Article Figures & Data
Figures
- Fig. 1.
Growth curves of M. tuberculosis ATCC 27294 in reconstitution fluid (A) or PANTA/caz (B) at various concentrations of CB-18.
- Fig. 2.
Growth curves of M. tuberculosis 571/573-S1 in reconstitution fluid (A) or PANTA/caz (B) at various concentrations of CB-18.
- Fig. 3.
Growth curves of M. avium ATCC 25291 in reconstitution fluid (A) or PANTA/caz (B) at various concentrations of CB-18.
- Fig. 4.
Growth curves of M. fortuitum ATCC 6841 in reconstitution fluid (A) or PANTA/caz (B) at various concentrations of CB-18.
- Fig. 5.
Growth curves of 571/573-S1 resuspended in and planted in buffer/RF, buffer/PANTA/caz (P/caz), lecithin/RF, lecithin/PANTA/caz, CB-18/RF, CB-18/PANTA/caz, lecithin (Lec)/CB-18/RF, and lecithin/CB-18/PANTA/caz.
- Fig. 6.
Time-dependent kill curves of M. tuberculosis(MTB) ATCC 27294, M. tuberculosis 571/573-S1, M. avium ATCC 25291, M. kansasii ATCC 12478, and M. fortuitum ATCC 6841 following incubation in 1 mM CB-18.
Tables
- Table 1.
Culture sensitivity and contamination rate comparisons on split specimens processed by NALC/NaOH (4) and different versions of the CB-18 procedure
Processing method or study (n) No. of specimens AFB positive Result by decontamination method NALC/NaOH CB-18 Contamination rate (%) Culture sensitivity (%) Contamination rate (%) Culture sensitivity (%) CB-18 preliminary study (489) 37 5.0 62.2 16.1 81.1 NaOH/CB-18 study (531) 67 6.4 91.0 10.9 56.7 OxAc/CB-18 study (224) 27 5.9 96.3 6.7 37.0 CB-18 pilot study (573) 106 7.5 61.3 20.8 87.7 CB-18/Acid redigestion (119)a 18 16.0 27.7 6.9 22.2 ↵a The 119 specimens described in this study represent the subset of contaminated liquid cultures subjected to CB-18/Acid redigestion in the CB-18 pilot study (24). There were 18 AFB-positive specimens within this group. The corresponding 7H11-selective slants (from the original CB-18-processed specimens) identified 12 of these 18 (66.7%), and NALC/NaOH-processed specimens identified 5 of these 18 (27.7%), whereas CB-18/Acid-redigested specimens identified only 4 of these 18 (22.2%). The contamination rate among NALC/NaOH-processed specimens represents the contamination rate within this subset of 119 specimens, and the contamination rate among the CB-18/Acid-processed specimens represents subsequent contamination among liquid cultures following redigestion.
- Table 2.
Spectrum of contaminants isolated from CB-18-processed respiratory specimens
Identification No. (%) of specimens with resulta Contamination spectrum study; Quest microbiology laboratory CB-18 pilot study LZCT studies All AFB laboratories Quest AFB laboratory Quest microbiology laboratory Quest AFB laboratory Gram negative Pseudomonassp. 11b 31c 9d 13d 1d Providencia stuartii 13 7 Proteus mirabilis 7 1 Alcaligenes sp. 3 2 4 1 Morganella morganii 3 1 2 Serratia marcescens 2 5 3 Klebsiella sp. 3 2 Xanthomonas maltophilia 1 5 Acinetobactersp. 1 3 1 Enterobacter sp. 1 2 Escherichia coli 1 1 Citrobacter freundii 1 Flavobacterium breve 1 Cedecae davisae 1 Nonfermenter 1 Total 48 (84.2) 55 (38.2) 9 (25.7) 30 (73.2) 2 (100) Gram positive Staphylococcus 2 16 3 8 Cocci 3 1 2 Rods 3 10 2 Total 5 (8.8) 29 (20.1) 6 (17.1) 10 (24.4) Yeast 3 (5.3) 50 (34.7)e 17 (48.6) 1 (2.4) Fungal 1 (1.8) 9 (6.2) 3 (8.6) Unknown 1 (0.7)f Total contaminants isolated 57 144 35 41 2 Total specimens contaminated 40 (14.4g) 119 (20.8g) 31 (18.1g) 36 (18.6g) 2 (4.3g) Total specimens processed 277 573 171 194 46 ↵a The contamination spectrum study used CB-18/12B/PANTA, the CB-18 pilot study used CB-18/12B/PANTA/caz, and the LZCT studies used CB-18/LZCT/12B/PANTA/caz.
