A STUDY ON PULMONARY DISEASE ASSOCIATED WITH MYCOBACTERIA OTHER THAN MYCOBACTERIUM TUBERCULOSIS - IDENTIFICATION AND CHARACTERIZATION OF MYCOBACTERIA .18. A REPORT OF VETERANS ADMINISTRATION-ARMED FORCES COOPERATIVE STUDY

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Abstract
A study to increase understanding of pulmonary disease in which there appears to be an etiologic relationship with mycobacteria other than M. tuberculosis was conducted by the U.S. Veterans Administration-Armed Forces Cooperative Study hospitals. Isolation and characterization of the mycobacteria from each patient was fundamental to the study; and the strains isolated were characterized on the basis of their morphology, biochemical reactions, phage-susceptibility patterns, and by serotyping. Of the 576 myco-bacterial strains received, 14 were strains of M. tuberculosis and 513 (91%) of the remaining 562 showed clearcut patterns indicating group identification. Of the 391 out of 562 mycobacterial strains obtained 240 were found to belong to Group I, 3 to Group II, 114 to Group HI, and 19 to Group IV. Only 15 cultures failed to clearly fit 1 of the 4 groups; and a portion of these 15 appeared to be "unique," possibly intermediate between Groups II and HI. Occasional cultures of Battey bacilli were atypical in that they were unusually pigmented, resistant to oleate, or vigorous in catalase activity. Reliable and reproducible procedures are available for grouping of mycobacteria. The inclusiveness of each group, however, is an indication that in group determination the goal of species identification was not obtained. The Group I cultures studied were distinguished by greater susceptibility to isoniazid, and the majority of these were also susceptible in vitro to ethionamide, cycloserine, streptomycin, and viomycin. Data derived from the small number of Group II strains included in the study suggest that frequently these may be susceptible to streptomycin, viomycin, ethionamide, kanamycin, and PAS. The Group HI and Group IV strains tested showed little in vitro susceptibility to any of the antituberculous drugs used.