Glutaraldehyde test for the rapid diagnosis of pulmonary and extra-pulmonary tuberculosis in an area with high tuberculosis incidence

BACKGROUND Tuberculosis (TB) remains one of the leading causes of morbidity and mortality worldwide. The primary method for controlling TB is the rapid and accurate identification of infected individuals. Immune response exploitation represents one of the main methods used for early TB diagnosis; however, few studies have reported that whole blood originating from TB-infected patients gels faster in the presence of aldehyde than blood originating from healthy subjects, which is the focus of the current study. OBJECTIVES The study objectives are to determine the diagnostic value of a glutaraldehyde test (GT) in pulmonary tuberculosis (PTB) and extra-pulmonary tuberculosis (EPTB) and to assess its performance compared with light-emitting diode fluorescence microscopy (LED-FM). MATERIALS AND METHODS This study included 272 specimens (176 suspected PTB specimens and 96 suspected EPTB specimens). Of the 272 patients, 98 patients had TB infection confirmed by culture (64 PTB cases and 34 EPTB cases), and 174 patients had no TB infection. The gold standard technique (culture) was used as reference to verify the GT's performance. RESULTS The GT showed a high sensitivity (96.9%) and specificity (82.1%) for PTB with a good positive predictive value (PPV = 75.6%) and negative predictive value (NPV = 97.9%). For EPTB, the GT showed a sensitivity of 91.2% and a specificity of 77.4%, with PPV = 68.9% and NPV = 94.1%. LED-FM had lower sensitivities for PTB (65.6%) and EPTB (42.1%) and an excellent specificity of 100%, with PPV = 100% and NPV = 100%. CONCLUSION We concluded that GT is rapid, easy, simple and cost-effective and does not require qualified personnel with a specific background or sophisticated equipment like molecular biology or mycobacterium-specific genotyping techniques. These qualities make the GT attractive for use in low- and high-income countries in addition to other conventional methods, particularly culture, which continues to be the gold standard.

[Clinical, epidemiologic and bacteriological characteristics of urinary tract infections due to staphylococcus saprophyticus in the central part of Tunisia]

We assess the clinical, epidemiologic and bacteriological aspects of urinary tract infections due to S. saprophyticus through a sample collected in the central part of Tunisia. Retrospective study, related to 92 strains of S. saprophyticus, isolated among positive urinary specimens in 2006. Considered data were: sex, age, original departments, symptoms, type of urinary tract infection, diagnosis date and susceptibility of strains to antibiotics. Patients are young women in 98% [average age: 31.5 years] with cystitis in 99%. They are outpatients in 90%. S. saprophyticus represents 2.8% of all uropathogens; it is the first cocci with positive Gram [28.2%]. Any seasonal variation is noticed. S. saprophyticus has shown higher susceptibility to antibiotics than other staphylococci; cotrimoxazole, fluoroquinolons and nitrofurans represent the best treatment. S. saprophyticus is responsible of cystitis in young women. There is no seasonal variation in our area. This community staphylococci is very susceptible to antibiotics