Skin lesions Skin LJ + pyruvate 28 - 30 Air 8 weeks Weekly M. marinum Tissue Biopsy infections extending to 12 M. ulcerans weeks if - tank ‘fish required58 M. chelonae granuloma’ - cutaneous ulcer (or or “Buruli” “Bairnsdale ulcer” Post-surgery Automated liquid If automated monitoring systems are used, after sites eg systems decontamination of clinical samples, refer to local sternotomy protocols and manufacturer’s recommendations. These should be checked continuously for bottles that flag positive. A blood agar plate should be set up for M.chimaera / M. all bottles that are flagged positive to check for Cardiac avium contamination. – surgery intracellulare group LJ + pyruvate 35 - 37 Air 8 weeks Weekly extending to 12 weeks if required58 For these situations, add the following: Clinical Specimen Supplementary Incubation Cultures Target details/ media read organism(s) Temp Time Conditions oC Tuberculous CSF and other Kirchner’s liquid 35 37 Air 8 weeks Weekly Mycobacterium – meningitis non-sputum media extending to 12 species specimens weeks if OR required58 Middlebrook 7H9 Clinical Specimen Optional media Incubation Cultures Target details/ read organism(s) Conditions Temp Atmos Time oC Consider for Automated If automated monitoring systems are used, after bone and liquid systems* decontamination of clinical samples, refer to local fluids eg from protocols and manufacturer’s recommendations. These extremities should be checked continuously for bottles that flag Non-tuberculous and/or direct positive. A blood agar plate should be set up for all mycobacteria smear positive bottles that are flagged positive to check for Osteomyelitis contamination. LJ + pyruvate 28 - 30 Air 8 weeks Weekly extending to 12 weeks if required58 Pulmonary Smear +ve LJ + pyruvate 28 30 Air 4-6 weeks Weekly Rapidly growing – tuberculosis BAL/washing mycobacteria LJ + glycerol 42 Air 8 weeks Weekly M. xenopi extending to 12 Sputum Note: M.xenopi weeks if Brochoalveolar do not grow well Pulmonary required58 on medium with tuberculosis washings pyruvate Gastric preferring glycerol. washings
Skin infections - ‘fish tank granuloma’ - cutaneous ulcer (or “Buruli” or “Bairnsdale ulcer” Skin lesions Tissue Biopsy LJ + pyruvate 28 - 30 Air 8 weeks extending to 12 weeks if required58 Weekly M. marinum M. ulcerans M. chelonae Cardiac surgery Post-surgery sites eg sternotomy Automated liquid systems If automated monitoring systems are used, after decontamination of clinical samples, refer to local protocols and manufacturer’s recommendations. These should be checked continuously for bottles that flag positive. A blood agar plate should be set up for all bottles that are flagged positive to check for contamination. M.chimaera / M. avium – intracellulare group LJ + pyruvate 35 - 37 Air 8 weeks extending to 12 weeks if required58 Weekly For these situations, add the following: Clinical details/ Conditions Specimen Supplementary media Incubation Cultures read Target organism(s) Temp oC Time Tuberculous meningitis CSF and other non-sputum specimens Kirchner’s liquid media OR Middlebrook 7H9 35 – 37 Air 8 weeks extending to 12 weeks if required58 Weekly Mycobacterium species Clinical details/ Conditions Specimen Optional media Incubation Cultures read Target organism(s) Temp oC Atmos Time Osteomyelitis Consider for bone and fluids eg from extremities and/or direct smear positive Automated liquid systems* If automated monitoring systems are used, after decontamination of clinical samples, refer to local protocols and manufacturer’s recommendations. These should be checked continuously for bottles that flag positive. A blood agar plate should be set up for all bottles that are flagged positive to check for contamination. Non-tuberculous mycobacteria LJ + pyruvate 28 - 30 Air 8 weeks extending to 12 weeks if required58 Weekly Pulmonary tuberculosis Smear +ve BAL/washing LJ + pyruvate 28 – 30 Air 4-6 weeks Weekly Rapidly growing mycobacteria Pulmonary tuberculosis Sputum Brochoalveolar washings Gastric washings LJ + glycerol Note: M.xenopi do not grow well on medium with pyruvate preferring glycerol. 42 Air 8 weeks extending to 12 weeks if required58 Weekly M. xenopi
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