Culture remains the cornerstone of diagnosis for pulmonary tuberculosis, but the fastidiousness of Mycobacterium tuberculosis
may delay culture-based diagnosis for weeks. We evaluated the performance of real-time high-resolution imaging for the rapid
detection of M. tuberculosis colonies growing on a solid medium. A total of 50 clinical specimens, including 42 sputum specimens,
4 stool specimens, 2 bronchoalveolar lavage fluid specimens, and 2 bronchial aspirate fluid specimens were prospectively
inoculated into (i) a commercially available Middlebrook broth and evaluated for mycobacterial growth indirectly detected by
measuring oxygen consumption (standard protocol) and (ii) a home-made solid medium incubated in an incubator featuring
real-time high-resolution imaging of colonies (real-time protocol). Isolates were identified by Ziehl-Neelsen staining and matrix-assisted
laser desorption ionization–time of flight mass spectrometry. Use of the standard protocol yielded 14/50 (28%) M.
tuberculosis isolates, which is not significantly different from the 13/50 (26%) M. tuberculosis isolates found using the real-time
protocol (P 1.00 by Fisher’s exact test), and the contamination rate of 1/50 (2%) was not significantly different from the contamination
rate of 2/50 (4%) using the real-time protocol (P 1.00). The real-time imaging protocol showed a 4.4-fold reduction
in time to detection, 82 54 h versus 360 142 h (P < 0.05). These preliminary data give the proof of concept that real-time
high-resolution imaging of M. tuberculosis colonies is a new technology that shortens the time to growth detection and the laboratory
diagnosis of pulmonary tuberculosis.
My
Culture remains the cornerstone of diagnosis for pulmonary tuberculosis, but the fastidiousness of Mycobacterium tuberculosismay delay culture-based diagnosis for weeks. We evaluated the performance of real-time high-resolution imaging for the rapiddetection of M. tuberculosis colonies growing on a solid medium. A total of 50 clinical specimens, including 42 sputum specimens,4 stool specimens, 2 bronchoalveolar lavage fluid specimens, and 2 bronchial aspirate fluid specimens were prospectivelyinoculated into (i) a commercially available Middlebrook broth and evaluated for mycobacterial growth indirectly detected bymeasuring oxygen consumption (standard protocol) and (ii) a home-made solid medium incubated in an incubator featuringreal-time high-resolution imaging of colonies (real-time protocol). Isolates were identified by Ziehl-Neelsen staining and matrix-assistedlaser desorption ionization–time of flight mass spectrometry. Use of the standard protocol yielded 14/50 (28%) M.tuberculosis isolates, which is not significantly different from the 13/50 (26%) M. tuberculosis isolates found using the real-timeprotocol (P 1.00 by Fisher’s exact test), and the contamination rate of 1/50 (2%) was not significantly different from the contaminationrate of 2/50 (4%) using the real-time protocol (P 1.00). The real-time imaging protocol showed a 4.4-fold reductionin time to detection, 82 54 h versus 360 142 h (P < 0.05). These preliminary data give the proof of concept that real-timehigh-resolution imaging of M. tuberculosis colonies is a new technology that shortens the time to growth detection and the laboratorydiagnosis of pulmonary tuberculosis.My
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