title: Comparison of Mycobacterium tuberculosis drug susceptibility using solid and liquid culture in Nigeria.
abstract: BACKGROUND
  This study compares Mycobacterium tuberculosis culture isolation and drug sensitivity testing (DST) using solid (LJ) and liquid (BACTEC-MGIT-960) media in Nigeria.
  
  
  METHODS
  This was a cross sectional survey of adults attending reference centres in Abuja, Ibadan and Nnewi with a new diagnosis of pulmonary tuberculosis (TB) or having failed the first-line TB treatment. Patients were requested to provide three sputum specimens for smear-microscopy and culture on LJ and BACTEC-MGIT-960. Positive cultures underwent DST for streptomycin, isoniazid, rifampicin and ethambutol.
  
  
  RESULTS
  527 specimens were cultured. 428 (81%) were positive with BACTEC-MGIT-960, 59 (11%) negative, 36 (7%) contaminated and 4 (1%) had non-tuberculosis mycobacteria (NTM). 411 (78%) LJ cultures were positive, 89 (17%) negative, 22 (4%) contaminated and 5 (1%) had NTM. The mean (SD) detection time was 11 (6) and 30 (11) days for BACTEC-MGIT-960 and LJ. DST patterns were compared in the 389 concordant positive BACTEC-MGIT-960 and LJ cultures. Rifampicin and isoniazid DST patterns were similar. Streptomycin resistance was detected more frequently with LJ than BACTEC-MGIT-960 and ethambutol resistance was detected more frequently with BACTEC-MGIT-960 than LJ, but differences were not statistically significant. MDR-TB was detected in 27 cases by LJ and 25 by BACTEC-MGIT-960 and using both methods detected 29 cases.
  
  
  CONCLUSIONS
  There was a substantial degree of agreement between the two methods. However using the two in tandem increased the number of culture-positive patients and those with MDR-TB. The choice of culture method should depend on local availability, cost and test performance characteristics.
authors.affiliation: Zankli Medical Centre, Plot 1021 Shehu YarAdua Way, Abuja, Nigeria. lovettlawson@hotmail.com
authors.forename: Lovett
authors.initials: L
authors.lastname: Lawson
authors.forename: Nanmdi
authors.initials: N
authors.lastname: Emenyonu
authors.forename: Saddiq T
authors.initials: ST
authors.lastname: Abdurrahman
authors.forename: Juliana O
authors.initials: JO
authors.lastname: Lawson
authors.forename: Gertrude N
authors.initials: GN
authors.lastname: Uzoewulu
authors.forename: Olumide M
authors.initials: OM
authors.lastname: Sogaolu
authors.forename: Juliana N
authors.initials: JN
authors.lastname: Ebisike
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Parry
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Yassin
authors.forename: Luis E
authors.initials: LE
authors.lastname: Cuevas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D009549:Nigeria; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents