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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,dagger

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.

dagger 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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