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Id: biblio-894849
Autor: Cayci, Yeliz Tanriverdi; Bilgin, Kemal; Coban, Ahmet Yilmaz; Birinci, Asuman; Durupınar, Belma.
Título: An evaluation of false-positive rifampicin resistance on the Xpert MTB/RIF
Fonte: Mem. Inst. Oswaldo Cruz;112(11):756-759, Nov. 2017. tab.
Idioma: en.
Resumo: BACKGROUND Mycobacterium tuberculosis (MTB) is one of the most significant causes of mortality and morbidity. Early diagnose is important especially in multiple drug resistant tuberculosis to avoid transmission. Traditional techniques requires at least one to three weeks for diagnosis of tuberculosis. Diagnostic delays with multiple drug resistant tuberculosis are associated with worse clinical outcomes and increased transmission The Xpert MTB/RIF assay is one of the new diagnostic device for the diagnosis of tuberculosis and rapid detection of rifampicin resistance. OBJECTIVE We assessed the performance of Xpert MTB/RIF assay for detecting rifampicin resistance using phenotypic drug susceptibility tests as automated BD MGIT 960. METHODS Total of 2136 specimens were included in the study. Xpert MTB/RIF testing was performed on samples, using version 4 cartridges, according to the manufacturer's recommendations. The MTBC culture and first-line phenotypic DST were performed in automated BD MGIT 960 (Becton & Dickinson, USA) according to the recommendations of the manufacturer. Agar proportion was used in the case of inconsistency for rifampicin resistance. FINDINGS Thirty-four samples (19 respiratory and 15 nonrespiratory samples) were determined as positive for M. tuberculosis complex by Xpert MTB/RIF (Cepheid GeneXpert® System, USA). Xpert MTB/RIF assay detected 4/34 (11.7%) specimens as rifampicin resistant. One of the rifampicin resistant isolates was determined susceptible in MGIT 960 automated system. This isolate was also tested with agar proportion method and found susceptible to rifampicin. MAIN CONCLUSION The Xpert MTB/RIF assay can be used as first-line assay for the detection of M. tuberculosis. However, microbiologists must be aware of the limitations of the assay.
Descritores: Tuberculose Pulmonar/diagnóstico
Tuberculose Pulmonar/tratamento farmacológico
Testes de Sensibilidade Microbiana
Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico
Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico
Antibióticos Antituberculose/uso terapêutico
Mycobacterium tuberculosis/efeitos dos fármacos
-Fenótipo
Sensibilidade e Especificidade
Limites: Seres Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-841801
Autor: Santos, Paula Fernanda Gonçalves dos; Costa, Elis Regina Dalla; Ramalho, Daniela M; Rossetti, Maria Lucia; Barcellos, Regina Bones; Nunes, Luciana de Souza; Esteves, Leonardo Souza; Rodenbusch, Rodrigo; Anthony, Richard M; Bergval, Indra; Sengstake, Sarah; Viveiros, Miguel; Kritski, Afrânio; Oliveira, Martha M.
Título: Detection of tuberculosis drug resistance: a comparison by Mycobacterium tuberculosis MLPA assay versus Genotype®MTBDRplus
Fonte: Mem. Inst. Oswaldo Cruz;112(6):396-403, June 2017. tab.
Idioma: en.
Projeto: CNPq; . CNPq; . FAPERJ; . CAPES.
