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1.
Int J Mycobacteriol ; 9(1): 24-28, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32474484

RESUMEN

Background: Drug-resistant tuberculosis (TB) is an ongoing health threat, and the greatest challenge to adequate control of TB in many countries lies in the lack of proper laboratory drug-susceptibility test. The aim of this study was to evaluate the activity-based costs (ABC) of Kit SIRE Nitratase® (Kit SIRE) and compare its values with the conventional drug-susceptibility test. Methods: The ABC was calculated for three different approaches: Kit SIRE (clinical samples and cultures), proportion methods in Lowenstein Jensen (PM-LJ), and the Bactec™ MGIT™ 960 system based on Mycobacterial Research Laboratory's routine. Results: The ABC of Kit SIRE from cultures was US$ 148.54, while from clinical samples was US$ 136.12. In the case of conventional tests, the ABC of Bactec™ MGIT™ 960 was US$ 227.63 and of the PM-LJ was US$ 132.64. The Kit SIRE has a lower ABC when clinical samples are used instead of cultures. Compared to conventional tests, the ABC is similar to the PM-LJ and lower the Bactec™ MGIT™ 960. Conclusion: The Kit SIRE should be used as a screening method in clinical specimens and in culture for laboratories that do not have Bactec™ MGIT™ 960. Therefore, it can be incorporated into the routine of laboratories in countries with low resources and a high burden of TB and drug-resistant TB.

2.
J Bras Pneumol ; 46(2): e20180386, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32130331

RESUMEN

OBJECTIVE: To evaluate the risk factors for the development of tuberculosis and multidrug-resistant tuberculosis (MDR-TB) in patients treated at a tertiary referral hospital. METHODS: This was a cross-sectional study based on data obtained from patients treated at the Júlia Kubitschek Hospital, located in the city of Belo Horizonte, Brazil, between October of 2012 and October of 2014. We evaluated sociodemographic, behavioral, clinical, and radiological variables. The outcome considered to identify associations between tuberculosis and the explanatory variables was the treatment prescribed. To evaluate the associations between MDR-TB and the same explanatory variables, the change in MDR-TB treatment was considered. RESULTS: The factors associated with tuberculosis were alcoholism, comorbidities, pulmonary cavitations, and a radiological pattern suggestive of tuberculosis. Cavitation and previous treatment for tuberculosis were associated with MDR-TB. CONCLUSIONS: Despite the significant progress made in the fight against tuberculosis, there is a need for coordinated actions that include social protection measures and patient support.


Asunto(s)
Antituberculosos/farmacología , Mycobacterium tuberculosis/efectos de los fármacos , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Tuberculosis Pulmonar/tratamiento farmacológico , Antituberculosos/uso terapéutico , Brasil/epidemiología , Estudios Transversales , Humanos , Pruebas de Sensibilidad Microbiana , Centros de Atención Terciaria , Tuberculosis Resistente a Múltiples Medicamentos/diagnóstico , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Tuberculosis Pulmonar/epidemiología , Tuberculosis Pulmonar/microbiología
3.
Rev Soc Bras Med Trop ; 53: e20190175, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049199

RESUMEN

INTRODUCTION: The present study sought to assess the mean and activity based cost (ABC) of the laboratory diagnosis for tuberculosis through the application of conventional and molecular techniques-Xpert®MTB/RIF and Genotype®MTBDRplus-in a tertiary referral hospital in Brazil. METHODS: The mean cost and ABC formed the basis for the cost analysis of the TB laboratory diagnosis. RESULTS: The mean cost and ABC were US$ 4.00 and US$ 3.24, respectively, for a bacilloscopy; US$ 6.73 and US$ 5.27 for a Lowenstein-Jensen (LJ) culture; US$ 105.42 and US$ 76.56 for a drug sensitivity test (DST)-proportions method (PM) in LJ; US$ 148.45 and US$ 136.80 for a DST-BACTECTM MGITTM 960 system; US$ 11.53 and US$ 9.89 for an Xpert®MTB/RIF; and US$ 84.21 and US$ 48.38 for a Genotype®MTBDRplus. CONCLUSIONS: The mean cost and ABC proved to be good decision-making parameters in the diagnosis of TB and MDR-TB. The effective implementation of algorithms will depend on the conditions at each location.


