Infrequent MODS TB culture cross-contamination in a high-burden resource-poor setting.

Moore, David AJORCID logo; Caviedes, Luz; Gilman, Robert H; Coronel, Jorge; Arenas, Fanny; LaChira, Doris; Salazar, Cayo; Carlos Saravia, Juan; Oberhelman, Richard A; Hollm-Delgado, Maria-Graciela; +3 more...Escombe, A Roderick; Evans, Carlton AW; and Friedland, Jon S (2006) Infrequent MODS TB culture cross-contamination in a high-burden resource-poor setting. Diagnostic microbiology and infectious disease, 56 (1). pp. 35-43. ISSN 0732-8893 DOI: 10.1016/j.diagmicrobio.2006.03.009
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One obstacle to wider use of rapid liquid culture-based tuberculosis diagnostics such as the microscopic observation drug susceptibility (MODS) assay is concern about cross-contamination. We investigated the rate of laboratory cross-contamination in MODS, automated MBBacT, and Lowenstein-Jensen (LJ) cultures performed in parallel, through triangulation of microbiologic (reculturing stored samples), molecular (spoligotype/RFLP), and clinical epidemiologic data. At least 1 culture was positive for Mycobacterium tuberculosis for 362 (11%) of 3416 samples; 53 were regarded as potential cross-contamination suspects. Cross-contamination accounted for 17 false-positive cultures from 14 samples representing 0.41% (14/3416) and 0.17% (17/10248) of samples and cultures, respectively. Positive predictive values for MODS, MBBacT (bioMérieux, Durham, NC), and LJ were 99.1%, 98.7%, and 99.7%, and specificity was 99.9% for all 3. Low rates of cross-contamination are achievable in mycobacterial laboratories in resource-poor settings even when a large proportion of samples are infectious and highly sensitive liquid culture-based diagnostics such as MODS are used.

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