APMAdvances in Precision Medicine2424-85922424-9106WHIOCE PUBLISHING PTE. LTD.10.18063/apm.v6i2.237ArticleEvaluation of the Use of Distilled Water as a Sodium  Hydroxide Wash in Antimicrobial Cultureshttps://artdesignp.com/journal/APM/6/2/10.18063/apm.v6i2.237BaekHae-Gyeong,KoHyun-Mi,LeeMyung-Hee2021622021-07-25Background: Respiratory specimens subjected to mycobacterial  detection were initially pretreated with N-acetyl-L-cysteine-sodium  hydroxide (NALC-NaOH) to remove the mucus and normal flora.  Next, they were washed and neutralized with a phosphate-buffered  solution (PBS). The effectiveness of distilled water (DW) compared to  PBS as a washing neutralizer during the identification of mycobacteria  was evaluated in this study. Methods: We analyzed the results of  the mycobacterial test conducted at a general hospital in Gwangju  from October 2016 to September 2018. PBS and DW were used  as a respiratory sample-washing agent for one year each. Results: The positive culture rate for the culture of mycobacteria was 12.7%  (1,843/14,532) and 14.7% (2,095/14,291), when PBS and DW were  used, respectively. The recovery rate of the mycobacteria growth  indicator tubes (MGIT) and the separation rates of the Mycobacterium  tuberculosis complex and nontuberculous mycobacteria (NTM) showed  no significant change. However, in the 2% Ogawa medium, as the  NTM culture increased from 47.4% (399/841) to 56.1% (630/1,122),  the recovery rate increased from 45.6% (841/1,843) to 53.6%  (1,122/2,095). The MGIT contamination rate decreased from 6.5% to  4.1%. Conclusion: DW as a washing agent for NALC-NaOH increased  the recovery rate of Ogawa medium and reduced the contamination  rate of MGIT. Therefore, the use of DW instead of PBS as a washing  neutralizer during the identification of mycobacteria might be useful.Mycobacterial culture,Mycobacterium spp,Nontuberculous mycobacteria,Sodium hydroxide,Sputum

1. Hwang SS, Oh KJ, Jang IH, et al. Evaluation of the Diagnostic Performance of the AdvanSure TB/NTM Real-Time PCR Kit for Detection of Mycobacteria. Korean J Clin Microbiol. 2011;14:55–59.2. Kim YS, Jo YH, Lee HJ, et al. Comparison of the MGIT (Mycobacteria Growth Indicator Tube) with Ogawa Media for Recovery of Mycobacteria. Korean J Clin Microbiol. 2001;4:58–61.3. Go UY, Park MS, Kim UN, et al. Tuberculosis Prevention and Care in Korea: Evolution of Policy and Practice. J Clin Tuberc Other Mycobact Dis. 2018;11:28–36.4. Schlossberg D. Tuberculosis and nontuberculous mycobacterial infections. 6th ed. ASM Press, Washington, DC. 2011.5. Griffith DE, Aksamit T, Brown-Elliott BA, et al. An Official ATS/IDSA Statement: Diagnosis, Treatment, and Prevention of Nontuberculous Mycobacterial Diseases. Am J Respir Crit Care Med. 2007;175:367–416.6. Kang H, Sung N, Lee S, et al. Comparison of Smear and Culture Positivity Using NaOH Method and NALC-NaOH Method for Sputum Treatment. Tuberc Respir Dis. 2008;65:379–384.7. Beran V, Havelkova M, Kaustova J, et al. Cell Wall Deficient Forms of Mycobacteria: A Review. Vet Med. 2006;7:365–389.8. Yi JY, Kim JP, Shin JH, et al. Detection of Mycobacterium tuberculosis using BACTEC Mycobacteria Growth Indicator Tube (MGIT) 960 System: Comparison with BACTEC 460 TB System and Ogawa Media. Korean J Clin Pathol. 2000;20:384–391.9. Subramanyam B, Sivaramakrishnan G, Sangamithrai D, et al. Reprocessing of Contaminated MGIT 960 Cultures to Improve Availability of Valid Results for Mycobacteria. Int J Microbiol. 2020;1721020:1–3.10. Jung H, Bang HI, Choi TY. Evaluation of the Effectiveness of a Re-Decontaminating Process with Bacterial Contaminated Specimens Showing a Positive MGIT Signal for the Detection of Mycobacteria. Korean J Clin Lab Sci. 2019;51:171–176.11. Krasnow I, Wayne LG. Sputum Digestion. I. The Mortality Rate of Tubercle Bacilli in Various Digestion Systems. Am J Clin Pathol. 1966;45:352–355.12. Bae E, Im JH, Kim SW, et al. Evaluation of Combination of BACTEC Mycobacteria Growth Indicator Tube 960 System and Ogawa Media for Mycobacterial Culture. Korean J Lab Med. 2008;28:299–306.13. Joung US, Jeong J, Lee SH, et al. Comparison of Mycobacterial Culture by Mycobacterium Growth Indicator Tube and Ogawa Media. Korean J Clin Microbiol. 2004;7:135–138.14. Kim YS, Jo YH, Lee HJ, et al. Comparison of the MGIT (Mycobacteria Growth Indicator Tube) with Ogawa Media for Recovery of Mycobacteria. Korean J Clin Microbiol. 2001;4:58–61.