Resumo: BACKGROUND To cope with the emergence of multidrug-resistant tuberculosis (MDR-TB), new molecular methods that can routinely be used to screen for a wide range of drug resistance related genetic markers in the Mycobacterium tuberculosis genome are urgently needed. OBJECTIVE To evaluate the performance of multiplex ligaton-dependent probe amplification (MLPA) against Genotype® MTBDRplus to detect resistance to isoniazid (INHr) and rifampicin (RIFr). METHOD 96 culture isolates characterised for identification, drug susceptibility testing (DST) and sequencing of rpoB, katG, and inhA genes were evaluated by the MLPA and Genotype®MTBDRplus assays. RESULTS With sequencing as a reference standard, sensitivity (SE) to detect INHr was 92.8% and 85.7%, and specificity (SP) was 100% and 97.5%, for MLPA and Genotype®MTBDRplus, respectively. In relation to RIFr, SE was 87.5% and 100%, and SP was 100% and 98.8%, respectively. Kappa value was identical between Genotype®MTBDRplus and MLPA compared with the standard DST and sequencing for detection of INHr [0.83 (0.75-0.91)] and RIFr [0.93 (0.88-0.98)]. CONCLUSION Compared to Genotype®MTBDRplus, MLPA showed similar sensitivity to detect INH and RIF resistance. The results obtained by the MLPA and Genotype®MTBDRplus assays indicate that both molecular tests can be used for the rapid detection of drug-resistant TB with high accuracy. MLPA has the added value of providing information on the circulating M. tuberculosis lineages.
Descritores: DNA Bacteriano/genética
Tuberculose Resistente a Múltiplos Medicamentos/microbiologia
Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos
Farmacorresistência Bacteriana Múltipla/genética
Isoniazida/farmacologia
Antibióticos Antituberculose/farmacologia
Mycobacterium tuberculosis/efeitos dos fármacos
Mycobacterium tuberculosis/genética
-Resistência a Medicamentos
Antibacterianos
Limites: Seres Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-893834
Autor: Sogebi, Olusola Ayodele; Fadeyi, Muse Olatunbosun; Adefuye, Bolanle Olufunlola; Soyinka, Festus Olukayode.
Título: Hearing thresholds in patients with drug-resistant tuberculosis: baseline audiogram configurations and associations / Limiares auditivos em pacientes com tuberculose resistente: configurações do audiograma basal e associações
Fonte: J. bras. pneumol;43(3):195-201, May-June 2017. tab.
Idioma: en.
Resumo: ABSTRACT Objective: To use baseline audiogram parameters in order to ascertain whether drug-resistant tuberculosis (DR-TB) has effects on hearing, as well as to describe the configurations of the audiograms and to determine whether there are parameters that can be associated with those configurations. Methods: This was a prospective study involving patients diagnosed with DR-TB at a tuberculosis treatment center in the state of Ogun, in Nigeria. The patients included in the study were submitted to pure tone audiometry at baseline (within two weeks after treatment initiation). For comparative analyses, data regarding demographic and clinical characteristics were collected from the medical records of the patients. Results: The final sample comprised 132 patients. The mean age of the patients was 34.5 ± 12.6 years (range, 8-82 years), and the male:female ratio was 2:1. Of the 132 patients, 103 (78.0%) resided in neighboring states, 125 (94.7%) had previously experienced antituberculosis treatment failure, and 18 (13.6%) were retroviral-positive. Normal audiograms were found in 12 patients (9.1%), whereas sensorineural hearing loss was identified in 104 (78.8%), the two most common configurations being ascending, in 54 (40.9%), and sloping, in 26 (19.7%). Pure-tone averages at low frequencies (0.25-1.0 kHz) and high frequencies (2.0-8.0 kHz) were 33.0 dB and 40.0 dB, respectively. Regarding the degree of hearing loss in the better ear, 36 patients (27.3%) were classified as having normal hearing and 67 (50.8%) were classified as having mild hearing loss (26-40 dB), whereas 29 (21.9%) showed moderate or severe hearing loss. Among the variables studied (age, gender, retroviral status, previous treatment outcome, and weight at admission), only male gender was associated with audiometric configurations. Conclusions: In this sample of patients with DR-TB, most presented with bilateral, mild, suboptimal sensorineural hearing loss, and ascending/sloping audiometric configurations were associated with male gender.

