Srisuwanvilai La-Ong, Monkongdee Patama, Podewils Laura Jean, Ngamlert Keerataya, Pobkeeree Vallerut, Puripokai Panitchaya, Kanjanamongkolsiri Photjanart, Subhachaturas Wonchat, Akarasewi Pasakorn, Wells Charles D, Tappero Jordan W, Varma Jay K
Health Laboratory Division, Department of Health, Bangkok Metropolitan Health Administration, Bangkok, Thailand 10330.
Diagn Microbiol Infect Dis. 2008 Aug;61(4):402-7. doi: 10.1016/j.diagmicrobio.2008.02.015. Epub 2008 Apr 25.
Controlled trials have demonstrated that liquid media culture (LMC) is superior to solid media culture for diagnosis of Mycobacterium tuberculosis (MTB), but there is limited evidence about its performance in resource-limited settings. We evaluated the performance of LMC in a demonstration project in Bangkok, Thailand. Sputum specimens from persons with suspected or clinically diagnosed tuberculosis were inoculated in parallel on solid (Lowenstein-Jensen [LJ]) and liquid (mycobacterial growth indicator tube [MGIT 960]) media. Biochemical tests identified isolates as MTB or nontuberculosis mycobacteria (NTM). Of 2566 specimens received from October 2004 to September 2006, 1355 (53%) were culture positive by MGIT compared with 1013 (39%) by LJ. Median time to growth for MGIT was significantly less than LJ: 11 versus 27 days. Of 1417 isolates detected by at least 1 media, 1255 (86%) were identified as MTB and 162 (11%) NTM. MGIT improved speed and sensitivity of MTB isolation and drug susceptibility testing, regardless of HIV status.
对照试验已证明，液体培养基培养（LMC）在诊断结核分枝杆菌（MTB）方面优于固体培养基培养，但关于其在资源有限环境中的性能证据有限。我们在泰国曼谷的一个示范项目中评估了LMC的性能。将疑似或临床诊断为结核病患者的痰液标本同时接种在固体（罗-琴[LJ]）和液体（分枝杆菌生长指示管[MGIT 960]）培养基上。生化试验将分离株鉴定为MTB或非结核分枝杆菌（NTM）。在2004年10月至2006年9月收到的2566份标本中，MGIT培养阳性的有1355份（53%），而LJ培养阳性的有1013份（39%）。MGIT的中位生长时间明显短于LJ：分别为11天和27天。在至少一种培养基检测到的1417株分离株中，1255株（86%）被鉴定为MTB，162株（11%）为NTM。无论HIV感染状况如何，MGIT都提高了MTB分离和药敏试验的速度及敏感性。
