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Background & Objectives: In human immunodeficiency virus (HIV) infected persons with pulmonary tuberculosis (TB), sputum may not always show acid fast bacilli (AFB). Moreover, in most cases of suspected extrapulmonary TB (irrespective of HIV status) mycobacteria-containing material is not readily available for investigation. This study evaluated whether blood culture for Mycobacterium tuberculosis bacteraemia (mycobacteraemia) help in diagnosing TB in such cases., Methods: A total of 93 consecutive subjects with a clinical diagnosis of tuberculosis with or without laboratory confirmation, 42 with and 38 without coexisting HIV infection, and 13 patients with HIV infection without clinical evidence of TB were enrolled. Mycobacterial blood cultures were done using lysis centrifugation technique followed by subculturing onto the modified Lowenstein-Jenson medium (LJ-1) and Selective Kirchner's medium followed by subculturing onto the modified Lowenstein-Jenson medium (LJ-2, LJ-3)., Results: Of the 15 (16.2%) subjects with evidence of mycobacteremia in 4 (26.7%) blood was the first/ only source of diagnosing TB. Among 80 patients with clinical diagnosis of TB whether supported by laboratory tests or not, 14 (17.5%) had mycobacteraemia. Among the 21 HIV infected patients with laboratory proven TB, 9 (43%) had mycobacteraemia., Interpretation & Conclusion: Blood culture appears to be a useful additional test to diagnose TB in persons with HIV infection. In patients without HIV infection, but with clinical picture compatible with TB, blood culture for mycobacteraemia may occasionally help in the diagnosis. We recommend the use of the lysis centrifugation technique followed by direct smear of the sediment along with inoculation of the sediment into both modified Lowenstein-Jenson medium and the Selective Kirchner's medium with subsequent subculturing onto the modified Lowenstein-Jenson medium for mycobacterial blood culture for detecting mycobacteraemia.

Apparent resistance to trimethoprim-sulphamethoxazole (TMP-SMZ) in disc diffusion method was found in 14 strains of Salmonella typhi and 2 strains of S. paratyphi A grown on Mueller Hinton agar (MHA) of one manufacturer. On MHA from another manufacturer and on diagnostic sensitivity test agar (DSTA), these 16 strains were sensitive to TMP-SMZ. The minimum inhibitory concentration of trimethoprim (TMP) assayed by agar dilution method, on DSTA medium for these 16 strains was in the range of 0.01 to 0.04 micrograms/ml. Thus, the apparent resistance was a spurious result due to the unsatisfactory quality of the batch of MHA of the first manufacturer. Presumably the medium contained thymine or its derivatives which act as antagonists to TMP and sulphonamide drugs.