Blood Agar can be an Effective Alternate Media for Solid Culture of Mycobacterium tuberculosis in Resource-poor Settings, a Report from Warangal, India
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 5, Issue 10
Abstract
Introduction: Tuberculosis (TB) diagnosis is mainly based on clinical features and demonstration of Mycobacterium tuberculosis (MTb) under microscopy or culture. Solid culture is considered to be gold standard tool in diagnosing MTb. Preparation of Lowenstein and Jensen (LJ) medium for solid culture is time taking and costly. Purpose: Our cross-sectional study attempts to identify the utility of blood agar (BA) against LJ as medium for solid culture toward reducing cost and time of procedure. Materials and Methods: Sputum samples were collected at District TB Center, Warangal, Karunapuram Care and Treatment Center for people living with HIV, and processed at Shivani College of Pharmacy in a biosafety Level II laboratory. Sheep BA, LJ, and Middlebrook 7H9 liquid media were used. Samples were homogenized using N-acetyl L-cysteine (NALC) NaOH method; inoculums prepared and processed in the media, incubated at 37°C, and were observed daily for visible growth through naked eyes. DNAs were extracted from all the colonies from BA and sequence confirmed for MTb. Time taken in the growth of MTb and cost were compared for each media. Results: Sputum samples from 400 TB suspects were tested which included 250 HIV-negative presumptive TB and 150 HIV-TB coinfected. Of 250 HIV-negative samples, 73 were culture positive in liquid culture, 65 on LJ medium, and 61 on BA medium. Of 150 HIV-TB coinfected cases, it was 40, 35, and 37, respectively. The highest yield of MTb in BA was before 10 days compared to >50 days with LJ medium. Conclusion: BA can be preferred over LJ medium with equal efficacy for the growth of MTb irrespective of HIV status. Lower cost and shorter incubation period of BA may overweigh LJ medium in resource-limited settings.
Authors and Affiliations
Sireesha Tanniru, Lavanya Poonem, Mamatha Padde, Father Jyothish, Chakrapani Chatla, Suryaprakash Chakramahanti, Malathi Jojula
Keywords
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