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

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Date
2011-11Author
Worodria, William
Anderson, Julian
Cattamanchi, Adithya
Davis, J. Lucian
Boon, Saskia Den
Andama, Alfred
Yoo, Samuel D.
Joloba, Moses
Huang, Laurence
Kato-Maeda, Midori
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Objective: To determine the need for routine speciation of positive Lowenstein-Jensen mycobacterial cultures in HIVinfected
patients suspected of having pulmonary tuberculosis at Mulago Hospital in Kampala, Uganda.
Methods: Sputum and bronchoalveolar lavage Lowenstein-Jensen mycobacterial culture isolates from consecutive, HIVinfected
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 HIVinfected
Ugandans suspected of having tuberculosis. Routine molecular confirmation of positive Lowenstein-Jensen
cultures is unnecessary in this low resource setting.