Comparative performance of Thin Layer Agar and Löwenstein–Jensen culture for diagnosis of tuberculosis
Sputum smear microscopy for the diagnosis of tuberculosis (TB) is cheap and simple but its sensitivity is low. Culture on Löwenstein–Jensen (LJ) is more sensitive but it takes a long time to yield results. Thin-Layer Agar (TLA) culture was suggested as an equally sensitive and faster alternative. We...
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| Veröffentlicht in: | Clinical microbiology and infection 2013-11, Vol.19 (11), p.E502-E508 |
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| creator | Battaglioli, T. Rintiswati, N. Martin, A. Palupi, K.R. Bernaerts, G. Dwihardiani, B. Ahmad, R.A. Matthys, F. Mahendradhata, Y. Van der Stuyft, P. |
| description | Sputum smear microscopy for the diagnosis of tuberculosis (TB) is cheap and simple but its sensitivity is low. Culture on Löwenstein–Jensen (LJ) is more sensitive but it takes a long time to yield results. Thin-Layer Agar (TLA) culture was suggested as an equally sensitive and faster alternative. We evaluated the performance of TLA for diagnosing TB in Jogjakarta, Indonesia. People with suspected TB presenting from July 2010 to July 2011 to two chest clinics of the National TB Control Programme network of Jogjakarta were eligible for inclusion. A sputum sample was sent to the Gadjah Mada University microbiology laboratory for concentration, smearing, Ziehl–Neelsen staining and culture on LJ and TLA. Sensitivity of cultures was evaluated against a composite reference standard (any positive culture). Time to detection of Mycobacteria was recorded. Out of 1414 samples, 164 (12%) were smear positive, 99 (7%) were scanty and 1151 (81%) were negative. On TLA and LJ respectively, 168 (12%) and 149 (11%) samples were positive, 72 (5%) and 32 (2%) were contaminated (κ = 0.64; 95% CI 0.59–0.69, p |
| doi_str_mv | 10.1111/1469-0691.12265 |
| format | Article |
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Culture on Löwenstein–Jensen (LJ) is more sensitive but it takes a long time to yield results. Thin-Layer Agar (TLA) culture was suggested as an equally sensitive and faster alternative. We evaluated the performance of TLA for diagnosing TB in Jogjakarta, Indonesia. People with suspected TB presenting from July 2010 to July 2011 to two chest clinics of the National TB Control Programme network of Jogjakarta were eligible for inclusion. A sputum sample was sent to the Gadjah Mada University microbiology laboratory for concentration, smearing, Ziehl–Neelsen staining and culture on LJ and TLA. Sensitivity of cultures was evaluated against a composite reference standard (any positive culture). Time to detection of Mycobacteria was recorded. Out of 1414 samples, 164 (12%) were smear positive, 99 (7%) were scanty and 1151 (81%) were negative. On TLA and LJ respectively, 168 (12%) and 149 (11%) samples were positive, 72 (5%) and 32 (2%) were contaminated (κ = 0.64; 95% CI 0.59–0.69, p <0.01). Using the reference standard, 196 (14%) TB cases were identified. The sensitivity of TLA was 0.86 (95% CI 0.80–0.90), significantly higher (p 0.03) than for LJ (0.76; 95% CI 0.69–0.81). The median time to detection in days was significantly shorter (p <0.01) for TLA (12; 95% CI 11–13) than for LJ (44; 95% CI 43–45). TLA is a rapid and sensitive method for the diagnosis of TB. Implementation studies to evaluate the cost-effectiveness and impact of its introduction into programmatic settings are urgently needed.</description><identifier>ISSN: 1198-743X</identifier><identifier>EISSN: 1469-0691</identifier><identifier>DOI: 10.1111/1469-0691.12265</identifier><identifier>PMID: 23738759</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Agar ; Aged ; Aged, 80 and over ; Culture ; Culture Media - chemistry ; Female ; Humans ; Indonesia ; Male ; Middle Aged ; Mycobacterium ; Mycobacterium - isolation & purification ; Prospective Studies ; rapid detection ; sensitivity ; Sensitivity and Specificity ; Thin Layer Agar ; Time Factors ; tuberculosis ; Tuberculosis - diagnosis ; Young Adult</subject><ispartof>Clinical microbiology and infection, 2013-11, Vol.19 (11), p.E502-E508</ispartof><rights>2013 European Society of Clinical Infectious Diseases</rights><rights>2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases</rights><rights>2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.