RESUMO Objetivo: Utilizar parâmetros do audiograma basal para verificar se a tuberculose resistente (TB-R) tem efeitos na audição, descrever as configurações dos audiogramas e determinar se há parâmetros que possam ser associados a essas configurações. Métodos: Estudo prospectivo com pacientes diagnosticados com TB-R em um centro de tratamento de tuberculose no estado de Ogun, Nigéria. Os pacientes incluídos no estudo foram submetidos à audiometria de tons puros em até duas semanas após o início do tratamento (audiometria basal). Características demográficas e clínicas foram coletadas dos prontuários médicos dos pacientes para análises comparativas. Resultados: A amostra final envolveu 132 pacientes. A média de idade dos pacientes foi de 34,5 ± 12,6 anos (variação, 8-82 anos), e a razão homem:mulher foi de 2:1. A maioria dos pacientes (n = 103; 78,0%) residia nos estados vizinhos e tinha história de falha de tratamento antituberculose (n = 125; 94.7%); 18 (13.6%) apresentavam status retroviral positivo. Doze pacientes (9,1%) apresentaram audiogramas normais, e 104 (78,8%) apresentaram perda auditiva neurossensorial, sendo as configurações mais comuns do tipo ascendente, em 54 (40,9%), e descendente, em 26 (19,7%). As médias de tons puros em frequências baixas (0,25-1,0 kHz) e altas (2,0-8,0 kHz) foram de 33,0 dB e 40,0 dB, respectivamente. Quanto ao grau de perda auditiva no melhor ouvido, 36 pacientes (27,3%) apresentaram audição normal, e 67 (50,8%) apresentaram perda auditiva leve (26-40 dB), enquanto 29 (21,9%) mostraram perda auditiva moderada ou grave. Entre as variáveis estudadas (idade, gênero, status retroviral, desfecho de tratamento anterior e peso na admissão), somente o gênero masculino foi associado às configurações audiométricas. Conclusões: Nesta amostra de pacientes com TB-R, a maioria apresentou perda auditiva neurossensorial leve e subótima bilateralmente, com configurações audiométricas ascendentes/descendentes associadas ao gênero masculino.
Descritores: Antibióticos Antituberculose/efeitos adversos
Limiar Auditivo/efeitos dos fármacos
Limiar Auditivo/fisiologia
Perda Auditiva/induzido quimicamente
Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico
Tuberculose Resistente a Múltiplos Medicamentos/fisiopatologia
-Audiometria de Tons Puros/métodos
Perda Auditiva/fisiopatologia
Estudos Prospectivos
Valores de Referência
Índice de Gravidade de Doença
Fatores Sexuais
Fatores de Tempo
Falha de Tratamento
Tuberculose Resistente a Múltiplos Medicamentos/complicações
Limites: Seres Humanos
Masculino
Feminino
Criança
Adolescente
Adulto
Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-841272
Autor: Silva, Vangie Dias da; Mello, Fernanda Carvalho de Queiroz; Figueiredo, Sonia Catarina de Abreu.
Título: Estimated rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a ­four-drug fixed-dose combination regimen at a tertiary health care facility in the city of Rio de Janeiro, Brazil / Estimativas das taxas de recidiva, cura e abandono de tratamento em pacientes com tuberculose pulmonar tratados com esquema de dose fixa combinada de quatro drogas em uma unidade de saúde terciária na cidade do Rio de Janeiro
Fonte: J. bras. pneumol;43(2):113-120, Mar.-Apr. 2017. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective: To estimate the rates of recurrence, cure, and treatment abandonment in patients with pulmonary tuberculosis treated with a four-drug fixed-dose combination (FDC) regimen, as well as to evaluate possible associated factors. Methods: This was a retrospective observational study involving 208 patients with a confirmed diagnosis of pulmonary tuberculosis enrolled in the Hospital Tuberculosis Control Program at the Institute for Thoracic Diseases, located in the city of Rio de Janeiro, Brazil. Between January of 2007 and October of 2010, the patients were treated with the rifampin-isoniazid-pyrazinamide (RHZ) regimen, whereas, between November of 2010 and June of 2013, the patients were treated with the rifampin-isoniazid-pyrazinamide-ethambutol FDC (RHZE/FDC) regimen. Data regarding tuberculosis recurrence and mortality in the patients studied were retrieved from the Brazilian Case Registry Database and the Brazilian Mortality Database, respectively. The follow-up period comprised two years after treatment completion. Results: The rates of cure, treatment abandonment, and death were 90.4%, 4.8%, and 4.8%, respectively. There were 7 cases of recurrence during the follow-up period. No significant differences in the recurrence rate were found between the RHZ and RHZE/FDC regimen groups (p = 0.13). We identified no factors associated with the occurrence of recurrence; nor were there any statistically significant differences between the treatment groups regarding adverse effects or rates of cure, treatment abandonment, or death. Conclusions: The adoption of the RHZE/FDC regimen produced no statistically significant differences in the rates of recurrence, cure, or treatment abandonment; nor did it have any effect on the occurrence of adverse effects, in comparison with the use of the RHZ regimen.

