Improved method for testing susceptibility of Mycobacterium tuberculosis to pyrazinamide

Abstract

The acid medium required to test susceptibility of Mycobacterium tuberculosis to pyrazinamide (PZA) is a major problem in obtaining reliable test results. Satisfactory growth is usually obtained on Middlebrook and Cohn 7H10 medium at pH 5.5 if albumin-dextrose-catalase (ADC) supplement rather than oleic acid-albumin-dextrose-catalase is used: however, some lots of ADC supplement still fail to support growth at this low pH. A rapid turbidimetric test was developed to determine the growth-supporting potential of ADC enrichment for M. tuberculosis at pH 5.5. An atmosphere supplemented with 5 to 10% carbon dioxide, used to stimulate growth of tubercle bacilli on 7H10 medium, counteracted the growth inhibiting effects of PZA. By using optimum conditions of medium and pH, the susceptibility of 90% of M. tuberculosis strains to PZA was determined.