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PLoS One. 2011;6(11):e27017. doi: 10.1371/journal.pone.0027017. Epub 2011 Nov 4.

The role of speciation in positive Lowenstein-Jensen culture isolates from a high tuberculosis burden country.

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1
Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.

Abstract

OBJECTIVE:

To determine the need for routine speciation of positive Lowenstein-Jensen mycobacterial cultures in HIV-infected patients suspected of having pulmonary tuberculosis at Mulago Hospital in Kampala, Uganda.

METHODS:

Sputum and bronchoalveolar lavage Lowenstein-Jensen mycobacterial culture isolates from consecutive, HIV-infected patients admitted to Mulago Hospital with 2 weeks or more of cough were subjected to IS6110 PCR and rpoB genetic analysis to determine the presence of Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM).

RESULTS:

Eighty (100%) mycobacterial cultures from 65 patients were confirmed to be members of MTBC. Subsequent analysis of the cultures from 54 patients by PCR and sequence analyses to identify co-infection with NTM confirmed the presence of MTBC as well as the presence of Micrococcus luteus (n = 4), Janibacter spp. (n = 1) and six cultures had organisms that could not be identified.

CONCLUSIONS:

Presumptive diagnosis of tuberculosis on the basis of a positive Lowenstein-Jensen culture is sufficient in HIV-infected Ugandans suspected of having tuberculosis. Routine molecular confirmation of positive Lowenstein-Jensen cultures is unnecessary in this low resource setting.

PMID:
22073241
PMCID:
PMC3208568
DOI:
10.1371/journal.pone.0027017
[Indexed for MEDLINE]
Free PMC Article
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