Asunto(s)
Costos y Análisis de Costo/estadística & datos numéricos , Mycobacterium tuberculosis/genética , Tuberculosis Resistente a Múltiples Medicamentos/diagnóstico , Tuberculosis Resistente a Múltiples Medicamentos/economía , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/economía , Brasil , Genotipo , Humanos , Mycobacterium tuberculosis/aislamiento & purificación , Sensibilidad y Especificidad , Centros de Atención Terciaria
4.
Rev. Soc. Bras. Med. Trop ; 53: e20190175, 2020. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1057267

RESUMEN

Abstract INTRODUCTION: The present study sought to assess the mean and activity based cost (ABC) of the laboratory diagnosis for tuberculosis through the application of conventional and molecular techniques-Xpert®MTB/RIF and Genotype®MTBDRplus-in a tertiary referral hospital in Brazil. METHODS: The mean cost and ABC formed the basis for the cost analysis of the TB laboratory diagnosis. RESULTS: The mean cost and ABC were US$ 4.00 and US$ 3.24, respectively, for a bacilloscopy; US$ 6.73 and US$ 5.27 for a Lowenstein-Jensen (LJ) culture; US$ 105.42 and US$ 76.56 for a drug sensitivity test (DST)-proportions method (PM) in LJ; US$ 148.45 and US$ 136.80 for a DST-BACTECTM MGITTM 960 system; US$ 11.53 and US$ 9.89 for an Xpert®MTB/RIF; and US$ 84.21 and US$ 48.38 for a Genotype®MTBDRplus. CONCLUSIONS: The mean cost and ABC proved to be good decision-making parameters in the diagnosis of TB and MDR-TB. The effective implementation of algorithms will depend on the conditions at each location.

5.
Rev. Soc. Bras. Med. Trop ; 53: e20190207, 2020. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1057305

RESUMEN

Abstract INTRODUCTION: Adverse drug reactions can develop when using anti-tuberculosis medication, and the effects of the drugs can also significantly hinder the treatment of patients. METHODS: A cross-sectional survey was conducted in 73 patients using two standardized questionnaires and the World Health Organization Quality of Life-Bref. RESULTS: All patients reported the presence of adverse drug reactions, 71.6% of which are minor and 28.3% both major and minor. The global quality of life analysis showed that patients with tuberculosis have a good average (67.3%). CONCLUSIONS: There is an association between quality of life and adverse drug reaction, educational level, and vulnerability.

6.
J. bras. pneumol ; 46(2): e20180386, 2020. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1090807

RESUMEN

ABSTRACT Objective: To evaluate the risk factors for the development of tuberculosis and multidrug-resistant tuberculosis (MDR-TB) in patients treated at a tertiary referral hospital. Methods: This was a cross-sectional study based on data obtained from patients treated at the Júlia Kubitschek Hospital, located in the city of Belo Horizonte, Brazil, between October of 2012 and October of 2014. We evaluated sociodemographic, behavioral, clinical, and radiological variables. The outcome considered to identify associations between tuberculosis and the explanatory variables was the treatment prescribed. To evaluate the associations between MDR-TB and the same explanatory variables, the change in MDR-TB treatment was considered. Results: The factors associated with tuberculosis were alcoholism, comorbidities, pulmonary cavitations, and a radiological pattern suggestive of tuberculosis. Cavitation and previous treatment for tuberculosis were associated with MDR-TB. Conclusions: Despite the significant progress made in the fight against tuberculosis, there is a need for coordinated actions that include social protection measures and patient support.


RESUMO Objetivo: Avaliar os fatores de risco de pacientes atendidos em um hospital de referência terciária para o desenvolvimento de tuberculose e tuberculose multirresistente (TBMR). Métodos: Estudo transversal baseado em dados obtidos de pacientes atendidos no Hospital Júlia Kubitschek, na cidade de Belo Horizonte (MG), entre outubro de 2012 e outubro de 2014. As variáveis utilizadas foram agrupadas em características sociodemográficas, comportamentais, clínicas e radiológicas. O desfecho considerado para verificar associações entre tuberculose e variáveis explicativas foi o tratamento prescrito para tuberculose. Para avaliar a associação entre a tuberculose resistente e as mesmas variáveis explicativas considerou-se a mudança de tratamento para TBMR. Resultados: Alcoolismo, padrão radiológico sugestivo de tuberculose, presença de comorbidades e presença de cavitações pulmonares foram fatores associados à tuberculose. A TBMR foi associada a tratamento prévio para tuberculose e presença de cavitações. Conclusões: Apesar dos importantes progressos na luta contra a tuberculose, é necessário um conjunto de ações articuladas que incluam medidas de proteção social e suporte aos pacientes.

