Discovery of Volatile Biomarkers for Bladder Cancer Detection and Staging through Urine Metabolomics.

Timely diagnosis is crucial to improve the long-term survival of bladder cancer (BC) patients. The discovery of new BC biomarkers based in urine analysis is very attractive because this biofluid is in direct contact with the inner bladder layer, in which most of the neoplasms develop, and is non-invasively collected. Hence, this work aimed to unveil alterations in the urinary volatile profile of patients diagnosed with BC compared with cancer-free individuals, as well as differences among patients diagnosed at different tumor stages, to identify candidate biomarkers for non-invasive BC diagnosis and staging. Urine analysis was performed by headspace solid-phase microextraction coupled with gas chromatography-mass spectrometry (HS-SPME-GC-MS). The results unveiled that BC patients have a distinct urinary volatile profile characterized by higher levels of several alkanes and aromatic compounds, and lower levels of aldehydes, ketones and monoterpenes. Seventeen significantly altered volatiles were used to evaluate the performance for overall BC detection, disclosing 70% sensitivity, 89% specificity and 80% accuracy. Moreover, distinct urinary volatile profiles were found among patients diagnosed at different tumor stages (Ta/Tis, T1 and ≥T2). This work identified distinct urinary volatile signatures of BC patients with potential for non-invasive detection and staging of bladder cancer.

Rapid detection of resistant tuberculosis by nitrate reductase assay performed in three settings in Brazil.

OBJECTIVES: To evaluate nitrate reductase assay (NRA) efficacy for streptomycin, isoniazid, rifampicin and ethambutol susceptibility testing of Mycobacterium tuberculosis strains. METHODS: Results were generated by three laboratories: the Instituto Adolfo Lutz (IAL) Mycobacteria Reference Laboratory and two IAL Regional Laboratories in Santo André and Sorocaba, São Paulo State, Brazil. One hundred and twenty M. tuberculosis strains were simultaneously tested using NRA and the proportion method (PM), while 117 strains were tested using both NRA and BACTEC MGIT 960 (M960). RESULTS: Repeatability analysis of NRA results showed rates of 100% for isoniazid and ethambutol and 97% for streptomycin and rifampicin susceptibility detection, representing substantial agreement. McNemar testing of the data also indicates that NRA and PM, as well as NRA and M960, do not differ significantly. On average, NRA results were available after 10 days. CONCLUSIONS: The data demonstrate that NRA is reliable for susceptibility testing of isoniazid and rifampicin, the two most important drugs for the treatment of tuberculosis. In addition, the reduction in the time necessary to obtain susceptibility results is of fundamental importance.

Reliable identification of mycobacterial species by PCR-restriction enzyme analysis (PRA)-hsp65 in a reference laboratory and elaboration of a sequence-based extended algorithm of PRA-hsp65 patterns.

BACKGROUND: Identification of nontuberculous mycobacteria (NTM) based on phenotypic tests is time-consuming, labor-intensive, expensive and often provides erroneous or inconclusive results. In the molecular method referred to as PRA-hsp65, a fragment of the hsp65 gene is amplified by PCR and then analyzed by restriction digest; this rapid approach offers the promise of accurate, cost-effective species identification. The aim of this study was to determine whether species identification of NTM using PRA-hsp65 is sufficiently reliable to serve as the routine methodology in a reference laboratory. RESULTS: A total of 434 NTM isolates were obtained from 5019 cultures submitted to the Institute Adolpho Lutz, Sao Paulo Brazil, between January 2000 and January 2001. Species identification was performed for all isolates using conventional phenotypic methods and PRA-hsp65. For isolates for which these methods gave discordant results, definitive species identification was obtained by sequencing a 441 bp fragment of hsp65. Phenotypic evaluation and PRA-hsp65 were concordant for 321 (74%) isolates. These assignments were presumed to be correct. For the remaining 113 discordant isolates, definitive identification was based on sequencing a 441 bp fragment of hsp65. PRA-hsp65 identified 30 isolates with hsp65 alleles representing 13 previously unreported PRA-hsp65 patterns. Overall, species identification by PRA-hsp65 was significantly more accurate than by phenotype methods (392 (90.3%) vs. 338 (77.9%), respectively; p < .0001, Fisher's test). Among the 333 isolates representing the most common pathogenic species, PRA-hsp65 provided an incorrect result for only 1.2%. CONCLUSION: PRA-hsp65 is a rapid and highly reliable method and deserves consideration by any clinical microbiology laboratory charged with performing species identification of NTM.

