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

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    Date
    2011-11
    Author
    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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    Abstract
    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.
    URI
    doi:10.1371/journal.pone.0027017
    http://hdl.handle.net/10570/643
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