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Journal of Clinical Microbiology, March 2000, p. 1203-1208, Vol. 38, No. 3
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Rapid, Efficient Detection and Drug Susceptibility
Testing of Mycobacterium tuberculosis in Sputum by
Microscopic Observation of Broth Cultures
Luz
Caviedes,1
Tien-Shun
Lee,2
Robert H.
Gilman,1,2,3,*
Patricia
Sheen,1
Emily
Spellman,2
Ellen H.
Lee,4
Douglas E.
Berg,5
Sonia
Montenegro-James,6 and
The Tuberculosis Working Group in
Peru1,
Department of Pathology, Universidad Peruana
Cayetano Heredia,1 and Asociación
Benefica Proyectos en Informatica, Salud, Medicina y Agricultura (AB
PRISMA),2 Lima, Peru; Johns Hopkins
School of Public Health and Hygiene, Baltimore,
Maryland3; State University of New
York
Stony Brook School of Medicine, Stony Brook, New
York4; Washington University, St. Louis,
Missouri5; and Ochsner Medical
Foundation, New Orleans, Louisiana6
Received 28 July 1999/Returned for modification 7 October
1999/Accepted 16 December 1999
Inexpensive, rapid, and reliable methods of detecting infection by
and drug susceptibility of Mycobacterium tuberculosis (MTB) are crucial to the control of tuberculosis. The novel microscopic observation broth-drug susceptibility assay (MODS) detects early growth
of MTB in liquid medium, allowing more timely diagnosis and drug
susceptibility testing. Sputum samples from hospitalized patients in
Peru were analyzed by using stains, culture, and PCR. Sensitivity of
MODS (92%) compared favorably with the most sensitive of the other
culture methods (93%). Sputum samples positive for tuberculosis were
tested for susceptibility to isoniazid and rifampin with the microwell
alamar blue assay (MABA) and MODS. In 89% of cases, there was
concordance between MODS and MABA. Of the diagnostic and susceptibility
testing methods used, MODS yielded results most rapidly (median, 9.0 and 9.5 days, respectively). MODS is a rapid, inexpensive, sensitive,
and specific method for MTB detection and susceptibility testing; it is
particularly appropriate for use in developing countries burdened by
significant infection rates and increasing numbers of
multiple-drug-resistant cases.
*
Corresponding author. Mailing address: Department of
International Health, Johns Hopkins University, School of Public Health and Hygiene, 615 North Wolfe St., Room 3501, Baltimore, MD 21205. Phone: (410) 614-3958. Fax: (410) 614-6060. E-mail:
rgilman{at}jhsph.edu.

Members of the Tuberculosis Working Group in Peru are Patricia
Fuentes, Teresa Valencia, Rosa Chumpitaz, Inex Salas, and S.
Recavarren
(Universidad Peruana Cayetano Heredia, Lima, Peru);
Rosa Cama and Lilia
Cabrera (AB PRISMA, Lima, Peru); L. M. Franchi
(Pediatric Hospital,
Lima, Peru); E. Ticona, L. Ticona, and V.
Chavez (Dos de Mayo Hospital,
Lima, Peru); A. Vivar (Loayza Hospital,
Lima, Peru); S. Rodriguez
(Maria Auxiliadora Hospital, Lima, Peru);
W. Checkley and R. Black
(Johns Hopkins University, Baltimore,
Md.); S. Franzblau (Hansens
Disease Center, Baton Rouge, La.);
J. Friedland (Imperial College,
London, United Kingdom); and C.
Evans (University of Cambridge,
Cambridge, United
Kingdom).
Journal of Clinical Microbiology, March 2000, p. 1203-1208, Vol. 38, No. 3
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
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