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Dwivedi H, MacDonald K, Angaali N, Garrett S, Klein J, Savidge T, Jacobs MR, Good CE, Lauzardo M, Patil MA, Garner CD, Pincus DH. Multicenter matched-pair study comparing BACT/ALERT® MP reagent systems for the recovery of mycobacteria from specimens other than blood. Diagn Microbiol Infect Dis 2023; 107:115959. [PMID: 37536260 DOI: 10.1016/j.diagmicrobio.2023.115959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 03/29/2023] [Accepted: 04/16/2023] [Indexed: 08/05/2023]
Abstract
The BACT/ALERT® MP Reagent System is a broth culture medium for optimal detection and recovery of mycobacteria from clinical samples. The MP formulation was recently modified to improve detection and recovery times. A multicenter prospective matched pair study design was conducted to validate the performance of improved MP (MP-I) versus current MP (MP-C) bottles utilizing nonsterile and normally sterile samples, except blood, from patients suspected of having mycobacterial infections. A total of 1488 clinical samples were collected to obtain 212 mycobacteria samples by either or both MP culture bottles. MP-I and MP-C sensitivities were 86.6% and 81.4%, respectively, but the difference was not significant (P = 0.163) while specificities were 96.8% and 93.8%, respectively, and that difference was significant (P = 0.002). Overall recovery was 94.34% for MP-I and 88.68% for MP-C (recovery was 100% for both bottles with 52 seeded samples). Overall performance of MP-I was better than MP-C for sensitivity, specificity, and recovery.
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Affiliation(s)
- Hari Dwivedi
- Global Medical Affairs-Microbiology, BioMérieux, Inc., Hazelwood, MO, USA.
| | | | - Neelima Angaali
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Sheri Garrett
- Clinical Affairs, BioMérieux, Inc., Hazelwood, MO, USA
| | - Jenna Klein
- R&D Microbiology, BioMérieux, Inc., Durham, NC, USA
| | - Theresa Savidge
- Mycobacteriology Laboratory, National Jewish Health, Denver, CO, USA
| | - Michael R Jacobs
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Caryn E Good
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Michael Lauzardo
- Department of Medicine, UF Emerging Pathogens Institute, Gainesville, FL, USA
| | - M A Patil
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Cherilyn D Garner
- Global Medical Affairs-Microbiology, BioMérieux, Inc., Hazelwood, MO, USA
| | - David H Pincus
- Global Medical Affairs-Microbiology, BioMérieux, Inc., Hazelwood, MO, USA
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Orvankundil S, Jose B, Yacoob F, Sreenivasan S. Culture positivity of smear negative pulmonary and extrapulmonary tuberculosis- A study from North Kerala, India. J Family Med Prim Care 2019; 8:2903-2907. [PMID: 31681664 PMCID: PMC6820437 DOI: 10.4103/jfmpc.jfmpc_424_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/06/2019] [Accepted: 07/12/2019] [Indexed: 11/29/2022] Open
Abstract
Introduction: The identification of smear negative pulmonary and extrapulmonary tuberculosis continues to remain a diagnostic challenge. This study was conducted in a tertiary care setup in north Kerala to isolate and identify mycobacteria by culture from radiologically and clinically suspected cases of smear negative pulmonary and extrapulmonary tuberculosis. Methods: A total of 200 samples (100 pulmonary and 100 extrapulmonary) were processed and cultured by automated (MB/BacT) and conventional methods. Heat stable catalase test, nitrate reduction test and detection of MPT 64 antigen were done to aid species identification. Results: Overall culture positivity was 7% (14 isolates - 8 pulmonary and 6 extrapulmonary) of which 92.9% (13) of the isolates were Mycobacterium tuberculosis and 7.1% (1) was Mycobacterium fortuitum (identified by molecular typing). Detection rate by automated method was 7% (14) and by conventional method was only 1.5% (3). Conclusion: Despite its shortcomings and low positivity, culture still remains the gold standard for the diagnosis of EPTB and SNPT. However, automated liquid cultures have better isolation rates than the conventional LJ culture. Subjecting these isolates to rapid diagnostic tests like antigen detection and LPA can aid in the early institution of appropriate treatment regimen.