RESUMO Objetivo: Estimar as taxas de recidiva, cura e abandono de tratamento em pacientes com tuberculose pulmonar tratados com o esquema de dose fixa combinada (DFC) de quatro drogas e avaliar possíveis fatores associados. Métodos: Estudo observacional retrospectivo com 208 pacientes com diagnóstico confirmado de tuberculose pulmonar registrados no Programa de Controle da Tuberculose Hospitalar do Instituto de Doenças do Tórax, localizado na cidade do Rio de Janeiro. Os pacientes tratados entre janeiro de 2007 e outubro de 2010 receberam o esquema rifampicina-isoniazida-pirazinamida (RHZ), e aqueles tratados entre novembro de 2010 e junho de 2013 receberam o esquema rifampicina-isoniazida-pirazinamida-etambutol em DFC (RHZE/DFC). Os dados dos pacientes sobre recidiva e óbito foram obtidos no Sistema de Informação de Agravos de Notificação e no Sistema de Informação de Mortalidade, respectivamente. O período de acompanhamento foi de dois anos após o encerramento do tratamento. Resultados: As taxas de cura, abandono e óbito foram de 90,4%, 4,8% e 4,8%, respectivamente. Houve 7 casos de recidivas durante o período de acompanhamento. Não houve diferenças significativas na taxa de recidiva entre os grupos de tratamento RHZ e RHZE/DFC (p = 0,13). Não foram identificados fatores associados com a ocorrência de recidiva, nem houve diferenças estatisticamente significativas na ocorrência dos efeitos adversos ou nas taxas de cura, abandono e óbito entre os grupos de tratamento. Conclusões: A adoção do esquema de tratamento RHZE/DFC não produziu diferenças estatisticamente significativas nas taxas de recidiva, cura e abandono nem na ocorrência de efeitos adversos em comparação com o esquema RHZ.
Descritores: Antibióticos Antituberculose/uso terapêutico
Tuberculose Pulmonar/tratamento farmacológico
Tuberculose Pulmonar/epidemiologia
-Antibióticos Antituberculose/classificação
Brasil/epidemiologia
Cidades/epidemiologia
Quimioterapia Combinada/métodos
Etambutol/uso terapêutico
Incidência
Isoniazida/uso terapêutico
Pirazinamida/uso terapêutico
Recidiva
Estudos Retrospectivos
Rifampina/uso terapêutico
Fatores de Risco
Tuberculose Pulmonar/diagnóstico
Limites: Seres Humanos
Masculino
Feminino
Adolescente
Adulto
Meia-Idade
Responsável: BR1.1 - BIREME


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Id: lil-782055
Autor: Ferraz-Carvalho, Rafaela S; Pereira, Marcela A; Linhares, Leonardo A; Lira-Nogueira, Mariane CB; Cavalcanti, Isabella MF; Santos-Magalhães, Nereide S; Montenegro, Lílian ML.
Título: Effects of the encapsulation of usnic acid into liposomes and interactions with antituberculous agents against multidrug-resistant tuberculosis clinical isolates
Fonte: Mem. Inst. Oswaldo Cruz;111(5):330-334, May 2016. tab.
Idioma: en.
Projeto: FACEPE; . FACEPE; . CNPq.
