Biomedical subjects
Publications and source records attributed to C H Collins.
BCG isolated from clinical material may be reliably differentiated from other variants within the species Mycobacterium tuberculosis by means of a few simple cultural and biochemical tests and by bacteriophage typing. Animal pathogenicity tests may therefore be avoided.
Strains of Mycobacterium tuberculosis were obtained from 65 patients with pulmonary tuberculosis resident in Uganda, and from pulmonary and extrapulmonary tuberculosis in 42 British patients of European ethnic stock and in 67 Asian immigrants, often from Uganda, resident in Britain. The bacteriophage-type patterns of the African, British and Asian strains were different. The pattern for the Asian strains resembled that found previously in patients from South India, suggesting that there has been little interchange of organisms between the Asian community and the African and British communities alongside whom they have lived. The patterns for pulmonary and extra-pulmonary tuberculosis were similar. Strains of bacteriophage type 1, mainly obtained from Asians, were characterized by a greater susceptibility to the bactericidal activity of hydrogen-peroxide and/or a greater sensitivity to thiophen-2-carbonic acid hydrazide than strains of other types.
The species Mycobacterium tuberculosis may be subdivided by its susceptibility to lysis by bacteriophages. In this study 300 strains have been typed with six phages to determine the prevalence of various phage types in South East England. The distribution of the phage types is considered in relation to the patients' racial origins and the clinical presentation of disease, whether pulmonary or extrapulmonary. The technical aspects of phage typing are described and modifications of existing techniques are discussed.
Two unusual cases of subacute necrotizing encephalopathy are described. In one, a marked hirsutism led to a suspicion of adrenal tumor or other endocrinopathy. In the other case, there was an agenesis of the corpus callosum, the second instance in which a malformation of the corpus callosum was associated with this condition. Electron micrographs from a case of Leigh's disease showed examples of marked axonal swelling and occasional splitting of the lamellae of the myelin sheath, probably responsible for the spongy state seen under light microscopy. That such marked changes were not seen in the "internal control" tended to exclude postmortem changes. The ultrastructure and histologic structure of striated muscle appeared normal in the one case examined.
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An increase in the number of isolations of Mycobacterium xenopei from sputum suggested environmental contamination. The organism was recovered from water taps in 61 of 111 pairs of hot and cold water taps in one hospital, 20 of the 74 pairs in another hospital, but from only 3 of 61 pairs of taps in a third hospital and two of 34 pairs in private houses. Scotochromogens were recovered from taps in the first two hospitals only, and M. kansasii was isolated twice from the same tap in the first hospital. No mycobacteria were isolated from pigeon droppings or viscera, nor from patients' tooth brushes, tooth powder or razor debris. The source of contamination is not known.
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Anonymous mycobacteria can be classified into 10 groups by methods and media usually available in the clinical bacteriology department. These groups are given names which reflect the species they are thought to contain or an important cultural characteristic.
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