Adequacy of examining one sputum specimen in tuberculosis drug resistance surveys. Issue 3 (September 2016)

• Record Type: Journal Article
• Authors: Balaji, Subramanyam; Kumar, Vanaja; Seenivasan, Prabu; Radhakrishnan, R.; Sekar, Gomathi; Kannan, Thiruvengadam; Chandrasekaran, Vedhachalam; Swaminathan, Soumya; Selvakumar, Nagamiah
• Is Part Of: International journal of mycobacteriology. Volume 5:Issue 3(2016:Sep.)
• Page Start: 265
• Page End: 268
• Publication Date: 2016-09
• Subjects: Drug resistance survey -- Löwenstein–Jensen media -- Mycobacterium tuberculosis -- Sputum; Mycobacteria -- Periodicals; Mycobacterial diseases -- Periodicals; Mycobacteriaceae; Mycobacteria; Electronic journals; Periodicals; 579.374
• DOI: 10.1016/j.ijmyco.2016.04.002
• Languages: English
• ISSNs: 2212-5531

Abstract

Abstract: Objective/background: Collection of one spot and one morning sputum specimen is recommended for tuberculosis (TB) drug resistance surveys. This was a retrospective analysis of Mycobacterium tuberculosis cultures isolated from two spot sputum specimens collected from smear positive TB patients in a TB drug resistance survey. It was conducted to understand the value of a second specimen. Methods: A TB drug resistance survey was conducted in the state of Tamil Nadu, India, to estimate the prevalence of drug resistance among new sputum smear-positive (NSP) and previously treated (PT) patients diagnosed in Revised National Tuberculosis Control Program microscopy centers. A total of 2425 patients (1524 NSP and 901 PT cases) were enrolled in the study. From these patients, two spot sputum specimens ( C and D ) were collected within a period of 2 h. No preservative was added to sputum. The samples were transported at ambient conditions without cold storage to the central laboratory for culture of M. tuberculosis . Culture yield from each sample was computed and analyzed. Results: The proportion of cultures retrieved from C and D specimens among NSP cases (89.3% and 89.7%) and PT cases (90.8% and 90.3%) were similar. The culture grades of C and D samples were comparable (chi-square test, 3560.135; p < .001) and the agreement was moderate (kappa test, 0.454). Conclusion: The findings of the study reveal the adequacy of single spot sputum specimen from smear positive pulmonary TB patients for bacteriological examination in a quality-assured TB laboratory to determine precisely the level of drug resistance in a province of India.