, El-Zimaity HM, Schwartz N, Shafran I, El-Zaatari FA (2001) Mycobacterium avium subsp. paratuberculosis one cause of Crohn's disease. Aliment Pharmacol Ther, 15:337-346.
Chao L, Vargas C, Spear BB, Cox EC (1983) Transposable elements as mutator genes in evolution. Nature, 303:633-635.
Chiodini RJ, Van Kruiningen H J, Merkal RS (1984) Ruminant paratuberculosis (Johne's disease): the current status and future prospects. Cornell Vet, 74:218-262.
Clark SL, Collins MT (1995) A single dose oral challenge model of disseminated Mycobacterium avium infection. Abstract of General Meeting of the American Society for Microbiology, 95:139.
Corner LA, Trajstman AC (1988) An evaluation of 1-hexadecylpyridinium chloride as a decontaminant in the primary isolation of Mycobacterium bovis from bovine lesions. Vet
Microbiol, 18:127-134.
Cornil V, Megnin Ρ (1884) Tuberculose et diphtérie des gallinacés. CR Soc Biol, 36:617-621.
Cowan and Steel's (1993) Manual for the identification of Medical Bacteria, 3rd edition, Cambridge University Press.
Coyle MB, Carlson LDC, Wallis CK, Leonard RB, Raisys VA, Kilburn JO, Samadpour M, Böttger EC (1992) Laboratory aspects of "Mycobacterium genavense", a proposed species
isolated from AIDS patients. J Clin Microbiol, 30: 3206-3212.
Cromie RL, Ash NJ, Brown MJ, Stanford JL (2000) Avian immuneresponse to Mycobacterium avium: the wildfowl example. Develop Comp Immunol, 24:169-185.
Curtis A (1999) The Dictionary of Cell and Molecular Biology, 3rd edition, http://www.viroldict.uk
Dumonceau JM, Fonteyne PA, Realini L, Van Gossum A, Van Vooren JP, Portaels F (1995) Species- specific Mycobacterium genavense DNA in intestinal tissues of individuals not infected with Human Immunodeficiency Virus. J Clin Microbiol., 33:2514-2515.
Dvorska L, Bartos M, Martin G, Erler W, Pavlik I (2001) Strategies for differentiation, identification and typing of medically important species of mycobacteria by molecular methods. Vet Med Chezch, 46:309-328.
Dvorska L, Bull TJ, Bartos M, Matlova L, Svastova P, Weston RT, Kintr J, Parmova I, van Soolingen D, Pavlik I (2003) A standarised restriction fragment length polymorphism (RFLP)
method for typing Mycobacterium avium isolates links IS901 with virulence for birds. J Microbiol Methods, 55:11-27.
Dvorska L, Matlova L, Bartos M, Parmova I, Bartl J, Svastova P, Bull TJ, Pavlik I (2004) Study of Mycobacterium avium complex strains isolated from cattle in the Czech Republic between 1996 and 2000. Vet Microbiol, 99:239-250.
Ehlers S, Richter E (2000) Gamma interferon is essential for clearing Mycobacterium genavense infection. Infection and Immunity, 68:3720-3723.
Feldman WH (1938) Avian tuberculosis infections. Williams & Williams, Baltimore, MD.
Fischer OA, Matlova L, Dvorska L, Svastova P, Bartl J, Melicharek I, Weston RT, Pavlik I (2001) Diptera as vectors of mycobacterial infections in cattle and pigs. Med Vet Entomol, 15:208-211.
Fischer OA, Matlova L, Dvorska L, Svastova P, Pavlik I (2003a) Nymphs of the Oriental cockroach (Blatta orientalis) as passive vectors of causal agents of avian tuberculosis and
paratuberculosis. Med Vet Entomol, 17:145-150.
Fischer OA, Matlova L, Bartl J, Dvorska L, Svastova P, du Maine R, Melicharek I, Bartos M, Pavlik Ι (2003ß) Earthworms (Oligochaeta, Lumbricidae) and mycobacteria. Vet Microbiol,
:325-338.
Gonzalez M, Rodriguez-Bettos A, Gimeno I, Flores JM, Pizarro M (2002) Outbreak of avian tuberculosis in 48-week-old commercial layer hen flock.. Avian Diseases, 46:1055-1061.
Guerrero C, Bernasconi C, Burki D, Bodmer T, Telenti A (1995) A a specific target for analysis of strain relatedness. J Clin Microbiol, 33:304-307.