7.
Rev. Soc. Bras. Med. Trop ; 53: e20190175, 2020. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1092185

RESUMEN

Abstract INTRODUCTION: The present study sought to assess the mean and activity based cost (ABC) of the laboratory diagnosis for tuberculosis through the application of conventional and molecular techniques-Xpert®MTB/RIF and Genotype®MTBDRplus-in a tertiary referral hospital in Brazil. METHODS: The mean cost and ABC formed the basis for the cost analysis of the TB laboratory diagnosis. RESULTS: The mean cost and ABC were US$ 4.00 and US$ 3.24, respectively, for a bacilloscopy; US$ 6.73 and US$ 5.27 for a Lowenstein-Jensen (LJ) culture; US$ 105.42 and US$ 76.56 for a drug sensitivity test (DST)-proportions method (PM) in LJ; US$ 148.45 and US$ 136.80 for a DST-BACTECTM MGITTM 960 system; US$ 11.53 and US$ 9.89 for an Xpert®MTB/RIF; and US$ 84.21 and US$ 48.38 for a Genotype®MTBDRplus. CONCLUSIONS: The mean cost and ABC proved to be good decision-making parameters in the diagnosis of TB and MDR-TB. The effective implementation of algorithms will depend on the conditions at each location.

8.
Rev Soc Bras Med Trop ; 53: e20190207, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31859946

RESUMEN

INTRODUCTION: Adverse drug reactions can develop when using anti-tuberculosis medication, and the effects of the drugs can also significantly hinder the treatment of patients. METHODS: A cross-sectional survey was conducted in 73 patients using two standardized questionnaires and the World Health Organization Quality of Life-Bref. RESULTS: All patients reported the presence of adverse drug reactions, 71.6% of which are minor and 28.3% both major and minor. The global quality of life analysis showed that patients with tuberculosis have a good average (67.3%). CONCLUSIONS: There is an association between quality of life and adverse drug reaction, educational level, and vulnerability.


Asunto(s)
Antituberculosos/efectos adversos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Calidad de Vida/psicología , Tuberculosis/tratamiento farmacológico , Anciano , Antituberculosos/administración & dosificación , Estudios Transversales , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Encuestas y Cuestionarios , Centros de Atención Terciaria , Tuberculosis/psicología
9.
Einstein (Sao Paulo) ; 17(4): eAO4696, 2019 Aug 22.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31460617

RESUMEN

OBJECTIVE: To determine the frequency of drug therapy problem in the treatment of patients with tuberculosis and HIV/AIDS. METHODS: Data were obtained through a cross-sectional study conducted between September 2015 and December 2016 at a reference hospital in infectious diseases in Belo Horizonte (MG), Brazil. Sociodemographic, clinical, behavioral and pharmacotherapeutic variables were evaluated through a semi-structured questionnaire. Drug-related problems of pharmaceutical care were classified using the Pharmacotherapy Workup method. Factors associated with indication, effectiveness, safety and compliance drug therapy problem were assessed through multiple logistic regression. RESULTS: We evaluated 81 patients, and 80% presented at least one drug therapy problem, with indication and adherence drug therapy problem being the most frequent. The factors associated with drug therapy problem were age, marital status, new case, ethnicity, time of HIV diagnosis and time to treat tuberculosis. CONCLUSION: The frequency of drug therapy problem in coinfected patients was high and the identification of the main drug therapy problem and associated factors may lead the multiprofessional health team to ensure the use of the most indicated, effective, safe and convenient medicines for the patients clinical condition. Tuberculosis and HIV/AIDS coinfected individuals aged over 40 years are more likely to have drug therapy problems during treatment; in that, the most frequente are those that signal toward need of medication for an untreated health condition and non-compliance to treatment. Thus, older patients, unmarried or married, who have treated tuberculosis before, with a shorter time to tuberculosis treatment and longer time to diagnose HIV/AIDS, should receive special attention and be better followed by a multiprofessional health team because they indicate a higher chance of presenting Problems related to the use of non-adherent drugs.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Antituberculosos/administración & dosificación , Cooperación del Paciente/estadística & datos numéricos , Medicamentos bajo Prescripción/normas , Tuberculosis/tratamiento farmacológico , Adulto , Antituberculosos/efectos adversos , Estudios Transversales , Femenino , Humanos , Masculino , Derivación y Consulta , Factores Socioeconómicos
10.
Einstein (Säo Paulo) ; 17(4): eAO4696, 2019. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1019808

