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Evaluation of Mycotube, a modified version of Lowenstein–Jensen (LJ) medium, for efficient recovery of Mycobacterium tuberculosis (MTB)

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Abstract

Timely diagnosis of tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is only achieved for ~58% cases. An improved, accurate, time- and cost-effective method for bacteriological confirmation of MTB is necessary. We evaluated Mycotube, a new variant of Lowenstein–Jensen (LJ) culture medium, by comparing it with Mycobacterium Growth Indicator Tube (MGIT) 960 (gold standard), local LJ, and bioMérieux LJ-T in terms of isolation rate and time-to-growth. Pulmonary and extra-pulmonary samples from treatment-naïve suspects (n = 207) were decontaminated by the N-acetyl-l-cysteine-sodium hydroxide method and used to inoculate the four media. Subjective and objective parameters were used for evaluation. Mycotube yielded 140 positive results, compared to 162, 69, and 141 from MGIT, local LJ, and LJ-T, respectively. Of these, 139 (67%) were true-positive results and 1 (0.5%) was false-positive. The mean time-to-growth detection was 17.4 days for Mycotube, compared to 14.5, 28.1, and 16.5 days for MGIT, local LJ, and LJ-T, respectively. The mean time-to-growth for local LJ significantly differed from that for MGIT, but not those for LJ-T and Mycotube. No contamination was observed. Mycotube had a sensitivity of 85.8% and a specificity of 97.8% as compared to MGIT. Mycotube offers good results, comparable with those observed for conventional LJ. It requires only basic laboratory infrastructure. The overall cost of the test should be nearly three times lower than that of MGIT. Mycotube helps with TB diagnosis and generates pure isolates for drug susceptibility testing.

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Acknowledgments

The authors would like to thank the staff of the Mycobacteriology section of the Department of Microbiology of the hospital for their support, as well as the bioMérieux team for their funding support and mentorship.

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Authors and Affiliations

  1. Section of Microbiology, Department of Laboratory Medicine, PD Hinduja Hospital and Medical Research Centre, Mumbai, India

    R. Nambiar, A. Shetty & C. Rodrigues

  2. bioMérieux, 3 route de Port Michaud, 38390, La Balme Les Grottes, France

    S. Chatellier & A. van Belkum

  3. bioMérieux, ZA des Lilas, 5 rue des Aqueducs, BP 10, 69290, Craponne, France

    N. Bereksi

  4. bioMérieux India Private Limited, New Delhi, India

    N. Singh & B. Barua

Authors
  1. R. Nambiar
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  2. S. Chatellier
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  3. N. Bereksi
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  4. A. van Belkum
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  5. N. Singh
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  6. B. Barua
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  7. A. Shetty
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  8. C. Rodrigues
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Corresponding author

Correspondence to R. Nambiar.

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Funding

This study was financially supported by bioMérieux India.

Conflict of interest

Five of the authors (SC, NB, AvB, NS, and BB) are employees of bioMérieux, a company designing, developing, and selling diagnostic tests in the field of infectious diseases. The opinions expressed in this manuscript are those of the authors, which may, in some cases, be different from formal company policy.

Ethical approval

The study design and corresponding documents were approved by the Institutional Ethics Committee of PD Hinduja Hospital and Medical Research Centre, Mumbai,

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Nambiar, R., Chatellier, S., Bereksi, N. et al. Evaluation of Mycotube, a modified version of Lowenstein–Jensen (LJ) medium, for efficient recovery of Mycobacterium tuberculosis (MTB). Eur J Clin Microbiol Infect Dis 36, 1981–1988 (2017). https://doi.org/10.1007/s10096-017-3052-2

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  • DOI: https://doi.org/10.1007/s10096-017-3052-2

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