Gupta UD, Katoch VM (1997) Understanding the phenomenon of persistence in mycobacterial infections. Indian J Lepr, 69:385-393.
Hejlicek K, Tremi F (1995) Comparison of pathogenesis and epizootology signification of avian mycobacteriosis in different sorts of domestic and free-living syanthropic fowl. Vet Med Czech, 40:187-194.
Hodges RD (1974) The histology of the fowl. Academic Press, 181-183.
Hoenerhoff M, Kiupel M, Sikarskie J, Bolin C, Simmons H, Fitzgerald S (2004) Mycobacteriosis in an American Bald Eagle (Haliaeeetus leucocephalus). Avian Diseases, 48: 437- 441.
Hoop RK (2002) Mycobacterium tuberculosis infection in a canary (Serinus canaria L.) and a blue-fronted Amazon Parrot (Amazona amazona aestiva). Avian Diseases, 46:502-504.
Hoop RK, Bottger EC, Pfyffer GE (1996) Etiological Agents of Mycobacterioses in pet birds between 1986 and 1995. J Clin Microbiol, 34:991-992.
Hoop RK, Böttger EC, Ossent P, Salfinger M (1993) Mycobacteriosis due to Mycobacterium genavense in six pet birds. J Clin Microbiol, 31:990-993.
Huard RC, Lazzarini LCO, Butler WR, van Soolingen D, Ho JL (2003) PCR-based method to differentiate the subspecies of Mycobacterium tuberculosis complex on the basis of genomic
deletions. J Clin Microb 41:1637-1650.
Hughes MS, Ball NW, Love DN and al. (1999) Disseminated Mycobacterium genavense infection in an FIV-positive cat. J Fel Med Surgery, 1:23-29.
Kauppinen J, Hintikka E, Iivanainen E, Katila M (2001) PCR-based typing of Mycobacterium avium isolates in an epidemic among farmed lesser white-fronted geese (Anser erythropus). Vet Microbiol, 81:41-50.
Kiehn TE, Hoefer H, Bottger EC, Ross R, Wong M, Edwards F, Antinoff N, Armstrong D (1996) Mycobacterium genavense infections in pet animals.. J Clin Microbiol, 34:1840-1842.
Kirschner PUV, Hein R, Bottger EC (1994) Bias of culture techniques for diagnosing mixed Mycobacterium genavense and Mycobacterium avium infection in AIDS. J Clin Microbiol,
:828-831.
Klausen J, Giese SB, Fursted K, Ahrens Ρ (1997) Distribution of serotypes, IS901 and a 40 kDa protein in Mycobacterium avium complex strains isolated from man and animals in Denmark. APMIS, 105:277-282.
Komijn RE, de Haas PEW, Schneider MME, Eger T, Nieuwenhuijs JHM, van den Hoek RJ, Bakker D, van Zijd Erveld FG, van Soolingen D (1999). Prevalence of Mycobacterium avium in slaughter pigs in the Netherlands and comparison of IS 1245 Restriction Fragment Length Polymorphism patterns of porcine and human isolates. J Clin Microbiol, 37:1254-1259.
Koptopoulos G. (1993) Fundamentals of Veterinary Immunology. Kyriakidis editions, Thessaloniki, 57, 148, 62.
Kunze ZM, Portaels F, McFadden J J (1992) Biologically distinct subtypes of Mycobacterium avium differ in possession of Insertion Sequence IS901. J Clin Microbiol, 30:2366-2372.
Long EG, Ewing EPJr, Barlett JH, Horsburgh CRJr, Birkness KA, Yakrus MA, Newman GW, Quinn FD (2000) Changes in the virulence of Mycobacterium avium after passage through embryonated hen's eggs. FEMS Microbiol Letters, 190:267-272.
Lucas J, Lucas A, Furber H, James G, Hughes Ms, Martin P, Chen S, Mitchell D, Love D, Malik R (2000) Mycobacterium genavense infection in two aged ferrets with conjunctival lesions. Austr Vet J, 78:685-689.
Manierala JM, Thornton CG, Padilla E, Lonca J, Corea I, Martinez E, Ausina V (2003) Comparison of the Sodium Dodecyl Sulfate-Sodium Hydroxide specimen processing method with the C18-Carboxypropylbetaine specimen processing method using the MB/BacT liquid culture system. Eur J Clin Microbiol Infect Dis, 22:35-42.
Marks J, Jenkins PA, Schaefer WB (1969) Infection and incidence of a third type of Mycobacterium avium. Tubercle, 50:394.
