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cost-effectiveness of blood agar for isolation of mycobacteria成本效益的血琼脂分枝杆菌的隔离
Cost-Effectiveness of Blood Agar for Isolation of
Mycobacteria
Michel Drancourt1,2, Didier Raoult1,2*
´ ´ ˆ ´ ´
1 Federation de Microbiologie Clinique, Assistance Publique – Hopitaux de Marseille, Marseille, France, 2 Unite des Rickettsies, CNRS UMR 6020, IFR 48, Faculte de
´ ´ ´ ´
Medecine, Universite de la Mediterranee, Marseille, France
Abstract
Background: Mycobacterium species are grown using specific media that increase laboratory cost, thus hampering their
diffusion in resource-limited countries. Preliminary data suggested that versatile blood agar may be also used for
mycobacterial culture.
Methodology: We examined the growth of 41 different Mycobacterium species on 5% blood agar. Over a 24-month period
we analysed isolation of mycobacteria after parallel inoculation of clinical specimens into both a reference automated
system (BACTEC 9000 MB broth) and 5% blood agar slant tubes, after NaOH decontamination, and compared the cost of
performing 1,000 analyses using these two techniques.
Conclusions: Mycobacterium reference species cultured on blood agar, with the exception of Mycobacterium ulcerans.
Inoculation of 1,634 specimens yielded 95 Mycobacterium isolates. Blood agar performed significantly more efficiently than
BACTEC 9000 MB broth (94 vs 88 isolates, P = 0.03). Decontamination of Candida albicans in 5 specimens by addition of
amphotericin B in blood agar yielded one more M. tuberculosis isolate that could not be isolated in BACTEC broth. Uneven
distribution of time to culture positivity for M. tuberculosis had a median (range) of 1965 days using blood agar and 26 66
days
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