Resumo: Mycobacterium tuberculosis (Mtb) has acquired resistance and consequently the antibiotic therapeutic options available against this microorganism are limited. In this scenario, the use of usnic acid (UA), a natural compound, encapsulated into liposomes is proposed as a new approach in multidrug-resistant tuberculosis (MDR-TB) therapy. Thus the aim of this study was to evaluate the effect of the encapsulation of UA into liposomes, as well as its combination with antituberculous agents such as rifampicin (RIF) and isoniazid (INH) against MDR-TB clinical isolates. The in vitro antimycobacterial activity of UA-loaded liposomes (UA-Lipo) against MDR-TB was assessed by the microdilution method. The in vitro interaction of UA with antituberculous agents was carried out using checkerboard method. Minimal inhibitory concentration values were 31.25 and 0.98 µg/mL for UA and UA-Lipo, respectively. The results exhibited a synergistic interaction between RIF and UA [fractional inhibitory concentration index (FICI) = 0.31] or UA-Lipo (FICI = 0.28). Regarding INH, the combination of UA or UA-Lipo revealed no marked effect (FICI = 1.30-2.50). The UA-Lipo may be used as a dosage form to improve the antimycobacterial activity of RIF, a first-line drug for the treatment of infections caused by Mtb.
Descritores: Antibióticos Antituberculose/farmacologia
Benzofuranos/farmacologia
Isoniazida/farmacologia
Lipossomos
Mycobacterium tuberculosis/efeitos dos fármacos
Rifampina/farmacologia
-Cápsulas
Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos
Sinergismo Farmacológico
Testes de Sensibilidade Microbiana
Limites: Seres Humanos
Responsável: BR1.1 - BIREME


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Id: lil-778712
Autor: Navas C., Alida M; Martínez, Pedro; Leggio, Kassandra.
Título: Hidroneumotórax tuberculoso / Hydropneumothorax tuberculosis
Fonte: Med. interna (Caracas);29(4):222-222, 2013. ilus.
Idioma: es.
Descritores: Antibióticos Antituberculose/uso terapêutico
Antituberculosos/uso terapêutico
Cavidade Pleural/patologia
Dispneia/patologia
Hidropneumotórax/complicações
Hidropneumotórax/diagnóstico
Tuberculose Latente/diagnóstico
Tuberculose Latente/patologia
Limites: Seres Humanos
Masculino
Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: VE1.1 - Biblioteca Humberto Garcia Arocha


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Id: lil-776464
Autor: Resende, Mariângela Ribeiro.
Título: How we can utilize the Xpert MTB/RIF assay to decide on airborne infection isolation of inpatients with tuberculosis suspicion in Brazil: a brief review of the current data
Fonte: Braz. j. infect. dis;20(1):105-106, Jan.-Feb. 2016.
Idioma: en.
Descritores: Isolamento de Pacientes
Tuberculose Pulmonar/diagnóstico
-Microbiologia do Ar
Antibióticos Antituberculose/farmacologia
Mycobacterium tuberculosis/efeitos dos fármacos
Mycobacterium tuberculosis/isolamento & purificação
Rifampina/farmacologia
Sensibilidade e Especificidade
Tuberculose Pulmonar/prevenção & controle
Limites: Seres Humanos
Tipo de Publ: Carta
Responsável: BR1.1 - BIREME


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Id: lil-772615
Autor: Martínez, Luz Maira Wintaco; Castro, Gloria Puerto; Guerrero, Martha Inírida.
Título: A molecular platform for the diagnosis of multidrug-resistant and pre-extensively drug-resistant tuberculosis based on single nucleotide polymorphism mutations present in Colombian isolates of Mycobacterium tuberculosis
Fonte: Mem. Inst. Oswaldo Cruz;111(2):93-100, Feb. 2016. tab, graf.
Idioma: en.
Projeto: COLCIENCIAS; . INS.