</rights><rights>Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4955-b66bbb1897cd9851f5cba8b3e6947671ae17afcb050161a25fbc2d65faecbf013</citedby><cites>FETCH-LOGICAL-c4955-b66bbb1897cd9851f5cba8b3e6947671ae17afcb050161a25fbc2d65faecbf013</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1469-0691.12265$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1469-0691.12265$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23738759$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Battaglioli, T.</creatorcontrib><creatorcontrib>Rintiswati, N.</creatorcontrib><creatorcontrib>Martin, A.</creatorcontrib><creatorcontrib>Palupi, K.R.</creatorcontrib><creatorcontrib>Bernaerts, G.</creatorcontrib><creatorcontrib>Dwihardiani, B.</creatorcontrib><creatorcontrib>Ahmad, R.A.</creatorcontrib><creatorcontrib>Matthys, F.</creatorcontrib><creatorcontrib>Mahendradhata, Y.</creatorcontrib><creatorcontrib>Van der Stuyft, P.</creatorcontrib><title>Comparative performance of Thin Layer Agar and Löwenstein–Jensen culture for diagnosis of tuberculosis</title><title>Clinical microbiology and infection</title><addtitle>Clin Microbiol Infect</addtitle><description>Sputum smear microscopy for the diagnosis of tuberculosis (TB) is cheap and simple but its sensitivity is low. Culture on Löwenstein–Jensen (LJ) is more sensitive but it takes a long time to yield results. Thin-Layer Agar (TLA) culture was suggested as an equally sensitive and faster alternative. We evaluated the performance of TLA for diagnosing TB in Jogjakarta, Indonesia. People with suspected TB presenting from July 2010 to July 2011 to two chest clinics of the National TB Control Programme network of Jogjakarta were eligible for inclusion. A sputum sample was sent to the Gadjah Mada University microbiology laboratory for concentration, smearing, Ziehl–Neelsen staining and culture on LJ and TLA. Sensitivity of cultures was evaluated against a composite reference standard (any positive culture). Time to detection of Mycobacteria was recorded. Out of 1414 samples, 164 (12%) were smear positive, 99 (7%) were scanty and 1151 (81%) were negative. On TLA and LJ respectively, 168 (12%) and 149 (11%) samples were positive, 72 (5%) and 32 (2%) were contaminated (κ = 0.64; 95% CI 0.59–0.69, p <0.01). Using the reference standard, 196 (14%) TB cases were identified. The sensitivity of TLA was 0.86 (95% CI 0.80–0.90), significantly higher (p 0.03) than for LJ (0.76; 95% CI 0.69–0.81). The median time to detection in days was significantly shorter (p <0.01) for TLA (12; 95% CI 11–13) than for LJ (44; 95% CI 43–45). TLA is a rapid and sensitive method for the diagnosis of TB. Implementation studies to evaluate the cost-effectiveness and impact of its introduction into programmatic settings are urgently needed.</description><subject>Adult</subject><subject>Agar</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Culture</subject><subject>Culture Media - chemistry</subject><subject>Female</subject><subject>Humans</subject><subject>Indonesia</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mycobacterium</subject><subject>Mycobacterium - isolation & purification</subject><subject>Prospective Studies</subject><subject>rapid detection</subject><subject>sensitivity</subject><subject>Sensitivity and Specificity</subject><subject>Thin Layer Agar</subject><subject>Time Factors</subject><subject>tuberculosis</subject><subject>Tuberculosis - diagnosis</subject><subject>Young Adult</subject><issn>1198-743X</issn><issn>1469-0691</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc9uFSEUxidGY2t17c6QuHEzLQwDDMvmxr8Z46Ym7ggwh0ozA1eYaXN3voPv4gv4Jn2SMt62CxOjbDjA7_uA81XVc4KPSRknpOWyxlySY9I0nD2oDu93HpaayK4WLf1yUD3J-QJj3FDaPq4OGipoJ5g8rPwmTlud9OwvAW0huZgmHSyg6NDZVx9Qr3eQ0Om5TkiHAfW_fl5ByDP4cP39x4dSQkB2GeclASpiNHh9HmL2eXWYFwOpnK7rp9Ujp8cMz27no-rzm9dnm3d1_-nt-81pX9tWMlYbzo0xpJPCDrJjxDFrdGcocNkKLogGIrSzBjNMONENc8Y2A2dOgzUOE3pUvdr7blP8tkCe1eSzhXHUAeKSVWlQRzuMBf0PtKVtI7FsC_ryD_QiLimUjyjCGskpERgX6mRP2RRzTuDUNvlJp50iWK2BrbdLtcajfgdWFC9ufRczwXDP3yVUALYHrvwIu3_5qU3_8c5Y7nVQen3pIalsPZRkB5_AzmqI_q-PugE1trQw</recordid><startdate>201311</startdate><enddate>201311</enddate><creator>Battaglioli, T.</creator><creator>Rintiswati, N.</creator><creator>Martin, A.</creator><creator>Palupi, K.R.</creator><creator>Bernaerts, G.</creator><creator>Dwihardiani, B.</creator><creator>Ahmad, R.A.</creator><creator>Matthys, F.</creator><creator>Mahendradhata, Y.</creator><creator>Van der Stuyft, P.