Martin G, Schimmel D (2000) Mycobacterium avium infections in poultry-a risk for human health or not?Dtsch Tierarztl Wochenschr, 107:53-58.
McAdam RA, Hermans PW, van Soolingen D, Zainuddin ZF, Catty D, van Embden JD, Dale JW (1990) Characterization of a Mycobacterium tuberculosis insertion sequence belonging to the IS3 family. Mol. Microbiol, 4:1607-1613.
McDiarmid A (1948) The occurrence of tuberculosis in the wild wood-pigeon. J Comp Path Ther, 58:128-133.
Mendenhall M.K., Ford S.L., Emerson C.L., Wells R.A., Gines L.G., Eriks LS. (2000) Detection and differentiation of Mycobacterium avium and Mycobacterium genavense by polymerase chain reaction and restriction enzyme digestion analysis J Vet Diagn Invest, 12:57-60.
Mijs W, De Haas P, Rossau R, Van Der Laan T, Rigouts L, Portaels F, van Soolingen D (2002) Molecular evidence to support a proposal to reserve the designation Mycobacterium avium subsp. avium for bird-type isolates and 'M. avium subsp. hominissuis' for the human/porcine type of M. avium. Int J Syst Evol Microbiol, 52:1505-1518.
Mullis KB, Faloona F (1987) Specific synthesis of DNA in vitro via a polymerase-catalyzed chain reaction. Meth Enzymol, 155:335-350.
OIE (2003) Validation and quality control of polymerase chain reaction methods used for the diagnosis of infectious diseases. Manual of Diagnostic Tests for Aquatic Animals, Office International des Epizooties.
OIE (2004). Treatment of mycobacterial infections.
Pavlik I, Svatova P, Bartl J, Dvorska L, Rychlik I (2000) Relationship between IS901 in the Mycobacterium avium complex stains isolated from birds, animals, humans, and the environment and virulence for poultry. Clin Diagn Lab Immunol, 7:212-217.
Pechere M, Opravil M, Wald A, Chave JP, Bessesen M, Sievers A, Hein R, von Overbeck J, Clark RA, Tortoli E and al. (1995) Clinical and epidemiologic features of infection with Mycobacterium genavense. Swiss HIV Cohort Study. Archives of Internal Médecine, 155(4).
Picardeau M, Vincent V (1996) Typing of Mycobacterium avium isolates by PCR. J Clin Microbiol, 34:389-392.
Portaels F, Realini L, Bauwens L, Hirscheil B, Meyers WM, De Meurichy W (1996) Mycobacteriosis caused by Mycobacterium genavense in birds kept in a zoo: 11-year survey. J Clin Microbiol, 34:319-323.
Quinn PJ, Markey BK, Carter ME, Donelly WJ, Leonard FC (2002) Veterinary microbiology and microbial disease. Blackwell Publishing, 97-105.
Realini L, De Ridder K, Palomino JC, Hirschel B, Portaels F (1998) Microaerophilic conditions promote growth of Mycobacterium genavense. J Clin Microbiol, 36:2565-2570.
Realini L, Van Der Stuyft P, De Ridder K, Hirschell B, Portaels F (1997) Inhibitory effects of polyoxyethylene stéarate, ΡΑΝΤΑ, and neutral pH on growth of Mycobacterium genavense in BACTEC primary cultures. J Clin Microbiol, 35:2791-2794.
Realini L, De Ridder K, Hirschel B, Portaels F (1999) Blood and Charcoal added to acidified agar media promote the growth of Mycobacterium genavense. Diagn Microbiol Infect Dis, 34:45-50.
Reddacliff LA, Vadali A, Whittington RJ (2003) The effect of decontamination protocols on the numbers of sheep strain Mycobacterium avium subsp. paratuberculosis isolated from tissues and faeces. Vet Microbiol, 95:271-282.
Ritacco V, Kremer Κ, van der Laan Τ, Pijennburg JE, de Haas PEW, van Soolingen D (1998) Use of IS901 and IS1245 in RFLP typing of Mycobacterium avium complex: relatedness among serovar reference strains, human and animal isolates. Int J Tuberc Lung Dis, 33:1389-1391.
Saif YM (2003) Diseases of poultry- 11th edition. Iowa State Press, 836-844.
Sangari FJ, Goodman J, Petrofsky M, Kolonoski P, Bermudez LE (2001) Mycobacterium avium invades the intestinal mucosa primarily by interacting with enterocytes. Infection and Immunity, 69:1515-1520.
