Multicentre evaluation of an automated BACTEC 960 system for susceptibility testing of Mycobacterium tuberculosis.

SETTING: Three mycobacteria reference laboratories in the south-eastern part of Brazil. OBJECTIVE: To evaluate the automated Mycobacteria Growth Indicator Tube (MGIT) for drug susceptibility testing of Mycobacterium tuberculosis. DESIGN: Performance of the automated BACTEC MGIT 960 (M960) system for testing M. tuberculosis susceptibility to streptomycin (SM), isoniazid (INH), rifampicin (RMP) and ethambutol (EMB) was evaluated with 95 clinical isolates and compared to the results of the radiometric BACTEC 460TB (B460) system, the proportion method (PM), and the resistance ratio method (RRM). Judicial susceptibility profiles of 88 isolates were defined based on two or more concordant results among B460, PM and RRM, and used as a reference for comparison with M960 results. RESULTS: Agreement rates between M960 and conventional methods were 95.2% with B460, 96.6% with the PM and 93.4% with the RRM. The lowest agreement rates were obtained for SM with the RRM and for EMB with B460. When comparing M960 with judicial susceptibility profiles, the agreement rate was 97.9%. The agreement rates obtained for INH and RMP were 99.2% and for SM and EMB they were 96.2% and 96.9%, respectively. The mean time to reporting the M960 results was 6.9 days. CONCLUSION: M960 offers great improvements when compared to the proportion and resistance ratio methods and would benefit patient treatment.

Differentiation of Mycobacterium tuberculosis from other mycobacteria with rho-nitrobenzoic acid using MGIT960.

SETTING: Mycobacteria growth in media with the addition of inhibitory substances has been used in species identification. Growth of the Mycobacterium tuberculosis complex (MTC) is inhibited by rho-nitrobenzoic acid (PNB), whereas non-tuberculous mycobacteria (NTM) are resistant. OBJECTIVE: To develop a rapid PNB test using the automated BACTEC MGIT960 system and to evaluate its usefulness in the screening of mycobacterial isolates. DESIGN: PNB tests were performed in 93 MTC strains and 61 NTM strains from the Instituto Adolfo Lutz Culture Collection. PNB was added to Löwenstein-Jensen (LJ) medium and to BACTEC MGIT960 medium. RESULTS: The MTC strains were all PNB-susceptible, confirming the original identification. Among 10 NTM species, all were found to be resistant to PNB, except for one strain of M. kansasii and another of M. marinum. The median time to obtain presumptive identification of MTC by inhibition test in the BACTEC MGIT960 system was 6.3 days and for NTM it was 2.5 days. The presumptive identification of MTC in LJ was mostly obtained after day 20. CONCLUSION: The key finding of this analysis was the possibility of combining the traditionally accepted method proposed by Tsukamura and Tsukamura in 1964 with the modern, safe and rapid BACTEC MGIT960 methodology.

Avaliacao da eficacia da estimulacao eletrica nervosa transcutanea sobre a intensidade da dor, volumes pulmonares e forca muscular respiratoria no pos-operatorio de cirurgia abdominal: estudo de caso / Evaluation of TENS effectivens in pain intensity, chest volumes and respiratory muscle force in posoperative abdominal surgery: case report

O procedimento cirurgico do abdome contribui para disfuncoes na musculatura respiratoria, em razao da dor e dos anestesicos utilizados, podendo resultar em complicacoes pulmonares. Este trabalho objetivou verificar a eficacia da Estimulacao Eletrica Nervosa transcutanea (TENS) sobre a intensidade da dor, os volumes pilmonares e a forca muscular respiratoria no pos-operatorio de cirurgia abdominal em paciente do sexo masculino, 55 anos, om doenca pulmonar obstrutiva cronica, submetido a incisao vertical mediana para realizacao de laparotomia exploratoria. Os instrumentos utilizados neste estudo foram escala analogo-visual (EAV), ventilometro OHMEDA, manovacuometro e TENS HTM convencional. Foi realizada avaliacao no pre e pos-operatorio, quando foram obtidos valores de EAV, ventilometria e manovacuometria. No pos-operatorio, os mesmos parametros foram avaliados apos uma hora de aplicacao da TENS. O valor numerico da dor referida variou de 7 para 4, da condicao de pre para pos-aplicacao da TENS. Da condicao pos-operatoria pre-TENS a pos-TENS, o paciente apresentou aumento de 3,5(por cento) do volume corrente (Vc), diminuicao de 9,5(por cento) da frequencia respiratoria (Fr) e de 6,34(por cento) do volume minuto (VM) e incremento de 33(por cento) da pImax e de 100(por cento) da PEmax. A utilizacao da TENS dimunuiu a dor e melhorou os volumes pulmonares e a forca muscular respiratoria no pos-operatorio de cirugia abdominal