Atypical Acid-alcohol-fast Bacilli Cultured from Human Urines

During thepastsevenyearsatthis hospital the urines ofallpatients withskeletal tuberculosis have beenexamined atregular intervals witha viewto detecting early renal infection. Ourpractice isto collect thefirst specimens passed onthree successive mornings insterile jars.Thesespecimens are centrifuged insterile tubesandsamples ofthe deposits examined forpus andredcells andfor acid-alcohol-fast bacilli. Thedeposits arestored at -10°C.until three havebeenexamined, thenthey arepooled, thepooltreated byPetroff's method andportions ofthepoolinoculated on tomedia andinto a guinea-pig. Inthecourseofthisworkacid-alcohol bacilli haveappeared on culture mediawhichdo not appeartobeM. tuberculosis or any ofthewellknownsaprophytes. Thesemycobacteria (for we believe themtobeso)were notstudied indetail until theyappeared ina sequenceofurines from eight patients during January andFebruary, 1954. Thisseries allappeared tobelong tothesame species withtheexception oftwo chromogens. InJanuary andFebruary, 1955, theurines of 21patients, andinOctober andNovember, 1955, theurines of16patients, were foundtocontain a similar organism. Theappearanceandthedisappearanceofthesemycobacteria couldnotbe explained byanychange inthemethodofcollection, inprocedure, orinpersonnel. Twopatients whose urine contained themwere out-patients andpassed their urine intothesterile jarssupplied bythe laboratory without attending thewards. A prolonged search hasbeenmadetotrack down thesourceofthese mycobacteria without success. TheLiwenstein mediahavebeenrepeatedly examined forcontamination atsource. Cultures were made ofwashings oftheglassware andofthereagents usedfromthetimepatients passtheir urine tothe timeitisinoculated ontotheL6wenstein me-dia. Thesearch hasbeenfruitless. Pus,synovial fluid, andotherliquid material sentfromthewardsfor bacteriological examination hasnot beencontaminated tothesameextent, thougha similar organism wasresponsible forafalse interpretation ofasensitivity test ofM.tuberculosis. Incidence ofAcid-alcohol-fast Mycobacteria Theincidence hasbeenoftheorder of0.500 of pooled urine deposits, themajority beinginthe three series already mentioned. Theaverage incubation period before growth appeared onLiwenstein's mediumonprimary isolation differed slightly in these three groups: Series Period Cultures