Evaluation of mycobacteria growth indicator tubes for susceptibility testing of Mycobacterium tuberculosis to isoniazid and rifampin.

The reliability of mycobacteria growth indicator tubes (MGIT) for determining the susceptibility of Mycobacterium tuberculosis to isoniazid (0.1 microgram/ml) and rifampin (2.0 micrograms/ml) was evaluated by comparing MGIT results to those obtained by the radiometric BACTEC TB method. We tested 29 isolates, many selected for resistance. The turnaround times were 3-8 days (median 6) for MGIT and 4-10 days (median 6) for BACTEC. Isoniazid results by both methods agreed for all isolates tested: 20 resistant and nine susceptible. Rifampin results agreed for 28 isolates: 10 resistant and 18 susceptible. One isolate yielded discrepant results: resistant to rifampin by BACTEC, but susceptible by MGIT. This isolate was also rifampin-resistant by the traditional Method of Proportion and when tested by the MGIT method using 1.0 micrograms/ml of rifampin. The MGIT system is a nonradiometric alternative to the BACTEC for rapid susceptibility testing of M. tuberculosis to isoniazid and rifampin; however, additional testing is needed to determine the optimal concentration of rifampin.