RESUMEN

ABSTRACT Objective: To determine the frequency of drug therapy problem in the treatment of patients with tuberculosis and HIV/AIDS. Methods: Data were obtained through a cross-sectional study conducted between September 2015 and December 2016 at a reference hospital in infectious diseases in Belo Horizonte (MG), Brazil. Sociodemographic, clinical, behavioral and pharmacotherapeutic variables were evaluated through a semi-structured questionnaire. Drug-related problems of pharmaceutical care were classified using the Pharmacotherapy Workup method. Factors associated with indication, effectiveness, safety and compliance drug therapy problem were assessed through multiple logistic regression. Results: We evaluated 81 patients, and 80% presented at least one drug therapy problem, with indication and adherence drug therapy problem being the most frequent. The factors associated with drug therapy problem were age, marital status, new case, ethnicity, time of HIV diagnosis and time to treat tuberculosis. Conclusion: The frequency of drug therapy problem in coinfected patients was high and the identification of the main drug therapy problem and associated factors may lead the multiprofessional health team to ensure the use of the most indicated, effective, safe and convenient medicines for the patients clinical condition. Tuberculosis and HIV/AIDS coinfected individuals aged over 40 years are more likely to have drug therapy problems during treatment; in that, the most frequente are those that signal toward need of medication for an untreated health condition and non-compliance to treatment. Thus, older patients, unmarried or married, who have treated tuberculosis before, with a shorter time to tuberculosis treatment and longer time to diagnose HIV/AIDS, should receive special attention and be better followed by a multiprofessional health team because they indicate a higher chance of presenting Problems related to the use of non-adherent drugs.


RESUMO Objetivo: Determinar a frequência de problemas relacionados ao uso de medicamentos no tratamento de pacientes com tuberculose e HIV/AIDS. Métodos: Os dados foram obtidos por estudo transversal realizado entre setembro de 2015 e dezembro de 2016 em hospital referência em doenças infectocontagiosas de Belo Horizonte (MG), Brasil. As variáveis sociodemográficas, clínicas, comportamentais e farmacoterapêuticas foram avaliadas por questionário semiestruturado. Classificaram-se os problemas relacionados ao uso de medicamento empregando o método Pharmacotherapy Workup de atenção farmacêutica. Os fatores associados aos problemas relacionados ao uso de medicamentos de indicação, efetividade, segurança e adesão foram avaliados pela regressão logística múltipla. Resultados: Foram avaliados 81 pacientes, e 80% apresentaram pelo menos um problema relacionado ao uso de medicamentos, sendo os mais frequentes ligados à problemas relacionados ao uso de medicamentos de indicação e adesão. Os fatores associados aos problemas relacionados ao uso de medicamentos foram idade, estado civil, caso novo, etnia, tempo de diagnóstico do HIV e tempo de tratamento da tuberculose. Conclusão: A frequência de problemas relacionados ao uso de medicamentos em pacientes coinfectados foi alta, e a identificação dos principais problemas relacionados ao uso de medicamentos e dos fatores associados aos mesmos pode direcionar a equipe multiprofissional de saúde, para garantir o uso dos medicamentos mais indicados, efetivos, seguros e convenientes para a condição clínica dos pacientes. Os indivíduos coinfectados com tuberculose e HIV/AIDS maiores de 40 anos possuem maior chance de apresentarem problemas relacionados ao uso de medicamentos durante o tratamento, sendo os mais frequentes os que indicam a necessidade de medicamento para condição de saúde não tratada e não adesão ao tratamento. Pacientes mais idosos, solteiros ou não, que já trataram a tuberculose antes, com menor tempo de tratamento de tuberculose e maior tempo de diagnóstico de HIV/AIDS devem ter atenção especial no acompanhamento por uma equipe multiprofissional de saúde por indicarem maior chance de apresentar Problemas Relacionados ao uso de Medicamentos de não adesão à terapia.

