An alternative method for sputum storage and transport for Mycobacterium tuberculosis drug resistance surveys
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.
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: 2006-02-01
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