High yield of culture-based diagnosis in a TB-endemic settingReport as inadecuate

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BMC Infectious Diseases

, 12:218

Tuberculosis and other mycobacterial diseases


BackgroundIn most of the world, microbiologic diagnosis of tuberculosis TB is limited to microscopy. Recent guidelines recommend culture-based diagnosis where feasible.

MethodsIn order to evaluate the relative and absolute incremental diagnostic yield of culture-based diagnosis in a high-incidence community in Cape Town, South Africa, subjects evaluated for suspected TB had their samples processed for microscopy and culture over a 21 month period.

ResultsFor 2537 suspect episodes with 2 smears and 2 cultures done, 20.0% 508 had at least one positive smear and 29.9% 760 had at least one positive culture. One culture yielded 1.8 times more cases as 1 smear relative yield, or an increase of 12.0% absolute yield. Based on the latter value, the number of cultures needed to diagnose NND one extra case of TB was 8, compared to 19 if second specimens were submitted for microscopy.

ConclusionIn a high-burden setting, the introduction of culture can markedly increase TB diagnosis over microscopy. The concept of number needed to diagnose can help in comparing incremental yield of diagnosis methods. Although new promising diagnostic molecular methods are being implemented, TB culture is still the gold standard.

KeywordsTuberculosis Diagnosis Culture Microscopy Electronic supplementary materialThe online version of this article doi:10.1186-1471-2334-12-218 contains supplementary material, which is available to authorized users.

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Author: Anne-Marie Demers - Suzanne Verver - Andrew Boulle - Robin Warren - Paul van Helden - Marcel A Behr - David Coetzee

Source: https://link.springer.com/

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