11.
J. bras. pneumol ; 44(6): 461-468, Nov.-Dec. 2018. tab, graf
Artículo en Inglés | LILACS | ID: biblio-984610

RESUMEN

ABSTRACT Objective: To estimate the prevalence of latent Mycobacterium tuberculosis infection (LTBI) in renal transplant recipients and to assess sociodemographic, behavioral, and clinical associations with positive tuberculin skin test (TST) results. Methods: This was a cross-sectional study of patients aged ≥ 18 years who underwent renal transplantation at the Renal Transplant Center of the Federal University of Minas Gerais Hospital das Clínicas, located in the city of Belo Horizonte, Brazil. We included renal transplant recipients who underwent the TST between January 2011 and July 2013. If the result of the first TST was negative, a second TST was administered. Bivariate and multivariate analyses using logistic regression were used to determine factors associated with positive TST results. Results: The sample included 216 patients. The prevalence of LTBI was 18.5%. In the multivariate analysis, history of contact with a tuberculosis case and preserved graft function (estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2) were associated with positive TST results. TST induration increased by 5.8% from the first to the second test, which was considered significant (p = 0.012). Conclusions: The prevalence of LTBI was low in this sample of renal transplant recipients. The TST should be administered if renal graft function is preserved. A second TST should be administered if the first TST is negative.


RESUMO Objetivo: Estimar a prevalência da infecção latente por Mycobacterium tuberculosis (ILTB) em transplantados renais e avaliar as associações sociodemográficas, comportamentais e clínicas com a prova tuberculínica (PT) positiva. Métodos: Estudo transversal, com pacientes com idade ≥ 18 anos, transplantados renais no Centro de Transplante Renal do Hospital das Clínicas da Universidade Federal de Minas Gerais, em Belo Horizonte (MG). Foram incluídos os pacientes submetidos a transplante renal que realizaram a PT no período entre janeiro de 2011 e julho de 2013. Quando o resultado da primeira PT foi negativo, uma segunda PT foi realizada. As análises bivariada e multivariada, por meio de regressão logística, foram utilizadas para determinar os fatores associados com PT positiva. Resultados: A amostra incluiu 216 pacientes. A taxa de prevalência para ILTB foi de 18.5%. Na análise multivariada, história de contato com caso de tuberculose e função do enxerto preservada (taxa de filtração glomerular estimada ≥ 60 ml/min/1,73 m2) foram associadas com PT positiva. O incremento da primeira PT para a segunda PT foi de 5,8%, considerado significante (p = 0,012). Conclusões: A prevalência da ILTB foi baixa nessa amostra de pacientes transplantados renais. A PT deve ser efetuada quando a função do enxerto renal estiver preservada. Uma segunda PT deve ser realizada quando a primeira PT for negativa.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Trasplante de Riñón/estadística & datos numéricos , Tuberculosis Latente/epidemiología , Factores Socioeconómicos , Brasil/epidemiología , Prueba de Tuberculina , Prevalencia , Estudios Transversales , Análisis Multivariante , Tuberculosis Latente/diagnóstico
12.
Braz. j. microbiol ; 49(3): 641-646, July-Sept. 2018. tab, graf
Artículo en Inglés | LILACS | ID: biblio-951817

RESUMEN

Abstract DNA genotyping of Mycobacterium tuberculosis has been widely applied in the understanding of disease transmission in many countries. The purpose of this study was to genotype the strains of M. tuberculosis isolated in patients with new tuberculosis (TB) cases in Minas Gerais, as well as to compare the similarity, discriminatory power, and agreement of the clusters between the IS6110 Restriction Fragment Length Polymorfism (RFLP) and 12 loci Variable Number Tandem Repeat - Mycobacterial Interspersed Repetitive Units (MIRU-VNTR) techniques. It was observed that 32% (66/204) of the isolated strains in the RFLP-IS6110 and 50.9% (104/204) of the isolated strains in the MIRU-VNTR presented a similarity of equal to or above 85%. The RFLP-IS6110 and MIRU-VNTR proved to contain a high discriminatory power. The similarity index resulting from the RFLP showed no recent transmission. Good agreement was observed between the techniques when clusters were detected; however, the best epidemiological relationship was found when using the RFLP-IS6110.


