Conventional Methods versus 16S Ribosomal DNA Sequencing for Identification of Nontuberculous Mycobacteria: Cost Analysis
Open Access
- 1 March 2003
- journal article
- research article
- Published by American Society for Microbiology in Journal of Clinical Microbiology
- Vol. 41 (3), 1010-1015
- https://doi.org/10.1128/jcm.41.3.1010-1015.2003
Abstract
The clinical profile of nontuberculous mycobacteria (NTM) has been raised by the human immunodeficiency virus and AIDS pandemic. Different laboratory techniques, often molecular based, are available to facilitate the rapid and accurate identification of NTM. The expense of these advanced techniques has been questioned. At the National Reference Center for Mycobacteriology and the Health Sciences Center, University of Manitoba, in Winnipeg, Canada, we performed a direct cost analysis of laboratory techniques for commercial DNA probe-negative (Gen-Probe, Inc., San Diego, Calif.), difficult-to-identify NTM. We compared the costs associated with conventional phenotypic methodology (biochemical testing, pigment production, growth, and colony characteristics) and genotypic methodology (16S ribosomal DNA [rDNA] sequence-based identification). We revealed a higher cost per sample with conventional methods, and this cost varied with organism characteristics: $80.93 for slowly growing, biochemically active NTM; $173.23 for slowly growing, biochemically inert NTM; and $129.40 for rapidly growing NTM. The cost per sample using 16S rDNA sequencing was $47.91 irrespective of organism characteristics, less than one-third of the expense associated with phenotypic identification of biochemically inert, slow growers. Starting with a pure culture, the turnaround time to species identification is 1 to 2 days for 16S rDNA sequencing compared to 2 to 6 weeks for biochemical testing. The accuracy of results comparing both methodologies is briefly discussed. 16S rDNA sequencing provides a cost-effective alternative in the identification of clinically relevant forms of probe-negative NTM. This concept is not only useful in mycobacteriology but also is highly applicable in other areas of clinical microbiology.Keywords
This publication has 20 references indexed in Scilit:
- Identification of Mycobacterium spp. by Using a Commercial 16S Ribosomal DNA Sequencing Kit and Additional Sequencing LibrariesJournal of Clinical Microbiology, 2002
- Burden of Unidentifiable Mycobacteria in a Reference LaboratoryJournal of Clinical Microbiology, 2001
- Mycolic Acid Analysis by High-Performance Liquid Chromatography for Identification ofMycobacteriumSpeciesClinical Microbiology Reviews, 2001
- Application of the Sherlock Mycobacteria Identification System Using High-Performance Liquid Chromatography in a Clinical LaboratoryJournal of Clinical Microbiology, 2001
- Identification of Non-tuberculous Mycobacteria: 16S rRNA Gene Sequence Analysis vs. Conventional MethodsScandinavian Journal of Infectious Diseases, 2000
- Identification of Clinical isolates of Mycobacterium spp. by sequence analysis of the 16S ribosomal RNA geneAPMIS, 1999
- NONTUBERCULOUS MYCOBACTERIAL INFECTIONSMedical Clinics of North America, 1997
- Disseminated "Mycobacterium genavense" infection in patients with AIDSThe Lancet, 1992
- Basic local alignment search toolJournal of Molecular Biology, 1990
- Differentiation of Mycobacterium species by direct sequencing of amplified DNAJournal of General Microbiology, 1990