title: An alternative method for sputum storage and transport for mycobacterium tuberculosis drug resistance surveys.
abstract: METHODS
  A district level tuberculosis (TB) programme in Indonesia.
  
  
  OBJECTIVE
  To evaluate whether a single sputum specimen could be stored by refrigeration for an extended period of time, then transported to a reference laboratory and successfully cultured for Mycobacterium tuberculosis.
  
  
  METHODS
  Single sputum specimens were collected from newly diagnosed smear-positive pulmonary TB patients, refrigerated at the study site without addition of 1% cetylpyridinium chloride, batched and sent to the reference laboratory, where they were decontaminated and inoculated into BACTEC MGIT 960 liquid media.
  
  
  RESULTS
  One hundred and seven patients were enrolled. The median specimen storage time was 12 days (range 1-38) and median transportation time was 4 days (2-12). The median time from specimen collection until processing was 18 days (4-42). Only 4 (3.7%) specimens failed to grow Mycobacterium species and M. tuberculosis was isolated from 101 (94.4%) specimens. Six specimens with breakthrough contamination successfully grew M. tuberculosis after a second decontamination procedure.
  
  
  CONCLUSIONS
  Single sputum specimens collected at a remote setting, refrigerated for relatively long periods without preservatives and transported without refrigeration to a reference laboratory can yield a high positive culture rate. These findings offer potential logistic simplification and cost savings for drug resistance surveys in low-resource countries.
authors.affiliation: Institute of Medical & Veterinary Science, Adelaide, South Australia, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Lumb
authors.forename: M
authors.initials: M
authors.lastname: Ardian
authors.forename: G
authors.initials: G
authors.lastname: Waramori
authors.forename: H
authors.initials: H
authors.lastname: Syahrial
authors.forename: E
authors.initials: E
authors.lastname: Tjitra
authors.forename: G P
authors.initials: GP
authors.lastname: Maguire
authors.forename: N M
authors.initials: NM
authors.lastname: Anstey
authors.forename: P M
authors.initials: PM
authors.lastname: Kelly
mesh_terms: D003625:Data Collection; D024881:Drug Resistance, Bacterial; D005500:Follow-Up Studies; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification*; D012189:Retrospective Studies; D013048:Specimen Handling / Q000379:methods*; D013183:Sputum / Q000382:microbiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000382:microbiology*