By Dr. Vincent LaBombardi, St. Vincent’s Medical Center, New York City

The laboratory at St. Vincent’s Hospital in Manhattan, New York City, NY has a long history using the ESP®/VersaTREK® system for mycobacterial culture and susceptibility testing. This laboratory took part in the initial clinical trial of the ESP Culture System for mycobacterial
culture. What became evident immediately was the increase in isolation rates. Besides
M. tuberculosis, we were able to recover many more of the non-tuberculous mycobacteria than we could in the past. This was extremely important to us considering our patient population.

St. Vincent’s went live with this system for mycobacteria in September of 1995. This laboratory also validated the use of nucleic acid probes and later, HPLC, to directly identify mycobacteria from positive Myco bottles. This had a tremendous impact on decreasing our turn around times. St. Vincent’s also participated in trials involving the first line anti-tubercular
agents and PZA.

The data was submitted to New York State which granted us the right to use this test on our patient samples for the first line agents even before the test was cleared by the FDA. In all the years I have been using ESP/VT to do NYS proficiencies I have never gotten a single susceptibility result wrong! That says something for the Myco system!

More importantly is what this system has done for us clinically. By identifying isolates directly from positive Myco bottles and using the growth from the bottle as the inoculum source for the susceptibility test, we now average 21 days for reporting the identification and susceptibility results on a smear positive specimen containing M. tuberculosis. The average of a smear negative specimen with M. tuberculosis is 28 days. We can therefore generate results within clinically relevant time frames and have a significant impact on patient care. We have also adapted this system to perform susceptibility tests on clinically relevant species of non- tuberculosis mycobacteria.

The VersaTREK Myco system continues to perform reliably and it is an integral part of our laboratory.