An evaluation of methods for the isolation of nontuberculous mycobacteria from patients with cystic fibrosis, bronchiectasis and patients assessed for lung transplantation

Dominic Stephenson, Audrey Perry, Martin Appleby, David Lee, John Davison, Annette Johnston, Amanda Jones, Andrew Nelson, Stephen Bourke, Matthew Thomas, Anthony de Soyza, James Lordan, Joanna Lumb, Ali Robb, Julie Samuel, Kathy Walton, John Perry

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9 Citations (Scopus)
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Abstract

Background: RGM medium is an agar-based, selective culture medium designed for the isolation of nontuberculous mycobacteria (NTM) from the sputum of patients with cystic fibrosis (CF). We evaluated RGM medium for the detection of NTM in patients with CF (405 samples), bronchiectasis (323 samples) and other lung diseases necessitating lung transplantation (274 samples).
Methods: In total, 1002 respiratory samples from 676 patients were included in the study. Direct culture on RGM medium, with incubation at two temperatures (30°C and 37°C), was compared with conventional culture of decontaminated samples for acid-fast bacilli (AFB) using both a solid medium (Löwenstein-Jensen medium) and a liquid medium (the Mycobacterial Growth Indicator Tube; MGIT).
Results: For all three patient groups, significantly more isolates of NTM were recovered using RGM medium incubated at 30°C than by any other method (sensitivity: 94.6% vs. 22.4% for conventional AFB culture; P < 0.0001). Significantly more isolates of Mycobacterium abscessus complex were isolated on RGM at 30°C than by AFB culture (sensitivity: 96.1% vs. 58.8%; P < 0.0001). The recovery of Mycobacterium avium complex was also greater using RGM medium at 30°C compared to AFB culture (sensitivity: 83% vs. 70.2%), although this difference was not statistically significant and a combination of methods was necessary for optimal recovery (P = 0.21).
Conclusions: In the largest study of RGM medium to date, we reaffirm its utility for isolation of NTM from patients with CF. Furthermore; we show that it also provides an effective tool for culture of respiratory samples from patients with bronchiectasis and other lung diseases.
Original languageEnglish
Article number19
Number of pages12
JournalBMC Pulmonary Medicine
Volume19
Issue number1
Early online date21 Jan 2019
DOIs
Publication statusE-pub ahead of print - 21 Jan 2019

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