Allergy and Airway |

Impact of Implementation of an Automated Liquid Culture System on the Diagnosis of Tuberculous Pleurisy FREE TO VIEW

Doosoo Jeon, MD; Seong Hoon Yoon, MD; Hye Ju Yeo, MD; Seung Hyun Lee, MD; Seung Eun Lee, MD; Woo Hyun Cho, MD; Yun Seong Kim, MD
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Pusan National University Yangsan Hospital, Yangsan, Korea (the Republic of)

Chest. 2015;148(4_MeetingAbstracts):7A. doi:10.1378/chest.2228495
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SESSION TITLE: Allergy and Airway Poster Discussions

SESSION TYPE: Original Investigation Poster Discussion

PRESENTED ON: Wednesday, October 28, 2015 at 08:45 AM - 10:00 AM

PURPOSE: The aim of this study were to assess how much the diagnostic yield is increased in HIV-uninfected patients by implementation of the liquid culture system, to evaluate whether supplemental solid media is necessary to maximize the sensitivity of effusion culture, and to determine the predictors of culture-positive effusion.

METHODS: We retrospectively compared the culture yield, time to positivity, and contamination rate of pleural effusion samples in the BACTEC Mycobacteria Growth Indicator Tube 960 (MGIT) and Ogawa media among patients with tuberculous pleurisy.

RESULTS: Out of 104 effusion samples, 43 (41.3%) were culture positive on either the MGIT or the Ogawa media. The culture yield of MGIT was higher (40.4%, 42/104) than of that of Ogawa media (18.3%, 19/104) (P < 0.001). One of the samples was positive only on the Ogawa medium. The median time to positivity was faster in the MGIT (18 days, range 8-32 days) than in the Ogawa media (37 days, range 20-59 days) (P < 0.001). No contamination or growth of nontuberculous mycobacterium was observed on either of the culture media. The combination of the effusion and sputum cultures contributed to a good diagnostic yield of 66.3% (69/104). The percentage of polymorphonuclear cell in effusion was independent predictors of the culture-positive effusion (aOR 1.026; 95% CI 1.006-1.046).

CONCLUSIONS: The automated liquid culture system could provide approximately twice as high yields and fast results in effusion culture, compared to solid media. Supplemental solid media may have a limited impact on maximizing sensitivity in effusion culture; however, further studies are required.

CLINICAL IMPLICATIONS: With the implementation of a liquid culture method, the sensitivity of effusion culture was much higher than has been previously reported. If TB pleurisy is suspected, the collection of sputum and pleural fluid samples for mycobacterial liquid culture should be encouraged.

DISCLOSURE: The following authors have nothing to disclose: Doosoo Jeon, Seong Hoon Yoon, Hye Ju Yeo, Seung Hyun Lee, Seung Eun Lee, Woo Hyun Cho, Yun Seong Kim

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