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Diriba G, Kebede A, Yaregal Z, Getahun M, Tadesse M, Meaza A, Dagne Z, Moga S, Dilebo J, Gudena K, Hassen M, Desta K. Performance of Mycobacterium Growth Indicator Tube BACTEC 960 with Lowenstein-Jensen method for diagnosis of Mycobacterium tuberculosis at Ethiopian National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia. BMC Res Notes 2017; 10:181. [PMID: 28486950 PMCID: PMC5424417 DOI: 10.1186/s13104-017-2497-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 04/25/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bacteriological confirmed active case detection remains the corner stone for diagnosing tuberculosis. Non-radiometric liquid culture system Mycobacterium Growth Indicator Tube with automated interface had been recommended by expert groups in addition to conventional solid culture media such as Lowenstein-Jensen. However in high burden resource limited countries advanced non-radiometric based tuberculosis diagnostic methods such as MGIT 960 is limited. Therefore we have evaluated the performance of MGIT 960 system compared to LJ for recovery of Mycobacterium complex (MTBC) from clinical specimens. METHODS A cross sectional study was conducted from a total of 908 samples between January 1st, 2013 to December 31st, 2014. Clinical specimens were processed following standard procedures and the final suspension was inoculated to MGIT tubes and LJ slant. Identification and confirmation of MTBC was done by ZN staining and SD Bioline test. Data was analyzed by SPSS version 20. The sensitivity, specificity, recovery rate and the average turnaround time to recover the organism was computed. RESULTS From a total of 908 clinical specimens processed using both LJ and BACTEC MGIT liquid culture methods the recovery rate for LJ and MGIT, for smear positive samples was 66.7% (74/111) and 87.4% (97/ 111) respectively while for smear negative samples was 13.4% (108/797) and 17.4% (139/797) for LJ and MGIT methods respectively. The overall recovery rate for MGIT is significantly higher than LJ methods [26% (236/908; vs. 20%, 182/908, P = 0.002)]. The average turnaround time for smear positive samples was 16 and 31 days for MGIT and LJ respectively. Turnaround time for smear negative samples was 20 and 36 days for MGIT and LJ respectively. The overall agreement between MGIT and LJ was fairly good with Kappa value of 0.59 (P < 0.001). In the present study the contamination rate for MGIT is higher than the LJ methods, 15 and 9.3% respectively. CONCLUSIONS The BACTEC MGIT liquid culture system has better MTBC recovery rate with shorter turnaround time for both smear positive and negative clinical specimens compared to Conventional LJ method. However, efforts should be made in order to reduce the high contamination rate in BACTEC MGIT system and to lesser extent to LJ methods.
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Affiliation(s)
- Getu Diriba
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia. .,School of Laboratory Science, College of Allied Science, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Abebaw Kebede
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | - Abyot Meaza
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Zekarias Dagne
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Shewki Moga
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Jibril Dilebo
- School of Laboratory Science, College of Allied Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kebebe Gudena
- School of Laboratory Science, College of Allied Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mulu Hassen
- Department of Laboratory Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Laboratory Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Cui Z, Wang J, Zhu C, Huang X, Lu J, Wang Q, Chen Z, Wang J, Zhang Y, Gu D, Jing L, Chen J, Zheng R, Qin L, Yang H, Jin R, Liu Z, Bi A, Liu J, Hu Z. Evaluation of a novel biphasic culture medium for recovery of mycobacteria: a multi-center study. PLoS One 2012; 7:e36331. [PMID: 22558436 PMCID: PMC3338644 DOI: 10.1371/journal.pone.0036331] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 03/31/2012] [Indexed: 11/30/2022] Open
Abstract
Background Mycobacterial culture and identification provide a definitive diagnosis of TB. Culture on Löwenstein-Jensen (L-J) medium is invariably delayed because of the slow growth of M. tuberculosis on L-J slants. Automated liquid culture systems are expensive. A low-cost culturing medium capable of rapidly indicating the presence of mycobacteria is needed. The aim of this study was to develop and evaluate a novel biphasic culture medium for the recovery of mycobacteria from clinical sputum specimens from suspected pulmonary tuberculosis patients. Methods and Findings The biphasic medium consisted of 7 ml units of L-J slant medium, 3 ml units of liquid culture medium, growth indicator and a mixture of antimicrobial agents. The decontamination sediments of sputum specimens were incubated in the biphasic culture medium at 37°C. Mycobacterial growth was determined based on the appearance of red granule sediments and the examination using acid-fast bacilli (AFB). The clinical sputum specimens were cultured in the biphasic medium, on L-J slants and in the Bactec MGIT 960 culture system. Among smear-positive specimens, the mycobacteria recovery rate of the biphasic medium was higher than that of the L-J slants (P<0.001) and similar to that of MGIT 960 (P>0.05). Among smear-negative specimens, the mycobacterial recovery rate of the biphasic medium was higher than that of L-J slants (P<0.001) and lower than that of MGIT 960 (P<0.05). The median times to detection of mycobacteria were 14 days, 20 days and 30 days for cultures grown in MGIT, in biphasic medium, on L-J slants for smear negative specimens, respectively (P<0.001). Conclusions The biphasic culture medium developed in this study is low-cost and suitable for mycobacterial recovery. It does not require any expensive detection instrumentation, decreases the time required for detection of M. tuberculosis complex, and increases the detection rate of M. tuberculosis complex.
