Evaluation of OMNIgene Sputum and Ethanol Reagent for Preservation of Sputum Prior to Xpert and Culture Testing in Uganda.

Abstract

Xpert MTB/RIF (Xpert) and culture are the most reliable methods for tuberculosis diagnosis but are still poorly accessible in many low-resource countries. We aimed to assess the effects of OMNIgene Sputum (OM-S) and ethanol in preserving sputum for Xpert and OM-S for mycobacterial growth indicator tube (MGIT) testing over periods of 15 and 8 days, respectively. Sputum samples were collected from newly diagnosed smear-positive patients. For Xpert, pooled samples were split into 5 aliquots: 3 for Xpert on days 0, 7, and 15 without additive and 2 with either OM-S or ethanol at day 15. For MGIT, 2 aliquots were tested without preservative and 2 with OM-S at 0 and 8 days. Totals of 48 and 47 samples were included in the analysis for Xpert and culture. With Xpert, using day 0 as a reference, untreated samples stored for 7 and 15 days showed concordances of 45/46 (97.8%) and 46/48 (95.8%). For samples preserved with OM-S or ethanol for 15 days compared with untreated samples processed at day 0 or after 15 days, OM-S concordances were 46/48 (95.8%) and 47/48 (97.9%), while those of ethanol were 44/48 (91.7%) and 45/48 (93.8%). With MGIT, concordances between untreated and OM-S-treated samples were 21/41 (51.2%) at day 0 and 21/44 (47.7%) at day 8. In conclusion, Xpert equally detected tuberculosis in OM-S-treated and untreated samples up to 15 days but showed slightly lower detection in ethanol-treated samples. Among OM-S-treated samples, MGIT positivity was significantly lower than in untreated samples at both time points.

• Authors: Elisa Ardizzoni, Patrick Orikiriza, Charles Ssuuna, Dan Nyehangane, Mourad Gumsboga, Ivan Mugisha Taremwa, Esther Turyashemererwa, Juliet Mwanga-Amumpaire, Céline Langendorf, Maryline Bonnet
• Journal: Journal of clinical microbiology (J Clin Microbiol) Vol. 58 Issue 1 (12 23 2019) ISSN: 1098-660X [Electronic] United States
• PMID: 31619525 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 American Society for Microbiology.

Chemical References

• Indicators and Reagents
• Ethanol

Topics

• Bacteriological Techniques (methods, standards)
• Ethanol
• Female
• Humans
• Indicators and Reagents
• Male
• Microbial Sensitivity Tests (methods, standards)
• Molecular Diagnostic Techniques (methods, standards)
• Mycobacterium tuberculosis (drug effects, isolation & purification)
• Preservation, Biological (methods)
• Reproducibility of Results
• Sensitivity and Specificity
• Specimen Handling (methods)
• Sputum (microbiology)
• Tuberculosis (diagnosis, microbiology)
• Uganda