</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope></search><sort><creationdate>201311</creationdate><title>Comparative performance of Thin Layer Agar and Löwenstein–Jensen culture for diagnosis of tuberculosis</title><author>Battaglioli, T. ; Rintiswati, N. ; Martin, A. ; Palupi, K.R. ; Bernaerts, G. ; Dwihardiani, B. ; Ahmad, R.A. ; Matthys, F. ; Mahendradhata, Y. ; Van der Stuyft, P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4955-b66bbb1897cd9851f5cba8b3e6947671ae17afcb050161a25fbc2d65faecbf013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Agar</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Culture</topic><topic>Culture Media - chemistry</topic><topic>Female</topic><topic>Humans</topic><topic>Indonesia</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mycobacterium</topic><topic>Mycobacterium - isolation & purification</topic><topic>Prospective Studies</topic><topic>rapid detection</topic><topic>sensitivity</topic><topic>Sensitivity and Specificity</topic><topic>Thin Layer Agar</topic><topic>Time Factors</topic><topic>tuberculosis</topic><topic>Tuberculosis - diagnosis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Battaglioli, T.</creatorcontrib><creatorcontrib>Rintiswati, N.</creatorcontrib><creatorcontrib>Martin, A.</creatorcontrib><creatorcontrib>Palupi, K.R.</creatorcontrib><creatorcontrib>Bernaerts, G.</creatorcontrib><creatorcontrib>Dwihardiani, B.</creatorcontrib><creatorcontrib>Ahmad, R.A.</creatorcontrib><creatorcontrib>Matthys, F.</creatorcontrib><creatorcontrib>Mahendradhata, Y.</creatorcontrib><creatorcontrib>Van der Stuyft, P.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical microbiology and infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Battaglioli, T.</au><au>Rintiswati, N.</au><au>Martin, A.</au><au>Palupi, K.R.</au><au>Bernaerts, G.</au><au>Dwihardiani, B.</au><au>Ahmad, R.A.</au><au>Matthys, F.</au><au>Mahendradhata, Y.</au><au>Van der Stuyft, P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative performance of Thin Layer Agar and Löwenstein–Jensen culture for diagnosis of tuberculosis</atitle><jtitle>Clinical microbiology and infection</jtitle><addtitle>Clin Microbiol Infect</addtitle><date>2013-11</date><risdate>2013</risdate><volume>19</volume><issue>11</issue><spage>E502</spage><epage>E508</epage><pages>E502-E508</pages><issn>1198-743X</issn><eissn>1469-0691</eissn><abstract>Sputum smear microscopy for the diagnosis of tuberculosis (TB) is cheap and simple but its sensitivity is low. Culture on Löwenstein–Jensen (LJ) is more sensitive but it takes a long time to yield results. Thin-Layer Agar (TLA) culture was suggested as an equally sensitive and faster alternative. We evaluated the performance of TLA for diagnosing TB in Jogjakarta, Indonesia. People with suspected TB presenting from July 2010 to July 2011 to two chest clinics of the National TB Control Programme network of Jogjakarta were eligible for inclusion. A sputum sample was sent to the Gadjah Mada University microbiology laboratory for concentration, smearing, Ziehl–Neelsen staining and culture on LJ and TLA. Sensitivity of cultures was evaluated against a composite reference standard (any positive culture). Time to detection of Mycobacteria was recorded. Out of 1414 samples, 164 (12%) were smear positive, 99 (7%) were scanty and 1151 (81%) were negative. On TLA and LJ respectively, 168 (12%) and 149 (11%) samples were positive, 72 (5%) and 32 (2%) were contaminated (κ = 0.64; 95% CI 0.59–0.69, p <0.01). Using the reference standard, 196 (14%) TB cases were identified. The sensitivity of TLA was 0.86 (95% CI 0.80–0.90), significantly higher (p 0.03) than for LJ (0.76; 95% CI 0.69–0.81). The median time to detection in days was significantly shorter (p <0.01) for TLA (12; 95% CI 11–13) than for LJ (44; 95% CI 43–45). TLA is a rapid and sensitive method for the diagnosis of TB. Implementation studies to evaluate the cost-effectiveness and impact of its introduction into programmatic settings are urgently needed.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>23738759</pmid><doi>10.1111/1469-0691.12265</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Agar Aged Aged, 80 and over Culture Culture Media - chemistry Female Humans Indonesia Male Middle Aged Mycobacterium Mycobacterium - isolation & purification Prospective Studies rapid detection sensitivity Sensitivity and Specificity Thin Layer Agar Time Factors tuberculosis Tuberculosis - diagnosis Young Adult |
| title | Comparative performance of Thin Layer Agar and Löwenstein–Jensen culture for diagnosis of tuberculosis |
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