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Background: Early laboratory detection of Mycobacterium tuberculosis is crucial for con- trolling tuberculosis. We developed a hydrogel mycobacterial culture method that retains the advantages of both solid and liquid methods in terms of speed, cost, and efficiency. Methods: Mycobacterium bovis bacillus Calmette-Guérin (BCG) suspensions and 200 acid-fast bacilli (AFB)-positive clinical specimens were inoculated in Middlebrook 7H9 liq- uid media (Becton-Dickinson and Company, USA) and mixed with 75 μL of 9-fluorenyl- methoxycarbonyl (Fmoc)-Phe-Phe-OH hydrogel stock solution in an Eppendorf tube just before culture incubation. The mixtures were cultured at 37°C for as long as 14 days to monitor culture status. Results: The number of M. bovis BCG increased with time. For 200 AFB smear-positive specimens, 155 of 158 conventional culture-positive specimens and 4 culture-negative or contaminated specimens yielded positive cultures within 14 days. For 128 specimens positive with the liquid culture method, the time to positive culture using the hydrogel method (mean, 12.6 days; range, 7 to 14 days) was significantly shorter than that for con- ventional liquid culture (mean, 16.2 days; range, 6 to 31 days; P <0.0001). Conclusions: The hydrogel scaffold culture system is useful for timely, economical, and efficient detection of mycobacteria in clinical specimens.

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