Early identification of Mycobacterium tuberculosis complex in BACTEC cultures by ligase chain reaction

A total of 1431 acid-fast bacilli (AFB) in Bactec culture vials from 1427 patients was differentiated by the Bactec NAP method and tested by the LCx Mycobacterium tuberculosis ligase chain reaction system. In all, 1321 of 1325 M. tuberculosis complex (MTBC) isolates were correctly detected by the LCx assay. All the 106 non-tuberculous mycobacteria (NTM) isolates were negative by the LCx assay. No false MTBC-positive result was obtained from NTM isolates. However, the LCx assay failed to detect four MTBC isolates from one patient. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 99.7, 100%, 100% and 96.4%, respectively. These data suggest that the LCx system can be used to identify MTBC in AFB-positive Bactec broth cultures when the growth index is > or = 100. The method gives a 100% PPV and allows a faster turnaround time for MTBC than the NAP test.