Characterization of Differentially Detectable Mycobacterium tuberculosis in the Sputum of Subjects with Drug-Sensitive or Drug-Resistant Tuberculosis before and after Two Months of Therapy
Kayvan Zainabadi, Kathleen F. Walsh, Stalz Charles Vilbrun, L Mathurin, Myung Hee Lee, Kohta Saito, Saurabh Mishra, Oksana Ocheretina, Jean W. Pape, Carl Nathan, Daniel W. Fitzgerald
Abstract
Standard methods for enumerating Mycobacterium tuberculosis in patient sputum can miss large populations of viable M. tuberculosis cells that are unable to grow either on solid medium or in liquid medium unless the medium has been extensively diluted. Because these bacteria can be detected in liquid medium after limiting dilution, they have been termed differentially culturable or differentially detectable M. tuberculosis (DD- Mtb ). Treatment with isoniazid (H), rifampin (R), pyrazinamide (Z), and ethambutol (E) (HRZE) for 1 to 2 weeks has been shown to increase the representation of DD- Mtb in the sputum of drug-sensitive (DS) tuberculosis (TB) patients.