Schaefer WB (1965) Serologic identification andclassification of the atypical mycobacteria by their agglutination. Am Rev Respir Dis, 92:S85- S93.
Schaefer WB, Beer JV, Wood NA, Boughton E, Jenkins PA, Marks JA (1973) A bacteriological study of endemic tuberculosis in birds. J Hyg, 71:549-558.
Squibb RL, Solotorovsky M, Beisel WR (1972) Quantitation of the Bioenergetics of a tuberculosis infection in chicks. Appi Microbiol, 24:924-928.
Tadesse S, Woldemeskel M, Molla B, Tibbo M, Kidane D, Medhim G, Britton S (2003α) Avian Mycobacteriosis in domestic chickens from selected agro-climatic regions in Ethiopia. J Applied Res in Vet Med, 62:254-260.
Tadesse S, Woldemeskel M, Medhia G, Tibbo M, Molla Β, Abate G, Britton S (2003ß) T-cell responses to Mycobacterium avium PPD antigens in gastro-intestinal helminth co-infected chickens in Central Ethiopia. J Immunoassay Immunochem, 24:57-72.
Tanaka MM, Rosenberg NA, Small PM (2004) The control of copy number of IS6110 in Mycobacterium tuberculosis. Molecular Biology and Evolution, 21:2195-2201.
Telenti A, Marchesi F, Balz M, Bally F, Böttger EC, Bodmer Τ (1993) Rapid identification of mycobacteria to the species level by Polymerase Chain Reaction and Restriction Enzyme Analysis. J Clin Microbiol, 31:175-178.
Tell LA, Woods L, Cromie RL (2001) Mycobacteriosis in birds. Rev Sei Tech Off int Epiz, 20:180-203.
Tell LA, Woods L, Foley J, Needham ML, Walker RL (2003a) A model of avian mycobacteriosis: clinical and histopathologic findings in Japanese Quail (Coturnix coturnix japonica) intravenously inoculated with Mycobacterium avium. Avian Diseases, 47: 433-443.
Tell LA, Foley J, Needham L, Walker RL (2003β) Diagnosis of avian mycobacteriosis: comparison of culture, acid-fast stains and polymerase chain reaction for the identification of Mycobacterium avium in experimentally inoculated Japanese Quail (Coturnix coturnix japonica).. Avian Diseases, 47:444-452.
Tell LA, Leutenegger CM, Larsen RS, Agnew DW, Keener L, Needha ML, Rideout ΒΑ (2003γ) Real-time polymerase chain reaction testing for the detection Mycobacterium genavense and Mycobacterium avium complex species in avian samples. Avian Diseases, 47:1406-1415.
Thomsen V0, Dragsted UB, Bauer J, Fuursted K, Lundgren J (1999) Disseminated infection with Mycobacterium genavense: a challenge to physicians and mycobacteriologists. J Clin Microbiol, 37:3901-3905.
Thorel MF, Krichevsky M, Levy-Frebault VV (1990) Numerical taxonomy of mycobactin-dependent mycobacteria, emended description of Mycobacterium avium, and description of Mycobacterium avium subsp. avium subsp. nov., Mycobacterium avium subsp. paratuberculosis subsp. nov., and Mycobacterium avium subsp. silvaticum subsp. nov.. Int J Syst Bacteriol, 40:254-260.
Tsaggaris Th. (1993) General Pathology. Kyriakidis Editions, Thessaloniki, 374-379.
van Soolingen D, Bauer J, Ritacco V, Leao SC, Pavlik I, Vincent V, Rastogi N, Gori A, Bodmer T, Garzelli C, Garcia MJ (1998) IS 1245 Restriction Fragment Length Polymorphism typing of Mycobacterium avium isolates: proposal for standarization. J Clic Microbiol, 36:3051-3054.
van Soolingen D (2001) Molecular epidemiology of tuberculosis and other mycobacterial infections: main methodologies and achievements. J Internal Medicine, 249:1-26.
Velasco-Velazquez MA, Barrera D, Gonzalez- Arenas A, Rosales C, Agramonte-Hevia J (2003) Macrophage- Mycobacterium tuberculosis interactions: role of complement receptor 3. Microbial Pathogenesis, 35:125-131.
Yakrus MA, Good RC (1990) Geographic distribution, frequency, and specimen source of Mycobacterium avium complex serotypes isolated from patients with acquired immunodeficiency syndrome. J Clin Microbiol, 28:926-929.