Modified protocol for drug susceptibility testing of MGIT cultures of Mycobacterium tuberculosis by the MGIT 960.

A rapid detection of resistance in Mycobacterium tuberculosis is crucial for management and control of tuberculosis. This study evaluated a more rapid and cost-effective drug susceptibility testing (DST) protocol using primary isolates of M. tuberculosis in mycobacteria growth indicator tube (MGIT). Ninety-four M. tuberculosis isolates in MGIT were subjected to DST by the manufacturer's method, i.e., primary isolates were subcultured and DST was performed from positive cultures for a maximum of 5days; and by our modified method, i.e., DST was performed directly from primary MGIT cultures positive for more than 5days. Results were concordant for 76 (81%) isolates. Agreement between both methods was 92.0%, 98.9%, 97.7%, and 95.5% for streptomycin, isoniazid, rifampicin, and ethambutol, respectively. Six isolates failed to grow on the recommended method, including 3 resistant isolates. Not performing subculture of primary M. tuberculosis isolates yields reliable results, decreasing the turnaround time and the cost of the test.

Viability of stressed Mycobacterium tuberculosis and association with multidrug resistance.

This study investigated biological characteristics of recovered stressed M. tuberculosis isolates that failed to grow in differential culture media for phenotypic identification and in culture media containing anti-tuberculosis drugs for drug-susceptibility testing, despite of having grown in primary culture. It represents an improvement in the diagnosis of MDR tuberculosis and tuberculosis control.

Population structure and circulating genotypes of drug-sensitive and drug-resistant Mycobacterium tuberculosis clinical isolates in São Paulo state, Brazil.

São Paulo is the most populous Brazilian state and reports the largest number of tuberculosis cases in the country annually (over 18,500). This study included 193 isolates obtained during the 2nd Nationwide Survey on Mycobacterium tuberculosis Drug Resistance that was conducted in São Paulo state and 547 isolates from a laboratory based study of drug resistance that were analyzed by the Mycobacteria Reference Laboratory at the Institute Adolfo Lutz. Both studies were conducted from 2006 to 2008 and sought to determine the genetic diversity and pattern of drug resistance of M. tuberculosis isolates (MTC) circulating in São Paulo. The patterns obtained from the spoligotyping analysis demonstrated that 51/740 (6.9%) of the isolates corresponded to orphan patterns and that 689 (93.1%) of the isolates distributed into 144 shared types, including 119 that matched a preexisting shared type in the SITVIT2 database and 25 that were new isolates. A total of 77/144 patterns corresponded to unique isolates, while the remaining 67 corresponded to clustered patterns (n=612 isolates clustered into groups of 2-84 isolates each). The evolutionarily ancient PGG1 lineages (Beijing, CAS1-DEL, EAI3-IND, and PINI2) were rarely detected in São Paulo and comprised only 13/740, or 1.76%, of the total isolates; all of the remaining 727/740, or 98.24%, of the MTC isolates from São Paulo state were from the recent PGG2/3 evolutionary isolates belonging to the LAM, T, S, X, and Haarlem lineages, i.e., the Euro-American group. This study provides the first overview of circulating genotypes of M. tuberculosis in São Paulo state and demonstrates that the clustered shared types containing seven or more M. tuberculosis isolates that are spread in São Paulo state included both resistant and susceptible isolates.

Maintenance of Mycobacterium tuberculosis on glass beads.

The intent of this study was to estimate the shelf life of Mycobacterium tuberculosis strains, and to observe the loss of viability in some of them from year to year. From 2000 to 2004, 10,015 cultures of M. tuberculosis were preserved by freezing on glass beads at -70 degrees C. With the expectation that the loss of viability might be around 5-10%/yr of storage, 730 strains were analyzed in order to establish the prevalence of recovery within a 5% margin of error. This study shows that 94% of the strains preserved at -70 degrees C on glass beads could be recovered within 30 days. The recovery rates for drug-susceptible and drug-resistant strains showed no significant differences. The growth rates and the number of strains that showed abundant growth before the 30th day of incubation represent important features, since the subculture of a strain preserved for future use ought to quickly produce abundant growth in order to avoid misinterpretation of the tests. Our experience indicates that storage of M. tuberculosis on glass beads at -70 degrees C is a suitable procedure for an active culture collection in a public health laboratory like ours, where maintenance of M. tuberculosis cultures is a complementary activity and must be quick, practical, effective, and economical.

Molecular characterization of Mycobacterium kansasii isolates in the State of São Paulo between 1995-1998.

