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Abstract
Background
We evaluated BacT/ALERT 3D liquid culture system (bioMérieux, USA) and PCR-restriction fragment length polymorphism (RFLP) for recovery and direct identification of mycobacteria, and the results were compared with a conventional culture system using an egg-based solid medium.
Methods
A total of 3,037 bronchial specimens (2,309 bronchial washing fluids and 728 bronchoalveolar lavages) were collected. Decontaminated specimens were inoculated to both BacT/ALERT MP liquid media and Ogawa solid media (3%, Shinyang, Korea). Recovery rate and detection time were compared between the two systems. Liquid media from positive cultures were centrifuged and the pellets were tested for direct identification of mycobacteria by PCR-RFLP using Myco-ID (M&D Inc., Korea).
Results
A total of 518 isolates, including 215 M. tuberculosis (MTB) and 303 non-tuberculosis mycobacteria (NTM), were recovered. The liquid media detected 492 isolates (16.2%), including 195 MTB and 297 NTM), whereas the solid media detected 416 isolates (13.7%), including 187 MTB and 229 NTM (P＜0.001); 102 isolates (28 MTB and 74 NTM) were recovered only by the liquid media, while 26 (20 MTB and 6 NTM) isolates were recovered only by the solid media. The mean time to detection was 18.1 days by the liquid media and 29.3 days by the solid media (P＜0.001). The overall time to species identification from inoculation was 21.8 days. Direct PCR-RFLP from the liquid media identified 39.1% of MTB, 6.3% of M. avium, 19.05 of M. abscessus, and 12.6% of M. intracellulare respectively.
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Table 1.
Isolations of mycobacteria from 3,037 specimens
| Method | BacT/ALERT liquid media | ||||||
|---|---|---|---|---|---|---|---|
| Egg-based solid media | Result | MTB | NTM | Total | |||
| ＋ | − | ＋ | − | ＋ | − | ||
| ＋ − | 167 28 | 20 2,822 | 223 74 | 6 2,734 | 390 102 | 26 2,519 | |
| P-value | 0.312 | ＜0.001 | ＜0.001 | ||||
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