Asunto(s)
Humanos , Tuberculosis/microbiología , Polimorfismo de Longitud del Fragmento de Restricción , Técnicas de Tipificación Bacteriana/métodos , Repeticiones de Minisatélite , Análisis del Polimorfismo de Longitud de Fragmentos Amplificados/métodos , Mycobacterium tuberculosis/aislamiento & purificación , Brasil , Mycobacterium tuberculosis/clasificación , Mycobacterium tuberculosis/genética
13.
J Bras Pneumol ; 44(6): 461-468, 2018.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-30726322

RESUMEN

OBJECTIVE: To estimate the prevalence of latent Mycobacterium tuberculosis infection (LTBI) in renal transplant recipients and to assess sociodemographic, behavioral, and clinical associations with positive tuberculin skin test (TST) results. METHODS: This was a cross-sectional study of patients aged ≥ 18 years who underwent renal transplantation at the Renal Transplant Center of the Federal University of Minas Gerais Hospital das Clínicas, located in the city of Belo Horizonte, Brazil. We included renal transplant recipients who underwent the TST between January 2011 and July 2013. If the result of the first TST was negative, a second TST was administered. Bivariate and multivariate analyses using logistic regression were used to determine factors associated with positive TST results. RESULTS: The sample included 216 patients. The prevalence of LTBI was 18.5%. In the multivariate analysis, history of contact with a tuberculosis case and preserved graft function (estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2) were associated with positive TST results. TST induration increased by 5.8% from the first to the second test, which was considered significant (p = 0.012). CONCLUSIONS: The prevalence of LTBI was low in this sample of renal transplant recipients. The TST should be administered if renal graft function is preserved. A second TST should be administered if the first TST is negative.


Asunto(s)
Trasplante de Riñón/estadística & datos numéricos , Tuberculosis Latente/epidemiología , Adulto , Anciano , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Tuberculosis Latente/diagnóstico , Masculino , Persona de Mediana Edad , Análisis Multivariante , Prevalencia , Factores Socioeconómicos , Prueba de Tuberculina , Adulto Joven
14.
Braz J Microbiol ; 49(3): 641-646, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29249565

RESUMEN

DNA genotyping of Mycobacterium tuberculosis has been widely applied in the understanding of disease transmission in many countries. The purpose of this study was to genotype the strains of M. tuberculosis isolated in patients with new tuberculosis (TB) cases in Minas Gerais, as well as to compare the similarity, discriminatory power, and agreement of the clusters between the IS6110 Restriction Fragment Length Polymorfism (RFLP) and 12 loci Variable Number Tandem Repeat - Mycobacterial Interspersed Repetitive Units (MIRU-VNTR) techniques. It was observed that 32% (66/204) of the isolated strains in the RFLP-IS6110 and 50.9% (104/204) of the isolated strains in the MIRU-VNTR presented a similarity of equal to or above 85%. The RFLP-IS6110 and MIRU-VNTR proved to contain a high discriminatory power. The similarity index resulting from the RFLP showed no recent transmission. Good agreement was observed between the techniques when clusters were detected; however, the best epidemiological relationship was found when using the RFLP-IS6110.


Asunto(s)
Análisis del Polimorfismo de Longitud de Fragmentos Amplificados/métodos , Técnicas de Tipificación Bacteriana/métodos , Repeticiones de Minisatélite , Mycobacterium tuberculosis/aislamiento & purificación , Polimorfismo de Longitud del Fragmento de Restricción , Tuberculosis/microbiología , Brasil , Humanos , Mycobacterium tuberculosis/clasificación , Mycobacterium tuberculosis/genética
15.
Mem Inst Oswaldo Cruz ; 112(11): 769-774, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-29091137

RESUMEN

BACKGROUND: The accurate detection of multidrug-resistant tuberculosis (MDR-TB) is critical for the application of appropriate patient treatment and prevention of transmission of drug-resistant Mycobacterium tuberculosis isolates. The goal of this study was to evaluate the correlation between phenotypic and molecular techniques for drug-resistant tuberculosis diagnostics. Molecular techniques used were the line probe assay genotype MTBDRplus and the recently described tuberculosis-spoligo-rifampin-isoniazid typing (TB-SPRINT) bead-based assay. Conventional drug susceptibility testing (DST) was done on a BACTECTM MGIT 960 TB. METHOD: We studied 80 M. tuberculosis complex (MTC) clinical isolates from Minas Gerais state, of which conventional DST had classified 60 isolates as MDR and 20 as drug susceptible. FINDINGS: Among the 60 MDR-TB isolates with MGIT as a reference, sensitivity, specificity, accuracy, and kappa for rifampicin (RIF) resistance using TB-SPRINT and MTBDRplus, were 96.7% versus 93.3%, 100.0% versus 100.0%, 97.5% versus 95.0% and 0.94 versus 0.88, respectively. Similarly, the sensitivity, specificity, accuracy, and kappa for isoniazid (INH) resistance were 85.0% and 83.3%, 100.0% and 100.0%, 88.8% and 87.5% and 0.74 and 0.71 for both tests, respectively. Finally, the sensitivity, specificity, accuracy, and kappa for MDR-TB were 85.0% and 83.3%, 100.0% and 100.0%, 88.8% and 87.5% and 0.74 and 0.71 for both tests, respectively. MAIN CONCLUSIONS: Both methods exhibited a good correlation with the conventional DST. We suggest estimating the cost-effectiveness of MTBDRplus and TB-SPRINT in Brazil.