Mycobacterium kansasii is the most common cause of pulmonary nontuberculous mycobacteria infection and classical identification of this pathogen needs a time consuming phenotypic tests. Polymerase chain reaction-restriction fragment length polymorphism analysis (PRA) of the gene enconding for the 65 kDa heat shock (hsp65) protein offers an easy, rapid, and inexpensive procedure to identify and subtype M. kansasii isolates. In the present study, we performed a retrospective analysis of patients who had mycobacteria identified on the basis of phenotypic tests by means of a review of database at Mycobacteria Laboratory of the Instituto Adolfo Lutz in the period 1995-1998. A total of 9381 clinical isolates were analyzed of which 7777 (82.9%) were identified as M. tuberculosis complex and 1604 (17.1%) as nontuberculous mycobacteria. Of the 296 M. kansasii isolates, 189 (63.8%) isolates obtained from 119 patients were viable and were analyzed by PRA-hsp65. Hundred eight two (98.9%) were classified as M. kansasii type I. Two isolates were classified as type II and III and five isolates were characterized as other Mycobacterium species. Clinical isolates of M. kansasii in the state of Sao Paulo was almost exclusively subtype I regardless of HIV status.

Micobactérias não-tuberculosas: diversidade das espécies no estado de São Paulo / Nontuberculous mycobacteria: species diversity in São Paulo state, Brazil

O gênero Mycobacterium é constituído por espécies do complexo M. tuberculosis e outras denominadas micobactérias não-tuberculosas (MNT). Até o momento, mais de cem MNT foram descritas. Os objetivos deste estudo foram avaliar a diversidade das espécies de MNT identificadas no estado de São Paulo, no período de 1991 a 1997, que antecedeu a expansão da terapia anti-retroviral, e determinar a freqüência dos casos que atenderam alguns critérios bacteriológicos para o diagnóstico das infecções causadas pelas MNT. MATERIAL E MÉTODOS: Foram analisadas 1.892 cepas isoladas de sítios estéreis e não-estéreis de 1.248 pacientes atendidos no estado de São Paulo. RESULTADOS: Do total de pacientes, 1.199 (96,1 por cento) tiveram suas cepas identificadas e 3,9 por cento apresentaram resultados não-conclusivos. As dez espécies encontradas foram o complexo M. avium (MAC), M. kansasii, M. chelonae, M. fortuitum, M. szulgai, M. xenopi, M. marinum, M. gordonae, M. terrae e M. nonchromogenicum. Quarenta e sete (7,8 por cento) casos pulmonares tiveram diagnóstico confirmado pelo isolamento da mesma espécie em três ou mais amostras e 67 (34 por cento) pacientes tiveram o diagnóstico bacteriológico confirmado por isolamento em sítios estéreis. CONCLUSÕES: As espécies de MNT mais freqüentemente isoladas no estado de São Paulo foram MAC e M. kansasii. Uma publicação nacional com recomendações para diagnóstico e tratamento dessas infecções seria fundamental para a conduta correta no diagnóstico e no tratamento de micobacterioses.

Staphylococcus aureus produtor de termonuclease em alimentos / Thermonuclease production by Staphylococcus aureus from foods

Foram testadas, quanto à produção de desoxirrtbonuclease (DNAse) e termonuclease (TNAse), 382 cepas de Staphylococcus aureU8, isoladas de 205 amostras de alimentos, separadas em grupos como segue: grupo a, 236 cepas isoladas de 158 amostras de alimentos não-causadores de enfermidades e, grupo b, 146 cepas isoladas de 47 amostras de alimentos recebidas para elucidação do agente causador de intoxicação alimentar, com sintomas clínicos nos afetados compatíveis aos causados pela en terotoxina estafilocócica. Considerando os resultados obtidos, no caso do grupo a, observou-se a presença de cepa não-produtora de DNAse e TNAse em amostra de macarrão e cepas produtoras de DNAse mas não de TNAse provenientes de leite em pó e bife frito, não sendo portanto 100% concordantes os resultados referentes à produção de DNAse e TNAse; no g.rupo b, verificou-se que todas as cepas demonstraram produção de DNAse e TNAse (AU).

