Effect of Neutralization of Gastric Aspirate on Culture Yield of Mycobacterium Tuberculosis in Children with Pulmonary Tuberculosis

Abstract Introduction Conventionally gastric aspirates are neutralized with sodium bicarbonate to improve the culture yield of MTB. However, only limited data is there to support this practice. The aim of this study was to compare the contamination rate, culture yield and time to detection of Mycobacterium tuberculosis (MTB) in neutralized and non-neutralized gastric aspirate samples and report the drug resistance. Materials and Methods A total of 336 neutralized and non-neutralized gastric aspirate samples were simultaneously cultured by both LJ culture and MGIT 960 to compare the difference in isolation rate, time to detection and contamination rate. First line drug susceptibility testing was performed using MGIT 960 SIRE kit. Results MTB was isolated from 8.6% (29/336) of GA samples by one or more of the culture methods. The isolation rate of MTB from neutralized and non-neutralized GA samples by combined LJ and MGIT 960 culture was 7.1% (24/336) and 6.8% (23/336), respectively. Both of them detected 18 MTB isolates in common. However, the neutralized and non-neutralized GA samples detected additional 6 and 5 MTB isolates, respectively. The mean time to detection of MTB were similar. In MGIT 960 culture, contamination rate of non-neutralized samples (17%) was significantly lower when compared to neutralized samples (21.1%) (P = 0.044). Drug susceptibility testing of MTB isolates revealed that, out of 26 isolates, 2 were resistant to ethambutol, one each was resistant to isoniazid and rifampicin. Conclusion The findings of this study suggest that non-neutralized samples should be routinely processed in addition to the neutralized samples for optimum isolation of MTB from gastric aspirate samples.