ABSTRACT
Objetivo: Avaliar um procedimento de fácil execução e baixo custo para incrementar o diagnóstico da tuberculose entre pessoas privadas de liberdade sem riscos de contaminação para profissionais de laboratório. Métodos: Amostras de escarro foram analisadas por baciloscopia após tratamento com hipoclorito de sódio e sedimentação espontânea em comparação à baciloscopia direta convencional, cultura pelo método Ogawa-Kudoh e o teste molecular rápido pelo sistema Xpert®MTB/RIF. Para as análises estatísticas foram empregados os programas Open Epi e SPSS. Resultados: De 436 amostras de escarro submetidas ao cultivo 71 foram positivas (verdadeiros positivos) e dessas 50 foram positivas pela baciloscopia direta convencional e 67 pela baciloscopia do escarro processado, o que corresponde a um incremento de 29% na positividade. Conclusão: O procedimento proposto preserva as vantagens e aumenta a sensibilidade da baciloscopia direta convencional. A implementação dessa técnica para diagnóstico entre grupos vulneráveis em locais de acesso e recursos limitados poderá aumentar a identificação de casos de tuberculose pulmonar.
Subject(s)
Prisoners , Sputum , Tuberculosis , Diagnosis , Mycobacterium tuberculosis , Laboratory PersonnelABSTRACT
INTRODUCTION: Microscopic identification of active pulmonary tuberculosis (PTB) from direct smears of sputum (DS) is widely used for detection, but has limited sensitivity. Here, we assessed the yield of acid-fast bacilli (AFB) detection in processed sputum smears (PSS). METHODS: Sputum samples were simultaneously analyzed by direct sputum smearing and after chemical treatment and spontaneous sedimentation. RESULTS: Of the 1,719 samples analyzed, 16.4% were positive for AFB in conventional DS and 21.4% in PSS, corresponding to a 30% increase in detection. CONCLUSIONS: Increased sensitivity from analyzing PSS and better safety protocols will contribute to improved detection and control of the disease.
Subject(s)
Mycobacterium tuberculosis/isolation & purification , Specimen Handling/methods , Sputum/microbiology , Tuberculosis, Pulmonary/diagnosis , Humans , Sensitivity and SpecificityABSTRACT
Abstract INTRODUCTION: Microscopic identification of active pulmonary tuberculosis (PTB) from direct smears of sputum (DS) is widely used for detection, but has limited sensitivity. Here, we assessed the yield of acid-fast bacilli (AFB) detection in processed sputum smears (PSS). METHODS: Sputum samples were simultaneously analyzed by direct sputum smearing and after chemical treatment and spontaneous sedimentation. RESULTS: Of the 1,719 samples analyzed, 16.4% were positive for AFB in conventional DS and 21.4% in PSS, corresponding to a 30% increase in detection. CONCLUSIONS: Increased sensitivity from analyzing PSS and better safety protocols will contribute to improved detection and control of the disease.