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1.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 60: e204539, 2023. tab, ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1451775

RESUMO

This study aimed to evaluate methods for studying the in vitro antimicrobial activity of lactic acid bacteria (LAB) against Brucella abortus and to evaluate the antagonistic effect of LAB on the viability of this pathogen. A total of 18 LAB strains (Lactobacillus plantarum, n = 11; Pediococcus acidilactici, n = 1; Lactobacillus rhamnosus, n = 4; and Lactobacillus brevis,n = 2), isolated from Minas artisanal cheeses produced in three regions (Canastra, Campos das Vertentes, and Araxá) of Minas Gerais State, Brazil, were tested for their antimicrobial activity against B. abortus using three methods: spot-on-lawn, agar well diffusion assay, and antagonistic activity of the culture supernatants. None of the tested LAB strains could inhibit B. abortus in the spot-on-lawn and agar-well diffusion assays. The supernatants produced by LAB had an acidic pH, with intensity depending on bacterial growth and strain, and could inhibit the growth of B. abortus. In contrast, pH-neutralized (pH 7.0) LAB supernatants did not suppress the growth of B. abortus. The results showed that the best technique to study the in vitro antagonism of LAB against B. abortus was the antagonistic activity of culture supernatants. The growth of B. abortus may have been inhibited by acid production.(AU)


Este estudo teve como objetivo avaliar métodos de estudo in vitro da atividade antimicrobiana de bactérias lácticas contra Brucella abortus e avaliar o efeito antagônico das mesmas sobre a viabilidade deste patógeno. Um total de 18 amostras de bactérias lácteas (Lactobacillus plantarum, n = 11; Pediococcus acidilactici, n = 1; Lactobacillus rhamnosus, n = 4; e Lactobacillus brevis, n = 2), isoladas de exemplares de Queijo Minas Artesanal produzidos em três regiões (Canastra, Campos das Vertentes e Araxá) do estado de Minas Gerais, Brasil, foram testados quanto à sua atividade antimicrobiana contra B. abortus usando três métodos: spot-on-lawn, ensaio de difusão em poço e atividade antagonista de sobrenadante de cultura. Nenhuma das cepas testadas foi capaz de inibir B. abortus nos ensaios spot-on-lawm e de difusão em poço. Os sobrenadantes produzidos pelas bactérias lácteas apresentaram pH ácido, com intensidade dependente do crescimento bacteriano e da amostra, podendo inibir o crescimento de B. abortus. Em contraste, os sobrenadantes com pH neutralizado (pH 7,0) não inibiram o crescimento de B. abortus. Os resultados mostraram que a melhor técnica para estudar o antagonismo in vitro de bactérias lácteas contra B. abortus foi a atividade antagonista de sobrenadante de cultura. O crescimento de B. abortus pode ter sido inibido pela produção de ácido.(AU)


Assuntos
Lactobacillaceae/isolamento & purificação , Queijo/microbiologia , Microbiota , Brasil , Brucella abortus , Abastecimento de Alimentos
2.
J Parasit Dis ; 43(4): 730-732, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31749546

RESUMO

The presence of Onchocerca guturosa in cattle is responsible for lesions similar to those observed in cases suspected of brucellosis, however, Onchocerca sp. is not a trade barrier, although it is also responsible for economic losses due to the removal of the affected parts of the carcasses. Brucella sp. is a zoonotic agent transmitted to humans through the consumption of contaminated animal products, the contact with infected animals and the handling of carcasses. This agent is also responsible for non-tariff trade barriers. Cervical bursitis is Brucella sp. suggestive lesions in bovine carcasses that requires laboratory tests to confirm the diagnosis. The objective of this study was to record the co-infection of Brucella abortus and Onchocerca sp. as a first report of co-infection of these two agents in the same lesion. The sample constituted of a nuchal bursitis in the cervical ligament, a suggestive lesion common to these two agents, submitted to histopathology and Brucella spp. isolation in the Brucellosis reference laboratory of the Brazilian Ministry of Agriculture, Livestock and Food Supply. Brucellosis serological diagnosis were also performed in the animal's serum sample. B. abortus was isolated from the lesion and filarid nematode structures were identified in histopathology. All serological tests were positive for brucellosis. Further studies are needed, however, to understand the co-infection by Onchocerca sp. and B. abortus.

