title: Microscopic morphology in smears prepared from MGIT broth medium for rapid presumptive identification of Mycobacterium tuberculosis complex, Mycobacterium avium complex and Mycobacterium kansasii.
abstract: Mycobacterium species has a specific morphology when grown in liquid medium. Mycobacterium tuberculosis complex (MTB) often exhibits serpentine cording, which is different from the dot and cross-barring morphology observed in Mycobacterium avium complex (MAC) and Mycobacterium kansasii (MK), respectively. These characteristic morphologies can be used as a cost-effective method for rapid, presumptive identification of mycobacterial isolates cultured from the MGIT 960 system. By using Kinyoun acid-fast stain, serpentine cording was found in 840 of 904 (92.1%) samples positive for MTB; dot or loose aggregation was observed in 112 of 136 (82.3%) samples positive for MAC; and the cross-barring, ladder-like, morphology was observed in 45 of 56 (80.5%) samples positive for MK. The sensitivity and specificity were 92.9% and 96.4% for MTB; 82.4% and 94.5% for MAC; and 80.4% and 94.6% for MK, respectively. Using growth rate selection to exclude rapid growers, the positive and negative predictive values were 98% and 87.6% for MTB; 78.3% and 98% for MAC; and 78.9% and 99.1% for MK, respectively. Twenty-eight (93.3%) of 30 strains with ball morphology were rapid growers. Microscopic morphology can be used for rapid, presumptive identification of M. tuberculosis complex, M. kansasii, and M. avium complex and act as a guide for appropriate selection of initial probes to reduce costs.
authors.affiliation: Section of Microbiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
authors.forename: Hui-Zin
authors.initials: HZ
authors.lastname: Tu
authors.forename: Shu-Huei
authors.initials: SH
authors.lastname: Chang
authors.forename: Tsi-Shu
authors.initials: TS
authors.lastname: Huaug
authors.forename: Wen-Kuei
authors.initials: WK
authors.lastname: Huaug
authors.forename: Yung-Ching
authors.initials: YC
authors.lastname: Liu
authors.forename: Susan Shin-Jung
authors.initials: SS
authors.lastname: Lee
mesh_terms: D003470:Culture Media; D005240:Feasibility Studies; D006801:Humans; D009161:Mycobacterium / Q000166:cytology / Q000254:growth & development / Q000302:isolation & purification*; D009162:Mycobacterium avium / Q000166:cytology / Q000254:growth & development / Q000302:isolation & purification; D019909:Mycobacterium kansasii / Q000166:cytology / Q000254:growth & development / Q000302:isolation & purification; D009169:Mycobacterium tuberculosis / Q000166:cytology / Q000254:growth & development / Q000302:isolation & purification; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D003470:Culture Media