Asunto(s)
Técnicas Bacteriológicas/métodos , Mycobacterium tuberculosis/genética , Tuberculosis Resistente a Múltiples Medicamentos/diagnóstico , Brasil , Genotipo , Humanos , Técnicas de Diagnóstico Molecular , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Tuberculosis Resistente a Múltiples Medicamentos/microbiología
16.
Mem. Inst. Oswaldo Cruz ; 112(11): 769-774, Nov. 2017. tab
Artículo en Inglés | LILACS | ID: biblio-894852

RESUMEN

BACKGROUND The accurate detection of multidrug-resistant tuberculosis (MDR-TB) is critical for the application of appropriate patient treatment and prevention of transmission of drug-resistant Mycobacterium tuberculosis isolates. The goal of this study was to evaluate the correlation between phenotypic and molecular techniques for drug-resistant tuberculosis diagnostics. Molecular techniques used were the line probe assay genotype MTBDRplus and the recently described tuberculosis-spoligo-rifampin-isoniazid typing (TB-SPRINT) bead-based assay. Conventional drug susceptibility testing (DST) was done on a BACTECTM MGIT 960 TB. METHOD We studied 80 M. tuberculosis complex (MTC) clinical isolates from Minas Gerais state, of which conventional DST had classified 60 isolates as MDR and 20 as drug susceptible. FINDINGS Among the 60 MDR-TB isolates with MGIT as a reference, sensitivity, specificity, accuracy, and kappa for rifampicin (RIF) resistance using TB-SPRINT and MTBDRplus, were 96.7% versus 93.3%, 100.0% versus 100.0%, 97.5% versus 95.0% and 0.94 versus 0.88, respectively. Similarly, the sensitivity, specificity, accuracy, and kappa for isoniazid (INH) resistance were 85.0% and 83.3%, 100.0% and 100.0%, 88.8% and 87.5% and 0.74 and 0.71 for both tests, respectively. Finally, the sensitivity, specificity, accuracy, and kappa for MDR-TB were 85.0% and 83.3%, 100.0% and 100.0%, 88.8% and 87.5% and 0.74 and 0.71 for both tests, respectively. MAIN CONCLUSIONS Both methods exhibited a good correlation with the conventional DST. We suggest estimating the cost-effectiveness of MTBDRplus and TB-SPRINT in Brazil.


Asunto(s)
Humanos , Técnicas Bacteriológicas/métodos , Tuberculosis Resistente a Múltiples Medicamentos/diagnóstico , Tuberculosis Resistente a Múltiples Medicamentos/microbiología , Mycobacterium tuberculosis/genética , Brasil , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Patología Molecular , Genotipo
17.
Rev Soc Bras Med Trop ; 50(4): 550-553, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28954080

RESUMEN

INTRODUCTION:: This study aimed to evaluate a new commercial kit, Kit SIRE Nitratase-PlastLabor, for testing the drug susceptibility of clinical Mycobacterium tuberculosis isolates. METHODS:: The accuracy of the Kit SIRE Nitratase was evaluated by examining the susceptibility (streptomycin, isoniazid, rifampicin, and ethambutol) of 40 M. tuberculosis isolates, using the proportion method with Lowenstein-Jensen medium or the BACTEC MGIT 960 system. RESULTS:: The detection accuracy for streptomycin, isoniazid, rifampicin, and ethambutol was 95%, 97.5%, 100%, and 80%, respectively. CONCLUSIONS:: The exceptional accuracy demonstrated by Kit SIRE Nitratase for isoniazid and rifampicin makes the kit an attractive option for screening M. tuberculosis strain resistance.