Molecular characterization of Mycobacterium kansasii isolates in the State of São Paulo between 1995-1998

Mycobacterium kansasii is the most common cause of pulmonary nontuberculous mycobacteria infection and classical identification of this pathogen needs a time consuming phenotypic tests. Polymerase chain reaction-restriction fragment lenght polymorphism analysis (PRA) of the gene enconding for the 65kDa heat shock (hsp65) protein offers an easy, rapid, and inexpensive procedure to identify and subtype M. kansasii isolates. In the present study, we performed a retrospective analysis of patients who had mycobacteria identified on the basis of phenotypic tests by means of a review of database at Mycobacteria Laboratory of the Instituto Adolfo Lutz in the period 1995-1998. A total of 9381 clinical isolates were analyzed of which 7777 (82.9 percent) were identified as M. tuberculosis complex and 1604 (17.1 percent) as nontuberculous mycobacteria. Of the 296 M. kansasii isolates, 189 (63.8 percent) isolates obtained from 119 patients were viable and were analyzed by PRA-hsp65. Hundred eight two (98.9 percent) were classified as M. kansasii type I. Two isolates were classified as type II and III and five isolates were characterized as other Mycobacterium species. Clinical isolates of M. kansasii in the state of São Paulo was almost exclusively subtype I regardless of HIV status.

Mycobacterium avium complex (MAC): an unusual potential pathogen in cerebrospinal fluid of AIDS patients

O complexo Myocobacterium avium (CMA) e frequentemente isolado de pacientes com complicacoes tardias de Sindrome de Imunodeficiencia Adquirida (AIDS), especialmente na America do Norte e Europa. Entretanto, existem poucos relatos do isolamento deste complexo a partir do sistema nervoso central (SNC) nestes paises da Africa e America Latina. Neste trabalho relatamos o isolamento do CMA do liquor de 11 pacientes portadores de AIDS dentre 1723 (0,63 por cento) atendidos no Centro de Referencia e Treinamento-AIDS, de Sao Paulo, e discutimos a significancia deste achado.

Mycobacterium avium complex (MAC) isolated from AIDS patients and the criteria required for its implication in disease

Anterior a pandemia de AIDS, o Complexo Mycobacterium avium (MAC) era responsavel pela maioria das vezes, por pneumopatias acometendo pacientes com doenca pulmonar cronica de base como enfisema e bronquite cronica. Em 1981, com o advento da sindrome de imunodeficiencia adquirida (SIDA), o MAC passou a representar mais uma das doencas bacterianas mais frequentes em pacientes com essa sindrome, sendo a doenca disseminada a principal forma de manifestacao clinica da infeccao. Entre Janeiro de 1989 e Fevereiro de 1991, no Setor de Microbacterias do Instituto Adolfo Lutz em Sao Paulo, o MAC foi isolado de 103 pacientes a partir do cultivo de diferentes especimes estereis processados coletados de 2.304 pacientes atendidos no Centro de Referencia e Treinamento AIDS e/ou Instituto de Infectologia Emilio Ribas...

Estratégias para a identificaçäo de espécies do complexo mycobacterium fortuitum / Strategies for identification of the mycobacterium fortuitum complex species

As micobactérias de crescimento rápido anteriormente classificadas como complexo micobacterium fourtuitum foram recentemente designadas M.fortuitum, M. peregrinum, M. chenonae e M. abcessus. A identificaçäo dessas micobactérias é importante para estabelecer a terapêutica adequada, visto que possuem diferentes padröes de resistência às drogas. Dentre 3.441 culturas de micobactérias recebidas em 1999 no Setor de micobactérias do Instituto Adolfo Lutz, foram selecionadas 13 cepas, classificadas como complexo M. fortuitum. O estudo incluiu o isolamento das colônias para certificar-se da pureza das culturas, a adiçäo de testes com carboidratos e citrato de sódio que separam as quatro espécies citadas e o uso da técnica de PCR restriction analysis do gene hsp65 (PRA) para elucidaçäo de resultados duvidosos dos tstes fetípicos. Na análise das 13 culturas, observou-se que oito apresentaram dois tipos de colônias (lisa e rugosa) e as cinco restantes apenas um tipo. As identificaçöes feitas com a técnica de PRA e c om os testes fenotípicos foram concordantes na maioria das cepas. Os resultados desse estudo de referência e implementada com testes específicos para cada espécie, que possibilitem a elucidaçäo rápida do diagnóstico