3.
Res Vet Sci ; 125: 14-23, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31108426

RESUMO

This study aimed to evaluate the performance of real-time PCR (qPCR), ELISA IDEXX™, and bacterial isolation as post-mortem diagnostic tests in animals with lesions compatible with bovine tuberculosis detected by Brazilian Federal Inspection Service as part of the bovine tuberculosis active surveillance. Bayesian latent class models were used to estimate diagnostic tests' sensitivity, specificity, correlations, predictive values and frequency of infected animals. Samples of tuberculosis-suggestive lesions collected by FIS sanitary inspection routine in slaughterhouses from 11 Brazilian states were analyzed. Isolation was the most sensitive technique, 94.54% (95% Credible Interval (CrI) 90.09%-97.65%), qPCR was 64.69% (95% CrI 54.41%-74.15%) sensitive and ELISA IDEXX™ 26.74% (95% CrI 22.82%-30.97%). Tests' specificities were 98.19% (95% CrI 95.75%-99.45%), 93.49% (95% CrI 79.28%-99.66%), 95.53% (95% CrI 91.71%-98.02%) respectively. Despite its low sensitivity, ELISA IDEXX™ was able to identify positive samples that were not detected by the other techniques. These samples had high probability to be true positives given ELISA's positive predictive value. The correlations between qPCR and isolation were neither biologically nor statistically significant. The low sensitivity of the qPCR is a limiting factor to its use as a post-mortem diagnosis in bovine tuberculosis suggestive lesions. Its use could be recommended in situations of high prevalence, or in parallel association with other tests, such as ELISA IDEXX™. ELISA IDDEX™ should not be used as a unique test, or in substitution of the other tests, for the post-mortem diagnosis of bovine tuberculosis due to its sensitivity.


Assuntos
Mycobacterium bovis/isolamento & purificação , Tuberculose Bovina/diagnóstico , Matadouros , Animais , Autopsia , Teorema de Bayes , Brasil , Bovinos , Estudos Transversais , Testes Diagnósticos de Rotina/normas , Testes Diagnósticos de Rotina/veterinária , Ensaio de Imunoadsorção Enzimática , Análise de Classes Latentes , Mycobacterium bovis/genética , Mycobacterium bovis/imunologia , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Sensibilidade e Especificidade
4.
Arch Microbiol ; 201(8): 1047-1051, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31111186

RESUMO

Bovine tuberculosis is a disease that is widely distributed around the world. Its causative agent, Mycobacterium bovis, has characteristics of a microorganism with clonal multiplication in populations with no evidence of genetic exchange between strains, and, consequently, a group of strains can be identified as descending from a common ancestor. The aim of this study was to investigate the clonal complexes of M. bovis isolated from samples of lesions suggestive of bovine tuberculosis collected from slaughterhouses in various states of Brazil between 2006 and 2012. Ninety samples were analyzed, and it was found that 14.4% belonged to the clonal complex European1 and 81.1% to the clonal complex European2, while 4.65% were not identified as any of the four known complexes.


