False positive direct films in tuberculosis bacteriology.
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Biomedical subjects
Publications and source records attributed to M D Yates.
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Hydroxylamine sensitivity offered no advantage over p-nitrobenzoic acid in distinguishing between tubercle bacilli and other (opportunist and non-significant) mycobacteria. It was of limited use in identification procedures. Salt tolerance assisted in the identification of strains which may be Mycobacterium triviale and M. chelonei var borstelense.
Initial screening of tubercle bacilli with 2-thiophene carboxylic acid hydrazide (TCH) or 2-furoic acid hydrazide (FAH) separates them into two groups. Resistant strains are Mycobacterium tuberculosis. Sensitive strains include M. tuberculosis, M. bovis and BCG which are separated by nitratase and oxygen requirement tests. Pyrazinamide sensitivity tests allow M. bovis and M. africanum to be identified. The niacin test is not used. Most strains of M. tuberculosis from Europeans are resistant to TCH and FAH and are in phage groups A and B, while most strains from Asians are sensitive and are in phage group I.
BCG isolated from clinical material may be reliably differentiated from other variants within the species Mycobacterium tuberculosis by means of a few simple cultural and biochemical tests and by bacteriophage typing. Animal pathogenicity tests may therefore be avoided.
A composite antigen prepared from strains of M. avium, M. intracellulare and M. scrofulaceum has been used in addition to PPD in differential skin tests, principally on children investigated for mycobacterial cervical adenitis. The tests were uniformly successful in 12 cases bacteriologically positive for opportunist mycobacteria and gave unequivocal positive or negative results in 30 cases awaiting diagnosis.
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