Performance of solid and liquid culture media for the detection of Mycobacterium tuberculosis in clinical materials: meta-analysis of recent studies

Excerpt

Tuberculosis (TB) is a universal disease: it occurs all over the globe, albeit with hugely varying regional incidence. Especially in Asian and African countries, the incidence and prevalence may be extremely high. The European Journal of Clinical Microbiology and Infectious Diseases published seven papers on TB in 2013, representing 3.3 % (7/211) of its annual production. Four of the papers concerned mechanistic studies on clinical patient management, cost-effectiveness of antibiotic treatment, importance of microbiota and host genetic polymorphisms, respectively. The other three papers concerned molecular diagnostics, so, overall, hardly any attention was paid to the more classical modes of diagnosing TB. And this clearly contrasts with international needs, since classical diagnostics is still very high on the agenda in those countries where TB testing is most needed. In their 2013 Global Tuberculosis Report, the World Health Organization (WHO) claimed that culture is still the reference method for the detection of Mycobacterium tuberculosis (Mtb), with smear staining and microscopy being considered as a method of “added value”. Hence, a wide array of culture systems has been developed by a large multitude of researchers and companies. Some of these are semi-automated, but most require manual intervention. Löwenstein–Jensen medium (LJ) is frequently considered the key mycobacterial growth medium when comparative studies for the verification and validation of new diagnostic tests are performed. Even the validation of liquid media in combination with semi-automated culture systems is usually performed in comparison with LJ-based cultivation as the diagnostic Gold Standard. …