Assuntos
Mycobacterium bovis/classificação , Mycobacterium bovis/genética , Tuberculose Bovina/epidemiologia , Animais , Brasil/epidemiologia , Bovinos , Evolução Clonal/genética , Mycobacterium bovis/isolamento & purificação , Tuberculose Bovina/microbiologia
5.
Braz. j. microbiol ; 48(1): 139-144, Jan.-Mar. 2017. tab
Artigo em Inglês | LILACS | ID: biblio-839347

RESUMO

Abstract For the definitive diagnosis of bovine tuberculosis, isolation of the etiologic agent is required. However, there is no consensus on the best methodology for isolation of Mycobacterium bovis in Brazil. This study evaluated the most used decontaminants and culture media in the country, in order to identify the best combination for the Brazilian samples. Three decontaminants - 2% sodium hydroxide (w/v), 0.75% hexadecylpiridinium chloride (w/v) and 5% sulphuric acid (v/v) and four culture media - 7H11 Middlebrook with additives and OADC supplement “A” (7H11 A), the same media with another supplement trademark (7H11 B), tuberculosis blood agar (B83) and Stonebrink's medium were compared. Regarding the isolation, there were no significant differences between the decontaminants and media combinations, except 7H11A combined to any decontaminant. However, the mean colonies score was significantly greater when the samples were decontaminated with 5% sulphuric acid and inoculated in 7H11 B or SB, without significant difference between them, although colonies appeared earlier on 7H11B than on SB. The trademark of OADC supplement influenced the isolation rate and the number of isolated colonies in Middlebrook 7H11. An incubation time of four weeks was required to detect all positive samples in 7H11 B after decontamination with 5% sulphuric acid but there was an increase in the number of colonies until the sixth week of incubation. Overall, the best strategy for the primary isolation of M. bovis from Brazilian samples was the decontamination with 5% sulphuric acid (final concentration) and inoculation in Middlebrook 7H11 medium formulated with OADC supplement “B”.


Assuntos
Animais , Bovinos , Tuberculose Bovina/diagnóstico , Tuberculose Bovina/microbiologia , Mycobacterium bovis/isolamento & purificação , Técnicas Bacteriológicas , Mycobacterium bovis/crescimento & desenvolvimento
6.
PLoS One ; 11(9): e0162459, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27631383

RESUMO

Mycobacterium bovis is the causative agent of bovine tuberculosis (BTB), the pathogen responsible for serious economic impact on the livestock sector. In order to obtain data on isolated M. bovis strains and assist in the control and eradication program for BTB, a cross sectional descriptive molecular epidemiology study in the Brazilian Midwest was conducted. Through spoligotyping and 24-loci MIRU-VNTR methods, 37 clinical isolates of M. bovis circulating in the region were analyzed, 10 isolated from the state of Mato Grosso, 12 from the state of Mato Grosso do Sul and 15 from the state of Goiás. The spoligotyping analysis identified 10 distinct M. bovis profiles (SB0121 n = 14, SB0295 n = 6, SB0140 n = 6, SB0881 n = 3, SB1144 n = 2, SB1145 n = 2, SB0134 n = 1, SB1050 n = 1, SB1055 n = 1, SB1136 n = 1) grouped in six clusters and four orphan patterns. The MIRU-VNTR 24-loci grouped the same isolates in six clusters and 22 unique orphan patterns, showing higher discriminatory power than spoligotyping. When associating the results of both techniques, the isolates were grouped in five clusters and 24 unique M. bovis profiles. Among the 24-loci MIRU-VNTR evaluated, two, ETR-A and QUB 11b loci, showed high discriminatory ability (h = ≥ 0.50), while MIRU 16, MIRU 27, ETR-B, ETR-C, Mtub21 and QUB 26 loci showed moderate ability (h = 0.33 or h = 0.49) and were the most effective in evaluating the genotypic similarities among the clinical M. bovis isolate samples. Herein, the 29 patterns found amongst the 37 isolates of M. bovis circulating in the Brazilian Midwest can be due to the animal movement between regions, municipalities and farms, thus causing the spread of various M. bovis strains in herds from Midwest Brazil.


