Optimizing mycobacterial culture in smear- negative, human immunodeficiency virus- infected tuberculosis cases

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dc.contributor.authorIsmail, N. A.en_ZA
dc.contributor.authorSaid, H. M.en_ZA
dc.contributor.authorPinini, Z.en_ZA
dc.contributor.authorOmar, S. V.en_ZA
dc.contributor.authorBeyers, Nuldaen_ZA
dc.contributor.authorNaidoo, P.en_ZA
dc.date.accessioned2016-08-26T08:57:32Z
dc.date.available2016-08-26T08:57:32Z
dc.date.issued2015
dc.descriptionCITATION: Ismail, N. A., et al. 2015. Optimizing mycobacterial culture in smear- negative, human immunodeficiency virus- infected tuberculosis cases. PLoS ONE, 10(11):1-9, doi:10.1371/journal.pone.0141851.
dc.descriptionThe original publication is available at http://journals.plos.org/plosone
dc.description.abstractIntroduction: Tuberculosis (TB) is a significant public health problem and the diagnosis in human immunodeficiency virus (HIV)—infected individuals is challenging. The use of mycobacterial culture remains an important complementary tool and optimizing it has important benefits. We sought to determine the effect of an increase in the number of specimens evaluated, addition of nutritional supplementation to the culture medium, sputum appearance and volume on diagnostic yield and time to detection of pulmonary TB among smear-negative, HIV-infected adults. Methods: In this prospective study conducted at the Tshwane District Hospital and Academic TB Laboratory, Pretoria, South Africa we collected three sputum specimens an hour apart from presumptive TB cases at an antiretroviral treatment site. We analysed specimens from 236 patients. Specimen appearance and volume were recorded. All specimens were processed for culture using both standard and supplemented media. Results: A single specimen identified 79% of PTB cases using standard media; the second and third specimens added 12.5% and 8.3% respectively. Media supplementation, sputum appearance and specimen volume had no effect on culture yield or contamination rates. The mean time to detection was reduced from 19.8 days in standard cultures to 11.8 days in nutrient supplemented cultures (p = 0.002). For every 1 ml increase in sputum volume, time to detection was decreased by a factor of 0.797 (p = 0.011). Conclusion: Use of an inexpensive culture supplement substantially reduced time to detection and could contribute to reducing treatment delay among HIV-infected cases.en_ZA
dc.description.urihttp://journals.plos.org/plosone/article?id=10.1371/journal.pone.0141851
dc.description.versionPublisher's version
dc.format.extent9 pages
dc.identifier.citationIsmail, N. A., et al. 2015. Optimizing mycobacterial culture in smear- negative, human immunodeficiency virus- infected tuberculosis cases. PLoS ONE, 10(11):1-9, doi:10.1371/journal.pone.0141851
dc.identifier.issn1932-6203 (online)
dc.identifier.otherdoi:10.1371/journal.pone.0141851
dc.identifier.urihttp://hdl.handle.net/10019.1/99480
dc.language.isoen_ZAen_ZA
dc.publisherPublic Library of Science
dc.rights.holderAuthors retain copyright
dc.subjectTuberculosis in HIV-positive personsen_ZA
dc.subjectMycobacteria -- Identificationen_ZA
dc.subjectHIV infections -- Diagnosisen_ZA
dc.subjectMycobacteria -- Cultures and culture mediaen_ZA
dc.subjectSaliva -- Testingen_ZA
dc.titleOptimizing mycobacterial culture in smear- negative, human immunodeficiency virus- infected tuberculosis casesen_ZA
dc.typeArticleen_ZA
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