The rapidly growing mycobacteria, previously classified as Mycobacterium fortuitumcomplex, has recently been designated M. fortuitum, M. peregrinum, M. chelonae and M. abscessus. Theidentification of these mycobacteria is important for establishing the proper treatment, because they havedifferent patterns to drugs. Among 3,441 cultures of mycobacteria received in 1999 by the MycobacteriaLaboratory of the Adolfo Lutz Institute, 13 cultures classified as M. fortuitum complex were selected to bestudied. The study included isolation of colonies in order to ensure the purity of the cultures, the additionof tests with carbohydrate and citrate, which differentiate the four previously mentioned species and theuse of the PCR restriction analysis of hsp65 (PRA) for the analysis of dubious results in conventionaltests. In the analysis of the 13 cultures, it was observed that eight showed two types of colonies (smoothand rough) and the remaining five showed only one type. The identification by PRA technique and byconventional tests agreed to the majority of the strains. The results of this study suggest that theidentification of mycobacteria, due to its complexity, should be centralized in Reference Laboratories andimplemented with specific tests for each specie in order to give a rapid diagnosis

Bacterial agents isolated from cerebrospinal fluid of patients with acquired immunodeficiency syndrome (AIDS) and neurological complications

Amostras de liquido cefalorraquidiano (LCR) de 2083 pacientes com Sindrome de Imunodeficiencia Adquirida (SIDA) e complicacoes neurologicas foram examinados durante um periodo de 7 anos (1984-1990). A porcentagem de pacientes que tiveram pelo menos um agente bacteriano cultivado do LCR foi de 6,2 por cento Mycobacterium tuberculosis foi o mais frequentemente isolado (4,3 por cento), seguido do complexo Mycobacterium avium ou MAC (0,7 por cento), de Pseudomas spp (0,5 por cento), Enterobacter spp (0,4 por cento), e Staphilococcus aureus (0,3 por cento). Entre 130 pacientes com cultura positiva, de 89 (68,5 por cento) foi isolado o M. tuberculosis e de 15 (11,6 por cento) MAC. A frequencia de isolamentos bacterianos foram mais frequentemente isolados de pacientes na faixa etaria de 21-30 anos e de mulheres (p<0.050).

Influência da qualidade das culturas de Mycobacterium tuberculosis nos resultados negativos dos testes da pirazinamidase / Influence of Mycobacterium tuberculosis cultures quality conditions on negative results on pyrazinamidase testing

A Organização Mundial da Saúde recomenda o uso do teste da pirazinamidase (PZAse) como método alternativo para determinação da resistência do Mycobacterium tuberculosis à pirazinamida, por ser um teste rápido e de fácil execução. Foram objetivos deste estudo: verificar a reprodutibilidade dos resultados negativos do teste da pirazinamidase quando realizado a partir das culturas originais e de seus subcultivos e relacioná-los com a qualidade das culturas originais e com os perfis de suscetibilidade à estreptomicina (S), isoniazida (I), rifampicina (R) e etambutol (E). Foram analisadas 115 culturas de Mycobacterium tuberculosis cujos cultivos originais apresentaram resultados negativos no teste da PZAse, o que representa resistência à pirazinamida. A qualidade das culturas foi avaliada, anotada e um segundo teste foi realizado a partir de subcultivos jovens e abundantes. A concordância entre os resultados do primeiro e do segundo teste foi de 72,2% e a qualidade das culturas mostrou correlação com os resultados (p< 0,001). O teste da pirazinamidase é útil quando utilizado juntamente com técnicas de detecção de suscetibilidade às drogas S,I,R,E, desde que seja realizado a partir de cultivos com boa qualidade, que permitam a utilização de inóculo abundante.

The pyrazinamidase is a fast and easy to perform assay, recommended by the World Health Organization as an alternative technique to determine pyrazinamide resistant Mycobacterium tuberculosis strains. This study aimed to assess the reproducibility of negative results on pyrazinamidase assay using both primary cultures and respective subcultures, and to correlate them with original cultures quality, as well as their susceptibility profile to streptomycin (S), isoniazid (I), rifampin (R) and ethambutol (E). A total of 115 Mycobacterium tuberculosis cultures were analyzed, which the original growth produced negative results on pyrazinamidase assay, implying a resistance to pyrazinamide. The cultures quality was assessed and recorded; a second testing was performed using recent and abundant subcultures. Results from the first and the second tests demonstrated an agreement rate of 72.2%, and the cultures quality showed correlation with the results (p<0.001). Pyrazinamidase testing is useful when it is combined with other techniques for analyzing mycobacteria susceptibility to S, I, R, E since it is performed with high quality cultures which allow the use of abundant inocula.

Culturas mistas de micobactérias: é importante isolar e identificar? / Mixed mycobacterial cultures: is it important to separate and to identify multiple species?