↵b Of these 11 pseudomonads, 10 were P. aeruginosa.
↵c Of these 31 pseudomonads, 24 were P. aeruginosa.
↵d All of these pseudomonads were P. aeruginosa.
↵e Candida albicans was by far the most common yeast isolate (≈90%).
↵f One isolate was lost before identification and was judged to be bacterial in nature.
↵g Contamination rate (percentage).
- Table 3.
Culture results for statistically significant concentrations of CB-18 (P < 0.05)
Critical parameter for isolate Time [days] to positive result [GI ≥ 15] (CB-18 concn [μg/ml]) Time [days] to max GI [999] (CB-18 concn [μg/ml]) CB-18 concn [μg/ml] with no growth 12B/RF 12B/PANTA/caz 12B/RF 12B/PANTA/caz 12B/RF 12B/PANTA/caz M. tuberculosis ATCC 27294 Control 8.8 ± 0.5a 10.2 ± 0.5 13.5 ± 1.0 16.8 ± 0.5 Time at significant concn of CB-18 >35 35 First 10.5 ± 0.6b (20)c 12.5 ± 1.0 (20) 17.5 ± 0.6 (20) 18.8 ± 0.5 (10) Second 12.5 ± 1.0d (30)e 15.0 ± 1.6 (25) 21.8 ± 2.5 (25) >28 (20) M. tuberculosis 571/573-S1 Control 9.2 ± 0.5 10.8 ± 1.0 15.0 ± 0.0 16.0 ± 0.8 Time at significant concn of CB-18 25 25 First 11.0 ± 0.8 (10) 12.5 ± 1.0 (10) >28 (20) 17.8 ± 0.5 (5) Second 18.2 ± 1.0 (20) >28 (20)f >28 (25) >28 (20) M. avium ATCC 25291 Control 6.0 ± 0.0 8.8 ± 1.0 10.2 ± 0.5 16.8 ± 2.1 Time at significant concn of CB-18 >35 >35 First 7.5 ± 0.6 (30) 11.8 ± 1.0 (15) 11.2 ± 0.5 (15) 21.0 ± 2.4 (15) Second Not tested (>35) 16.0 ± 2.7 (20) 13.8 ± 1.0 (20) >28 (25) M. kansasii ATCC 12478 Control 3.0 ± 0.0 4.5 ± 0.6 7.0 ± 0.0 8.8 ± 0.5 Time at significant concn of CB-18 30 >35 First 4.5 ± 0.6 (20) 5.8 ± 0.3 (25) >28 (25)g 24.0 ± 2.0 (20) Second 6.2 ± 0.5 (25) Not tested (>35) >28 (30) >28 (25) M. fortuitum ATCC 6841 Control 1.0 ± 0.0 1.0 ± 0.0 2.0 ± 0.0 3.2 ± 0.5 Time at significant concn of CB-18 >100 >100 First 2.5 ± 0.6 (30) 6.8 ± 1.7 (30) 4.8 ± 1.7 (30) 5.0 ± 0.8 (10) Second 7.2 ± 0.5 (100) 10.0 ± 1.4 (40) 8.8 ± 1.5 (40) 10.5 ± 1.7 (30) ↵a This is the average time (± standard deviation) to a given result in the absence of CB-18.
↵b This time represents the average time (± standard deviation) to a given result at the lowest CB-18 concentration at which the first statistically significant change occurred.
↵c This is the CB-18 concentration at which the first statistically significant change occurred for a given result relative to the control result.
↵d This time represents the average time (± standard deviation) to a given result at the second statistically significant CB-18 concentration.
↵e This concentration represents the next, or second, statistically significant change that occurred relative to the CB-18 concentration at which the first statistically significant change occurred.
↵f Although the graph of this result appears to be positive, only one of the four replicates became positive during the 4-week incubation.
↵g The time to maximum GI result at 20 μg/ml (17.8 ± 8.8 days) was not significantly different (P = 0.081) from the control result because of the wide replicate-to-replicate variation in this series of bottles.
- Table 4.
Percent survival of 571/573-S1 on 7H11-selective plates at different CB-18 concentrations in the presence or absence of lecithin
Concn (μg/ml) of CB-18 in inoculation solution % Survival (±SD) after inoculation onto 7H11 ina: CB-18/buffer CB-18/lecithin 255 67.7 ± 9.1 92.7 ± 4.1 191 87.9 ± 4.1 100 ± 7.6 77 95.9 ± 2.8 100 ± 9.3 ↵a Bacilli were diluted to 2,385 ± 260 CFU/ml in inoculation solution.
