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An alternative method for sputum storage and transport for Mycobacterium tuberculosis drug resistance surveys

Authors: Lumb, R.1; Ardian, M.2; Waramori, G.3; Syahrial, H.4; Tjitra, E.4; Maguire, G. P.5; Anstey, N. M.6; Kelly, P. M.6

Source: The International Journal of Tuberculosis and Lung Disease, Volume 10, Number 2, February 2006 , pp. 172-177(6)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

SETTING: A district level tuberculosis (TB) programme in Indonesia.

OBJECTIVE: To evaluate whether a single sputum specimen could be stored by refrigeration for an extended period of time, then transported to a reference laboratory and successfully cultured for Mycobacterium tuberculosis.

METHODS: Single sputum specimens were collected from newly diagnosed smear-positive pulmonary TB patients, refrigerated at the study site without addition of 1% cetylpyridinium chloride, batched and sent to the reference laboratory, where they were decontaminated and inoculated into BACTEC MGIT 960 liquid media.

RESULTS: One hundred and seven patients were enrolled. The median specimen storage time was 12 days (range 1–38) and median transportation time was 4 days (2–12). The median time from specimen collection until processing was 18 days (4–42). Only 4 (3.7%) specimens failed to grow Mycobacterium species and M. tuberculosis was isolated from 101 (94.4%) specimens. Six specimens with breakthrough contamination successfully grew M. tuberculosis after a second decontamination procedure.

CONCLUSIONS: Single sputum specimens collected at a remote setting, refrigerated for relatively long periods without preservatives and transported without refrigeration to a reference laboratory can yield a high positive culture rate. These findings offer potential logistic simplification and cost savings for drug resistance surveys in low-resource countries.

Keywords: drug resistance; specimens; sputum; survey; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Institute of Medical & Veterinary Science, Adelaide, South Australia, Australia 2: District Ministry of Health, Timika, Papua Province, Indonesia; International SOS, Timika, Papua Province, Indonesia; and Public Health and Malaria Control Department, PT Freeport Indonesia, Timika, Papua Province, Indonesia 3: Public Health and Malaria Control Department, PT Freeport Indonesia, Timika, Papua Province, Indonesia 4: National Institute of Health Research and Development, Jakarta, Indonesia 5: Menzies School of Health Research, Darwin, Northern Territory, Australia; and Western Australian Country Health Services—Kimberley region, Broome, Australia 6: Menzies School of Health Research, Darwin, Northern Territory, Australia; and Institute of Advanced Studies, Charles Darwin University, Darwin, Australia

Publication date: February 1, 2006

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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