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Int J Dermatol. 2008 Jul;47(7):681-7. doi: 10.1111/j.1365-4632.2008.03675.x.

Comparison of the radiometric BACTEC 460 TB culture system and Löwenstein-Jensen medium for the isolation of mycobacteria in cutaneous tuberculosis and their drug susceptibility pattern.

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  • 1Department of Dermatology & STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.

Abstract

BACKGROUND:

Mycobacterial isolation from cutaneous tuberculosis on Löwenstein-Jensen (L-J) medium has been reported to be low. The radiometric BACTEC 460 TB culture system (BACTEC system) has shown better isolation rates in pulmonary tuberculosis. There has been a progressive increase in the prevalence of multidrug resistance in pulmonary tuberculosis, but similar studies are lacking for cutaneous tuberculosis. Therefore, this study was undertaken to compare mycobacterial isolation on conventional L-J medium vs. the BACTEC system, and to determine the prevalence of multidrug resistance in cutaneous tuberculosis.

METHODS:

Thirty-five untreated, clinically diagnosed, and histopathologically documented patients with cutaneous tuberculosis constituted the study material. Lesional skin biopsy specimens were cultured on both L-J medium and the BACTEC system. The isolates obtained were identified and subjected to sensitivity to rifampicin, isoniazid, ethambutol, and streptomycin using the BACTEC system.

RESULTS:

Twenty-six mycobacterial isolates were recovered from 35 patients. Nine isolates (25.7%) grew on L-J medium after a mean period of 31.5 days, and 22 (62.8%) on the BACTEC system in 17.3 days. All of the isolates were identified as Mycobacterium tuberculosis. Drug susceptibility testing demonstrated 12 isolates to be resistant, seven multidrug resistant.

DISCUSSION:

The BACTEC system demonstrated an improved mycobacterial isolation rate and substantially reduced detection time when compared with L-J medium. The combined isolation rate on both media was 74.3% (26/35), greater than that of either used separately. Drug resistance was observed in 46.2% of isolates.

CONCLUSION:

Radiometric liquid culture medium together with conventional L-J medium may be recommended in practice to enable the institution of appropriate antituberculous therapy modifications in drug-resistant cases of cutaneous tuberculosis.

[PubMed - indexed for MEDLINE]
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