Resumo: Developing a fast, inexpensive, and specific test that reflects the mutations present in Mycobacterium tuberculosis isolates according to geographic region is the main challenge for drug-resistant tuberculosis (TB) control. The objective of this study was to develop a molecular platform to make a rapid diagnosis of multidrug-resistant (MDR) and extensively drug-resistant TB based on single nucleotide polymorphism (SNP) mutations present in therpoB, katG, inhA,ahpC, and gyrA genes from Colombian M. tuberculosis isolates. The amplification and sequencing of each target gene was performed. Capture oligonucleotides, which were tested before being used with isolates to assess the performance, were designed for wild type and mutated codons, and the platform was standardised based on the reverse hybridisation principle. This method was tested on DNA samples extracted from clinical isolates from 160 Colombian patients who were previously phenotypically and genotypically characterised as having susceptible or MDR M. tuberculosis. For our method, the kappa index of the sequencing results was 0,966, 0,825, 0,766, 0,740, and 0,625 forrpoB, katG, inhA,ahpC, and gyrA, respectively. Sensitivity and specificity were ranked between 90-100% compared with those of phenotypic drug susceptibility testing. Our assay helps to pave the way for implementation locally and for specifically adapted methods that can simultaneously detect drug resistance mutations to first and second-line drugs within a few hours.
Descritores: DNA Bacteriano/genética
Técnicas de Diagnóstico Molecular/métodos
Mutação/genética
Mycobacterium tuberculosis/isolamento & purificação
Polimorfismo de Nucleotídeo Único/genética
Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico
-Antibióticos Antituberculose/farmacologia
Colômbia
Tuberculose Extensivamente Resistente a Medicamentos/classificação
Tuberculose Extensivamente Resistente a Medicamentos/diagnóstico
Fluoroquinolonas/farmacologia
Amplificação de Genes
Isoniazida/farmacologia
Mycobacterium tuberculosis/efeitos dos fármacos
Hibridização de Ácido Nucleico/métodos
Rifampina/farmacologia
Análise de Sequência de DNA
Tuberculose Resistente a Múltiplos Medicamentos/genética
Limites: Seres Humanos
Tipo de Publ: Research Support, Non-U.S. Gov't
Estudos de Validação
Responsável: BR1.1 - BIREME


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Id: lil-745657
Autor: Atehortúa, Santiago; Ramírez, Faiver; Echeverri, Lina María; Peñata, Adrián; Ospina, Sigifredo.
Título: Xpert MTB/RIF test performance assay in respiratory samples at real work settings in a developing country / Rendimiento de la prueba Xpert MTB/RIF en muestras respiratorias en el escenario real de trabajo en un país en desarrollo
Fonte: Biomédica (Bogotá);35(1):125-130, ene.-mar. 2015. ilus, tab.
Idioma: en.
Resumo: Introduction: The Xpert MTB/RIF test detects DNA from Mycobacterium tuberculosis complex and susceptibility to rifampin. It has been evaluated repeatedly under "ideal" conditions including centrifugation of sputum and bronchoalveolar lavage, Ziehl Neelsen (ZN) and auramine/rhodamine staining, as well as with solid and liquid automated culture methods. Results from such evaluations cannot be extrapolated to low-income countries that do not routinely use all these processes. Objective: To assess the performance of the Xpert MTB/RIF test in respiratory samples under "real" conditions of work in a low-income country and its correlation with phenotypic susceptibility testing. Materials and methods: We conducted a cross-sectional study to assess the performance of the Xpert MTB/RIF test in =12 year-old patients with suspected pulmonary tuberculosis. In routine sample processing at the Hospital we do not use sputum centrifugation, staining with auramine/rhodamine or automated liquid culture. Results: We screened 152 patients of whom 108 were eligible for the study and 103 were included in the analysis; 34% of the samples were positive. The overall test sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 91%, 92%, 83% and 96%, respectively. In ZN-negative samples the sensitivity, specificity, PPV and NPV were 87%, 91%, 68% and 97%, respectively. The results of sensitivity and resistance to rifampin were concordant with susceptibility testing using the multiple proportions method (kappa=1, p<0.0001). Conclusions: The Xpert MTB/RIF test overall performance was similar to the one achieved under ideal conditions. Its performance in ZN-negative samples was better under "real" conditions of work in a low-income country.