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Affiliation(s)
- Zhenling Cui
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Jie Wang
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Changtai Zhu
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
- Department of Laboratory Medicine, Changzhou Tumor Hospital, Soochow University, Changzhou, China
| | - Xiaochen Huang
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Junmei Lu
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Qing Wang
- Anhui Province Chest Hospital, Hefei, China
| | | | | | - Yan Zhang
- Hangzhou Red Cross Hospital, Hangzhou, China
| | - Delin Gu
- The Sixth People Hospital of Nantong, Nantong, China
| | - Lingjie Jing
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Jin Chen
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Ruijuan Zheng
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Lianhua Qin
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Hua Yang
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Ruiliang Jin
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Zhonghua Liu
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Aixiao Bi
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
| | - Jinming Liu
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
- * E-mail: (JL); (ZH)
| | - Zhongyi Hu
- Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Medical School, Tongji University, Shanghai, China
- * E-mail: (JL); (ZH)
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Munseri PJ, Talbot EA, Bakari M, Matee M, Teixeira JP, von Reyn CF. The bacteraemia of disseminated tuberculosis among HIV-infected patients with prolonged fever in Tanzania. ACTA ACUST UNITED AC 2011; 43:696-701. [DOI: 10.3109/00365548.2011.577802] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ganoza CA, Ricaldi JN, Chauca J, Rojas G, Munayco C, Agapito J, Palomino JC, Guerra H. Novel hypertonic saline-sodium hydroxide (HS-SH) method for decontamination and concentration of sputum samples for Mycobacterium tuberculosis microscopy and culture. J Med Microbiol 2008; 57:1094-1098. [PMID: 18719178 DOI: 10.1099/jmm.0.2008/001339-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This study evaluated a new decontamination and concentration (DC) method for sputum microscopy and culture. Sputum samples from patients with suspected pulmonary tuberculosis (TB) (n=106) were tested using the proposed hypertonic saline-sodium hydroxide (HS-SH) DC method, the recommended N-acetyl-L-cysteine-sodium citrate-sodium hydroxide (NALC-NaOH) DC method and unconcentrated direct smear (Ziehl-Neelsen) techniques for the presence of mycobacteria using Löwenstein-Jensen culture and light microscopy. Of 94 valid specimens, 21 (22.3%) were positive in culture and were further characterized as Mycobacterium tuberculosis. The sensitivity for acid-fast bacilli (AFB) smears was increased from 28.6% using the direct method to 71.4% (HS-SH) and 66.7% (NALC-NaOH) using DC methods. Both concentration techniques were highly comparable for culture (kappa=0.794) and smear (kappa=0.631) for AFB. Thus the proposed HS-SH DC method improved the sensitivity of AFB microscopy compared with a routine unconcentrated direct smear; its performance was comparable to that of the NALC-NaOH DC method for AFB smears and culture, but it was methodologically simpler and less expensive, making it a promising candidate for evaluation by national TB control programmes in developing countries.
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Affiliation(s)
- Christian A Ganoza
- Laboratorio de Microbiología Clínica, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jessica N Ricaldi
- Laboratorio de Microbiología Clínica, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - José Chauca
- Laboratorio de Microbiología Clínica, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Gabriel Rojas
- Laboratorio de Microbiología Clínica, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - César Munayco
- Laboratorio de Micobacteriología, Oficina General de Epidemiología, Ministerio de Salud, Lima, Peru
| | - Juan Agapito
- Programa Nacional para el Control de la Tuberculosis, Hospital Nacional Cayetano Heredia, Lima, Peru
| | - Juan Carlos Palomino
- Mycobacteriology Unit, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium
| | - Humberto Guerra
- Laboratorio de Microbiología Clínica, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
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O'Sullivan DM, Sander C, Shorten RJ, Gillespie SH, Hill AVS, McHugh TD, McShane H, Tchilian EZ. Evaluation of liquid culture for quantitation of Mycobacterium tuberculosis in murine models. Vaccine 2007; 25:8203-5. [PMID: 17980937 DOI: 10.1016/j.vaccine.2007.09.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Accepted: 09/12/2007] [Indexed: 11/18/2022]
Abstract
Quantitation of bacterial load in tissues is essential for experimental investigation of Mycobacterium tuberculosis infection and immunity. We have used an automated liquid culture system to determine the number of colony forming units (CFU) in murine tissues and compared the results to those obtained by conventional plating on Middlebrook agar. There is an overall good correlation between results obtained by the two methods. Although less consistency and more contamination was observed in the automated liquid culture, the method is more sensitive, less labour intensive and allows the processing of large numbers of samples.
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