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Related Experiment Videos

Persistent tuberculosis or specimen contamination?

K Trakas1, V Stosor, S Dietrich

  • 1Department of Pathology, Northwestern University Medical School, Chicago, IL 60611, USA.

Archives of Pathology & Laboratory Medicine
|June 3, 2000
PubMed
Summary
This summary is machine-generated.

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Cross-contamination in sputum cultures can lead to false positives for tuberculosis. This case highlights how a susceptible Mycobacterium tuberculosis strain contaminated a resistant one, misdiagnosing a patient.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • Sputum culture is crucial for diagnosing tuberculosis (TB).
  • Sequential processing of patient specimens can lead to cross-contamination.
  • Mycobacterium tuberculosis (M. tuberculosis) is the causative agent of TB.

Observation:

  • A patient with acquired immunodeficiency syndrome (AIDS) and suspected persistent TB had one positive sputum culture for rifampin-susceptible M. tuberculosis.
  • The positive specimen was processed immediately after a sample from a patient with active pulmonary TB, which was positive for rifampin-resistant M. tuberculosis.
  • Molecular strain typing confirmed both isolates were the same M. tuberculosis strain.

Findings:

  • Agar proportion testing of the resistant isolate showed 1.5%–3.3% resistant organisms.

Related Experiment Videos

  • The rifampin-susceptible M. tuberculosis (98% of the resistant isolate) contaminated the patient's sputum sample.
  • The positive culture result was determined to be a false positive due to cross-contamination.

    • Implications:

    • This case underscores the critical importance of stringent laboratory protocols to prevent cross-contamination in mycobacterial cultures.
    • False-positive results can lead to unnecessary treatment and patient anxiety.
    • Accurate diagnostic methods are essential for effective tuberculosis management, especially in immunocompromised individuals.