A investigação de culturas mistas de micobactérias é importante pois geralmente estas incluem ao menosuma espécie patogênica ou potencialmente patogênica. Dentre 8.036 culturas recebidas entre 1999 e 2000,pelo Setor de Micobactérias do Instituto Adolfo Lutz, foram selecionadas 21 (0,26%) com resultados sugestivos de culturas mistas. Após o isolamento em meio 7H11 as colônias foram repicadas em Lõwenstein Jensen e incubadas à 37° C. A identificação dos 32 subcultivos foi feita por métodos fenotípicos e pela analise do perfil de restrição do produto da amplificação de 440 pares de base do gene hsp65. Em oito subcultivos foi encontrada a espécie M. tuberculosis associada com MNT, em 3 subcultivos foramencontradas 2 espécies de MNT e nos demais foi identificado apenas um tipo de micobacteria. O tempo decrescimento lento das micobactérias inviabiliza o plaqueamento de todas as culturas pois este procedimentoacarretaria demora na liberação do resultado final dos testes, além de representar gastos excessivos em áreas endêmicas, geralmente com escassos recursos econômicos. Embora as dificuldades mencionadas, os microbiologistas devem estar atentos quanto à presença de culturas mistas de micobactérias e usar todos os métodos disponíveis para separar e identificar as espécies

Micobactérias outras que näo o Mycobacterium tuberculosis: análise da ocorrência e de aspectos relevantes ao diagnóstico da infecçäo / Mycobacteria other than Mycobacterium tuberculosis: ocurrence analysis and of relevant aspects at infection diagnosis

Foram identificados no período de 1985 a 1990, 289 cepas de micobactérias outras que näo Mycobacterium tuberculosis (MOTT), oriundas de 228 pacientes com suspeita de infecçäo, matriculados em diversas unidades de assistência médica do Estado de Säo Paulo. Destes apenas 31 tiveram o diagnóstico etiológico confirmado apenas MOTT através de critérios básicos clínicos e laboratoriais. As espécies relacionadas com estas infecçöes foram, M. kansasii, M. avium intracellulare, M. chelonae, M. scrofulaceum, M. marinum e M. szulgai. A presença de MOTT nas amostras dos demais pacientes foi considerada meramente ocasional, sem significado clínico

Análise comparativa dos exames anatomopatológico e bacteriológico no diagnóstico laboratorial da linfadenite por microbactérias em pacientes HIV/AIDS / Comparative analysis of anatomopathological and bacteriological exams for diagnosis of mycobacterial lymphadenitis in HIV/AIDS patients

O objetivo deste estudo foi avaliar a histopatologia e a bacteriologia como recursos laboratoriais no diagnóstico de linfadenite por micobactérias, em pacientes HIV/AIDS em nosso meio. Foram realizados concomitantemente os exames anatomopatológico e bacteriológico de 136 linfonodos superficiais de sítios variados. Destes, 72 (53 por cento) foram positivos para micobactérias na análise histológica e/ou bacteriológica. Entre estes, 68 (94,4 por cento) casos foram positivos pelo histopatológico e 64 (88,9 por cento) pelo bacteriológico. Houve concordância de positividade em 83,3 por cento de casos e concordância de negatividade em 88,9 por cento. Entre os 136 linfonodos cultivados, 44,1 por cento foram positivos para micobactérias, sendo 98,3 por cento identificadas como M.tuberculosis e 1,7 por cento como pertencente ao complexo M. avium. Pela estatística, o nível de concordância entre as duas análise näo permite a escolha de uma delas como preferencial para o diagnóstico de linfadenite por micobactérias, mas sim pela complementariedade emtre ambas

Isolamento de micobactérias em espécimes clínicos, utilizando o sistema automatizado MB/BacT-TM / Mycobacteria isolation in clinical specimens using the MB/BacT-TM system

O aumento da incidência da tuberculose e outras micobacterioses têm demonstrado a importância de se isolar e identificar rapidamente as micobactérias. No período de março a dezembro de 2000 foram avaliados 791 espécimes clínicos coletados de pacientes com sorologia positiva para HIV. O sistema MB/BacTTM detectou 30,0 por cento de amostras positivas, enquanto o meio Lowenstein Jensen 19,0 por cento. As identificações das micobactérias foram realizadas pelo sistema molecular de DNA AccuProbe ou por provas fenotípicas. O Sistema Automatizado MB/BacTTM foi mais sensível e rápido para o isolamento de micobactérias que o método tradicional e, acoplado a um sistema de identificação molecular, poderá ser uma ferramenta útil para o Programa de Controle da Tuberculose