Asunto(s)
Antibióticos Antituberculosos/farmacología , Pruebas de Sensibilidad Microbiana/métodos , Mycobacterium tuberculosis/efectos de los fármacos , Oxidorreductasas/farmacología , Pruebas Enzimáticas Clínicas/métodos , Farmacorresistencia Bacteriana , Etambutol/farmacología , Humanos , Isoniazida/farmacología , Mycobacterium tuberculosis/aislamiento & purificación , Reproducibilidad de los Resultados , Rifampin/farmacología , Estreptomicina/farmacología
18.
Rev. Soc. Bras. Med. Trop ; 50(4): 550-553, July-Aug. 2017. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1041420

RESUMEN

Abstract INTRODUCTION: This study aimed to evaluate a new commercial kit, Kit SIRE Nitratase-PlastLabor, for testing the drug susceptibility of clinical Mycobacterium tuberculosis isolates. METHODS: The accuracy of the Kit SIRE Nitratase was evaluated by examining the susceptibility (streptomycin, isoniazid, rifampicin, and ethambutol) of 40 M. tuberculosis isolates, using the proportion method with Lowenstein-Jensen medium or the BACTEC MGIT 960 system. RESULTS: The detection accuracy for streptomycin, isoniazid, rifampicin, and ethambutol was 95%, 97.5%, 100%, and 80%, respectively. CONCLUSIONS: The exceptional accuracy demonstrated by Kit SIRE Nitratase for isoniazid and rifampicin makes the kit an attractive option for screening M. tuberculosis strain resistance.

19.
Rev Inst Med Trop Sao Paulo ; 59: e28, 2017 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-28591256

RESUMEN

The present study aimed to assess the association of outcomes with comprehension, adherence and behavioral characteristics of tuberculosis (TB) patients using fixed-dose combination (FDC) therapy in the city of Contagem, MG, Brazil. This study used standardized questionnaires to collect data. Outcomes included cure in 77.2% (64/ 83), noncompliance with treatment in 20.4% (17/ 83), and absence of organ failure or death cases. The rate of adherence to treatment was high (71.1% - 59/ 83), while the level of comprehension of the treatment was insufficient for the majority of patients (72.3% - 60/ 83). When a greater number of medicines was used, the chance of noncompliance with treatment increased exponentially (p = 0.00 - OR 1.72). Light-skinned black patients, alcoholics and those who live with HIV/ AIDS showed a significant association with noncompliance with treatment (p=0.039 - OR 3.38, p=0.002 - OR 4.68, and p=0.001 - OR 9.68, respectively). Comprehension also presented a significant association with noncompliance with treatment (p=0.01 and OR 5.76 and CI 1.49-22.29). The probability of noncompliance with treatment in the first few months was greater than in the subsequent months. This study demonstrates that if the TB patients had a better understanding of the treatment, the outcome would have been more favorable as regards a proper cure.


Asunto(s)
Antituberculosos/uso terapéutico , Cooperación del Paciente/estadística & datos numéricos , Tuberculosis/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Terapia Combinada , Comprensión , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores Socioeconómicos , Resultado del Tratamiento , Adulto Joven
20.
Rev. Inst. Med. Trop. Säo Paulo ; 59: e28, 2017. tab, graf
Artículo en Inglés | LILACS | ID: biblio-842784

RESUMEN

ABSTRACT The present study aimed to assess the association of outcomes with comprehension, adherence and behavioral characteristics of tuberculosis (TB) patients using fixed-dose combination (FDC) therapy in the city of Contagem, MG, Brazil. This study used standardized questionnaires to collect data. Outcomes included cure in 77.2% (64/ 83), noncompliance with treatment in 20.4% (17/ 83), and absence of organ failure or death cases. The rate of adherence to treatment was high (71.1% - 59/ 83), while the level of comprehension of the treatment was insufficient for the majority of patients (72.3% - 60/ 83). When a greater number of medicines was used, the chance of noncompliance with treatment increased exponentially (p = 0.00 - OR 1.72). Light-skinned black patients, alcoholics and those who live with HIV/ AIDS showed a significant association with noncompliance with treatment (p=0.039 - OR 3.38, p=0.002 - OR 4.68, and p=0.001 - OR 9.68, respectively). Comprehension also presented a significant association with noncompliance with treatment (p=0.01 and OR 5.76 and CI 1.49-22.29). The probability of noncompliance with treatment in the first few months was greater than in the subsequent months. This study demonstrates that if the TB patients had a better understanding of the treatment, the outcome would have been more favorable as regards a proper cure.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Antituberculosos/uso terapéutico , Cooperación del Paciente/estadística & datos numéricos , Tuberculosis/tratamiento farmacológico , Brasil , Terapia Combinada , Comprensión , Estudios Prospectivos , Factores Socioeconómicos , Resultado del Tratamiento
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