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Journal of Clinical Microbiology, March 2003, p. 1010-1015, Vol. 41, No. 3
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.3.1010-1015.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Conventional Methods versus 16S Ribosomal DNA Sequencing for Identification of Nontuberculous Mycobacteria: Cost Analysis

Victoria J. Cook,1 Christine Y. Turenne,2* Joyce Wolfe,2,3 Ryan Pauls,4 and Amin Kabani2,3,4

Department of Internal Medicine,1 Faculty of Medicine, University of Manitoba,4 National Reference Center for Mycobacteriology, National Microbiology Laboratory, Population and Public Health Branch, Health Canada,2 Department of Clinical Microbiology, Health Sciences Center, Winnipeg, Manitoba, Canada3

Received 29 July 2002/ Returned for modification 18 September 2002/ Accepted 12 December 2002

The clinical profile of nontuberculous mycobacteria (NTM) has been raised by the human immunodeficiency virus and AIDS pandemic. Different laboratory techniques, often molecular based, are available to facilitate the rapid and accurate identification of NTM. The expense of these advanced techniques has been questioned. At the National Reference Center for Mycobacteriology and the Health Sciences Center, University of Manitoba, in Winnipeg, Canada, we performed a direct cost analysis of laboratory techniques for commercial DNA probe-negative (Gen-Probe, Inc., San Diego, Calif.), difficult-to-identify NTM. We compared the costs associated with conventional phenotypic methodology (biochemical testing, pigment production, growth, and colony characteristics) and genotypic methodology (16S ribosomal DNA [rDNA] sequence-based identification). We revealed a higher cost per sample with conventional methods, and this cost varied with organism characteristics: $80.93 for slowly growing, biochemically active NTM; $173.23 for slowly growing, biochemically inert NTM; and $129.40 for rapidly growing NTM. The cost per sample using 16S rDNA sequencing was $47.91 irrespective of organism characteristics, less than one-third of the expense associated with phenotypic identification of biochemically inert, slow growers. Starting with a pure culture, the turnaround time to species identification is 1 to 2 days for 16S rDNA sequencing compared to 2 to 6 weeks for biochemical testing. The accuracy of results comparing both methodologies is briefly discussed. 16S rDNA sequencing provides a cost-effective alternative in the identification of clinically relevant forms of probe-negative NTM. This concept is not only useful in mycobacteriology but also is highly applicable in other areas of clinical microbiology.

* Corresponding author. Mailing address: National Reference Center for Mycobacteriology, National Microbiology Laboratory, Canadian Science Center for Human and Animal Health, 1015 Arlington St., Winnipeg, Manitoba, Canada R3E 3R2. Phone: (204) 789-6081. Fax: (204) 789-2036. E-mail: cturenne{at}hc-sc.gc.ca.

Journal of Clinical Microbiology, March 2003, p. 1010-1015, Vol. 41, No. 3
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.3.1010-1015.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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