Application of modern microbiological diagnostic methods for tuberculosis in Macha, Zambia

K. E. Verweij, A. R. Kamerik, J. Van Ingen, J. H. Van Dijk, P. Sikwangala, Philip E Thuma, J. L. Nouwen, D. Van Soolingen

Research output: Contribution to journalArticle

Abstract

SETTING: Macha, Zambia. OBJECTIVE: To assess the benefits of auramine-O staining fluorescence microscopy and Mycobacterial Growth Indicator Tube (MGIT) liquid culture with molecular identification in tuberculosis (TB) diagnostics. DESIGN: One hundred patients suspected of TB were subjected to three sputum sample examinations applying Ziehl-Neelsen (ZN) and auramine-O staining and MGIT culture. Positive cultures were identified using the Geno-Type® CM assay; cultures identified as Mycobacterium tuberculosis complex were the gold standard for a diagnosis of TB. RESULTS: The 100 patients produced 271 sputum samples; of these, 30 patients had positive cultures. M. tuberculosis complex bacilli were isolated in 17 (56.7%) patients, non-tuberculous mycobacteria (NTM) in 11 (36.7%) and other acid-fast bacilli in two. Forty-eight samples (17.7%) were contaminated. Auramine-O detected 16 (57.1%) patients culture-positive for mycobacteria and 12 patients with culture-proven TB, vs. respectively 8 (28.6%, P = 0.008) and 7 (41.2%, P =0.044) for ZN. Three of eight auramine-positive/ZN- negative patients were culture-positive for NTM only. CONCLUSION: The auramine-O method significantly i ncreases sensitivity, although the higher NTM detection rate implies that this does not in itself lead to a more accurate diagnosis of TB. MGIT culture is highly sensitive, although contamination rates were a drawback; the high frequency of NTM isolation warrants a robust identification method.

Original languageEnglish (US)
Pages (from-to)1127-1131
Number of pages5
JournalInternational Journal of Tuberculosis and Lung Disease
Volume14
Issue number9
StatePublished - Sep 2010
Externally publishedYes

Fingerprint

Zambia
Benzophenoneidum
Tuberculosis
Mycobacterium
Sputum
Mycobacterium tuberculosis
Bacillus
Growth
Staining and Labeling
Fluorescence Microscopy
Acids

Keywords

  • Auramine
  • MGIT
  • Non-tuberculous mycobacteria
  • Tuberculosis
  • Zambia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Verweij, K. E., Kamerik, A. R., Van Ingen, J., Van Dijk, J. H., Sikwangala, P., Thuma, P. E., ... Van Soolingen, D. (2010). Application of modern microbiological diagnostic methods for tuberculosis in Macha, Zambia. International Journal of Tuberculosis and Lung Disease, 14(9), 1127-1131.

Application of modern microbiological diagnostic methods for tuberculosis in Macha, Zambia. / Verweij, K. E.; Kamerik, A. R.; Van Ingen, J.; Van Dijk, J. H.; Sikwangala, P.; Thuma, Philip E; Nouwen, J. L.; Van Soolingen, D.

In: International Journal of Tuberculosis and Lung Disease, Vol. 14, No. 9, 09.2010, p. 1127-1131.

Research output: Contribution to journalArticle

Verweij, KE, Kamerik, AR, Van Ingen, J, Van Dijk, JH, Sikwangala, P, Thuma, PE, Nouwen, JL & Van Soolingen, D 2010, 'Application of modern microbiological diagnostic methods for tuberculosis in Macha, Zambia', International Journal of Tuberculosis and Lung Disease, vol. 14, no. 9, pp. 1127-1131.
Verweij, K. E. ; Kamerik, A. R. ; Van Ingen, J. ; Van Dijk, J. H. ; Sikwangala, P. ; Thuma, Philip E ; Nouwen, J. L. ; Van Soolingen, D. / Application of modern microbiological diagnostic methods for tuberculosis in Macha, Zambia. In: International Journal of Tuberculosis and Lung Disease. 2010 ; Vol. 14, No. 9. pp. 1127-1131.
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abstract = "SETTING: Macha, Zambia. OBJECTIVE: To assess the benefits of auramine-O staining fluorescence microscopy and Mycobacterial Growth Indicator Tube (MGIT) liquid culture with molecular identification in tuberculosis (TB) diagnostics. DESIGN: One hundred patients suspected of TB were subjected to three sputum sample examinations applying Ziehl-Neelsen (ZN) and auramine-O staining and MGIT culture. Positive cultures were identified using the Geno-Type{\circledR} CM assay; cultures identified as Mycobacterium tuberculosis complex were the gold standard for a diagnosis of TB. RESULTS: The 100 patients produced 271 sputum samples; of these, 30 patients had positive cultures. M. tuberculosis complex bacilli were isolated in 17 (56.7{\%}) patients, non-tuberculous mycobacteria (NTM) in 11 (36.7{\%}) and other acid-fast bacilli in two. Forty-eight samples (17.7{\%}) were contaminated. Auramine-O detected 16 (57.1{\%}) patients culture-positive for mycobacteria and 12 patients with culture-proven TB, vs. respectively 8 (28.6{\%}, P = 0.008) and 7 (41.2{\%}, P =0.044) for ZN. Three of eight auramine-positive/ZN- negative patients were culture-positive for NTM only. CONCLUSION: The auramine-O method significantly i ncreases sensitivity, although the higher NTM detection rate implies that this does not in itself lead to a more accurate diagnosis of TB. MGIT culture is highly sensitive, although contamination rates were a drawback; the high frequency of NTM isolation warrants a robust identification method.",
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AU - Kamerik, A. R.

AU - Van Ingen, J.

AU - Van Dijk, J. H.

AU - Sikwangala, P.

AU - Thuma, Philip E

AU - Nouwen, J. L.

AU - Van Soolingen, D.

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N2 - SETTING: Macha, Zambia. OBJECTIVE: To assess the benefits of auramine-O staining fluorescence microscopy and Mycobacterial Growth Indicator Tube (MGIT) liquid culture with molecular identification in tuberculosis (TB) diagnostics. DESIGN: One hundred patients suspected of TB were subjected to three sputum sample examinations applying Ziehl-Neelsen (ZN) and auramine-O staining and MGIT culture. Positive cultures were identified using the Geno-Type® CM assay; cultures identified as Mycobacterium tuberculosis complex were the gold standard for a diagnosis of TB. RESULTS: The 100 patients produced 271 sputum samples; of these, 30 patients had positive cultures. M. tuberculosis complex bacilli were isolated in 17 (56.7%) patients, non-tuberculous mycobacteria (NTM) in 11 (36.7%) and other acid-fast bacilli in two. Forty-eight samples (17.7%) were contaminated. Auramine-O detected 16 (57.1%) patients culture-positive for mycobacteria and 12 patients with culture-proven TB, vs. respectively 8 (28.6%, P = 0.008) and 7 (41.2%, P =0.044) for ZN. Three of eight auramine-positive/ZN- negative patients were culture-positive for NTM only. CONCLUSION: The auramine-O method significantly i ncreases sensitivity, although the higher NTM detection rate implies that this does not in itself lead to a more accurate diagnosis of TB. MGIT culture is highly sensitive, although contamination rates were a drawback; the high frequency of NTM isolation warrants a robust identification method.

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