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Free Content Comparison of four culture systems for Mycobacterium tuberculosis in the Zambian National Reference Laboratory

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SETTING: National TB Reference Laboratory, Zambia.

OBJECTIVE: To compare four TB culture systems when used in a resource-limited setting.

DESIGN: Comparison of four culture systems: automated Mycobacterium Growth Indicator Tube (AMGIT) 960, manual MGIT (MMGIT) and two Löwenstein-Jensen (LJ) culture media—commercial (CLJ) and homemade (HLJ).

RESULTS: A total of 1916 sputum specimens were received, of which 261 (13.6%) were positive on microscopy. Mycobacterium tuberculosis complex (MTC) was isolated on at least one of the media in 410 (21.4%) specimens: MMGIT recovered 336 (17.5%) MTC, AMGIT 329 (17.2%), CLJ 192 (10.0%) and HLJ 184 (9.6%). The median time to detection for smear-negative specimens was 14 days for AMGIT, 16 days for MMGIT and 34 days for both LJ. Isolation of non-tuberculous mycobacteria (NTM) was more frequent in both MGIT systems (3.5%) than in CLJ (0.9%) and HLJ (0.8%). Contamination rates were high: 29.6% on AMGIT, 23.8% on MMGIT, 14.9% on CLJ and 12.5% on HLJ.

CONCLUSION: Despite high contamination rates, either MGIT system considerably improved both the yield and the time to detection of MTC compared to LJ media. Investments in infrastructure and training are needed if culture is to be scaled up in low-income settings such as this.
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Keywords: MGIT; Mycobacteria tuberculosis; Zambia; mycobacteria culture

Document Type: Regular Paper

Affiliations: 1: Zambia AIDS-Related Tuberculosis Project (ZAMBART), University of Zambia School of Medicine, Lusaka, Zambia 2: Zambia AIDS-Related Tuberculosis Project (ZAMBART), University of Zambia School of Medicine, Lusaka, Zambia; and London School of Hygiene and Tropical Medicine, University of London, London, UK 3: Chest Diseases Laboratory, Lusaka, Zambia 4: London School of Hygiene and Tropical Medicine, University of London, London, UK

Publication date: 2009-04-01

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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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