Successful Mycobacterium tuberculosis culture isolation from tongue swabs: Results from both experimentally infected and clinical swabs from pulmonary tuberculosis patients

Diagn Microbiol Infect Dis. 2024 Oct;110(2):116423. doi: 10.1016/j.diagmicrobio.2024.116423. Epub 2024 Jul 6.

Abstract

This study explored Mycobacterium tuberculosis (MTB) growth from tongue swabs, both experimentally infected after sampling from healthy controls, or sampled from patients with smear-microscopy confirmed pulmonary tuberculosis (PTB). For both, we evaluated the performance of NALC-NaOH/MGIT960 (MGIT), Kudoh-Ogawa (KO), and cetylpyridinium chloride-Löwenstein-Jensen (CPC/LJ) culture processing methods. Experimentally spiked swabs from 20 participants exhibited 94.4% MTB growth when inoculated within 7 days of CPC exposure, declining significantly after 14-21 days (p<0.00001). KO-processed specimens showed 100% MTB growth, with a non-significant reduction after storage (94.1%; p=0.21), and all spiked swabs yielded growth in MGIT. In the field evaluation on 99 PTB patients, MGIT isolated MTB from 89% of tongue swabs, with an 8% contamination rate, compared to 99% MGIT positivity from sputum. Solid media had lower positivity, 62% for KO and 49% for CPC/LJ, suggesting MGIT as optimal for growing MTB from tongue swabs. Further testing of presumptive PTB patients is recommended.

Keywords: Culture; Mycobacterium tuberculosis; Tongue swab.

MeSH terms

  • Adult
  • Bacteriological Techniques / methods
  • Culture Media / chemistry
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis* / growth & development
  • Mycobacterium tuberculosis* / isolation & purification
  • Specimen Handling* / methods
  • Sputum / microbiology
  • Tongue* / microbiology
  • Tuberculosis, Pulmonary* / diagnosis
  • Tuberculosis, Pulmonary* / microbiology
  • Young Adult

Substances

  • Culture Media