Mycobacterial culture remains the gold standard for the diagnosis of
tuberculosis. However, an appropriate digestion and decontamination method (DDM) is essential for the effective recovery of tubercle bacilli in culture. Therefore, the current study was designed to compare the performance of
papain-
cetylpyridinium chloride [
papain-
CPC] and
pepsin-
cetylpyridinium chloride [
pepsin-
CPC]
DDMs against
N-acetyl L-Cysteine-
sodium hydroxide (NALC-NaOH) DDM for recovery of mycobacteria from clinically suspected
pulmonary tuberculosis cases. To evaluate
papain-
CPC,
pepsin-
CPC and NALC-NaOH
DDMs, sputum samples (N = 1381) were cultured on Löwenstein-Jensen medium and the results were compared. The
papain-
CPC DDM showed sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 93.27%, 71.7%, and 100%, respectively as compared to NALC-NaOH DDM. Similarly,
pepsin-
CPC DDM demonstrated sensitivity, specificity, positive predictive value and negative predictive value of 98.94%, 94.7%, 76.11%, and 99.81%, respectively. In summary, both
papain-
CPC and
pepsin-
CPC DDMs are highly sensitive and specific techniques for recovery of mycobacteria as compared to NALC-NaOH DDM. However, when the overall performances of all
DDMs compared,
papain-
CPC DDM isolated increased number of mycobacterial isolates with comparatively higher numbers of colonies on LJ media than both
pepsin-
CPC and NALC-NaOH
DDMs, indicating its potential to replace the NALC-NaOH DDM for recovery of mycobacteria from sputum samples.