Introducción. La prueba Xpert MTB/RIF detecta el ADN del complejo Mycobacterium tuberculosis y la sensibilidad a rifampicina. La prueba ha sido evaluada en condiciones "ideales" que incluyen la centrifugación de esputo y el lavado broncoalveolar, la tinción de Ziehl Neelsen (ZN) y de auramina-rodamina y los métodos de cultivo sólido y de cultivo líquido automatizado. Los resultados de tales evaluaciones no pueden extrapolarse a países de bajos ingresos que no utilizan habitualmente todos estos procesos. Objetivo. Evaluar el rendimiento de la prueba Xpert MTB/RIF en muestras respiratorias bajo condiciones "reales" de trabajo y su correlación con las pruebas fenotípicas de sensibilidad. Materiales y métodos. Se llevó a cabo un estudio transversal para evaluar el rendimiento de la prueba Xpert MTB/RIF en pacientes =12 años con sospecha de tuberculosis pulmonar. En el procesamiento rutinario de muestras en el Hospital del estudio no se usa la centrifugación del esputo, la tinción con auramina-rodamina ni el cultivo líquido automatizado. Resultados. Se incluyeron 152 pacientes, de los cuales 108 eran elegibles y 103 se incluyeron en el análisis. El 34 % de las muestras fueron positivas; la sensibilidad de la prueba fue de 91 %, la especificidad de 92 %, el valor diagnóstico positivo de 83 % y el valor diagnóstico negativo global de 96 %. En las muestras negativas con Ziehl Neelsen, la sensibilidad fue de 87 %, la especificidad de 91 % y los valores diagnósticos positivo y negativo alcanzaron 68 y 97 %, respectivamente. Los resultados de sensibilidad o resistencia a la rifampicina concordaron con los de la prueba fenotípica de sensibilidad (valor de kappa=1, p<0,0001). Conclusiones. El rendimiento global de la prueba fue similar al obtenido bajo condiciones "ideales". En las muestras negativas con Ziehl Neelsen se obtuvo un mejor rendimiento en las condiciones "reales" de trabajo de un país de bajos ingresos.
Descritores: Antibióticos Antituberculose/farmacologia
Antibióticos Antituberculose/uso terapêutico
Mycobacterium tuberculosis/efeitos dos fármacos
Rifampina/farmacologia
Rifampina/uso terapêutico
Tuberculose Pulmonar/tratamento farmacológico
-Colômbia
Estudos Transversais
Países em Desenvolvimento
DNA Bacteriano/análise
Mycobacterium tuberculosis/genética
Limites: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: CO332 - Facultad de Medicina


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Id: lil-715535
Autor: Santos, Josemir Belo dos; Figueiredo, Ana Roberta; Ferraz, Cláudia Elise; Oliveira, Márcia Helena de; Silva, Perla Gomes da; Medeiros, Vanessa Lucília Sileira de.
Título: Cutaneous tuberculosis: diagnosis, histopathology and treatment - Part II
Fonte: An. bras. dermatol;89(4):545-555, Jul-Aug/2014. tab, graf.
Idioma: en.
Resumo: The evolution in the knowledge of tuberculosis' physiopathology allowed not only a better understanding of the immunological factors involved in the disease process, but also the development of new laboratory tests, as well as the establishment of a histological classification that reflects the host's ability to contain the infectious agent. At the same time, the increasing bacilli resistance led to alterations in the basic tuberculosis treatment scheme in 2009. This article critically examines laboratory and histological investigations, treatment regimens for tuberculosis and possible adverse reactions to the most frequently used drugs.
Descritores: Antituberculosos/uso terapêutico
Tuberculose Cutânea/tratamento farmacológico
Tuberculose Cutânea/patologia
-Antibióticos Antituberculose/uso terapêutico
Granuloma
Isoniazida/uso terapêutico
Mycobacterium tuberculosis
Necrose
Pirazinamida/uso terapêutico
Rifampina/uso terapêutico
Sensibilidade e Especificidade
Limites: Adolescente
Adulto
Idoso
Criança
Feminino
Seres Humanos
Masculino
Responsável: BR1.1 - BIREME



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