Assuntos
Mycobacterium bovis/genética , Animais , Bovinos , Análise por Conglomerados , Genes Bacterianos
7.
Ciênc. rural ; 46(7): 1223-1228, July 2016. tab
Artigo em Inglês | LILACS | ID: lil-780864

RESUMO

ABSTRACT: Bovine tuberculosis is an infectious disease with a high impact on the cattle industry, particularly in developing countries. PCR is a very sensitive method for detection of infectious agents, but the sensitivity of molecular diagnosis is largely dependent on the efficiency of the DNA extraction methods. The objective of this study was to evaluate DNA extraction methods for direct detection of Mycobacterium bovis in bovine tissue. Nine commercial kits for DNA extraction were evaluated when combined with two real time PCRs. The DNeasy Blood & Tissue Kit from QIAGEN showed better performance and sensitivity followed by the DNA Mini Kit RBC and FTA Elute Micro Card. Results suggested that, even when the analytical sensitivity of the qPCR is very high, the extraction method can influence the diagnostic sensitivity.


RESUMO: A tuberculose bovina é uma doença infecciosa com um alto impacto na pecuária, particularmente em países em desenvolvimento. A PCR é um método muito sensível para a detecção de agentes infecciosos, mas a sensibilidade do diagnóstico molecular é em grande parte dependente da eficiência dos métodos de extração de DNA. O objetivo deste estudo foi avaliar métodos de extração de DNA para detecção direta de Mycobacterium bovisem tecido bovino. Nove kits comerciais para extração de DNA foram avaliados, quando combinados com duas PCRs em tempo real. O Kit Dneasy Blood & Tissue da Qiagen apresentou melhor desempenho e sensibilidade, seguido dos kits DNA Mini RBC e FTA Elute Micro Card (protocolo modificado com digestão enzimática prévia). Os resultados sugerem que, mesmo quando a sensibilidade analítica do qPCR é muito elevada, o método de extração pode influenciar na sensibilidade de diagnóstico.

8.
Ciênc. rural ; 46(5): 847-852, May 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-777297

RESUMO

ABSTRACT: A multiplex PCR technique for detection of Brucella spp. in samples of bacterial suspension was validated as a complementary tool in the diagnosis of the disease. This technique allows the characterization of the agent without performing biochemical tests, which greatly reduces the time for a final diagnosis, and provides more security for the analyst by reducing the time of exposure to microorganisms. The validation was performed in accordance with the Manual of Diagnostic Tests from OIE (2008) and following the requirements present in the ABNT NBR ISO/IEC 17025:2005. The mPCR validated in this study identified the different species of Brucella (Brucella abortus, B. suis, B. ovis e B. melitensis) of bacterial suspension obtained from the slaughterhouse samples, as well as distinguished the biovars (1, 2 e 4; 3b, 5, 6 e 9) of B. abortus in grouped form and differentiated the field strains from vaccine strains, as a quick, useful and less expensive technique in diagnosis of brucellosis in Brazil.


RESUMO: Validou-se neste trabalho uma técnica de PCR Multiplex (mPCR) para detecção de Brucella spp. em amostras de suspensão bacteriana, como ferramenta complementar no diagnóstico da doença. Esta técnica possibilita a caracterização do agente sem que seja necessária a realização de testes bioquímicos, o que diminui consideravelmente o tempo para o diagnóstico final, além de oferecer mais segurança ao analista ao diminuir o tempo de exposição ao agente infecioso. A validação foi realizada de acordo com o Manual de Testes de Diagnósticos da OIE (2008), seguindo as exigências presentes na norma de qualidade da ABNT NBR ISO/IEC 17025:2005. A mPCR validada neste trabalho identificou as diferentes espécies de Brucella (Brucella abortus, B. suis, B. ovis e B. melitensis) em suspensão bacteriana, obtidas a partir de amostras de frigorífico. Além disso, discriminou os biovares (1, 2 e 4; 3b, 5, 6 e 9) de B. abortus, de forma agrupada, e diferenciou cepa vacinal de cepa de campo, sendo esta uma técnica rápida, útil e de menor custo para o auxílio no diagnóstico de brucelose no Brasil.

9.
Braz. j. microbiol ; 45(4): 1362-1369, Oct.-Dec. 2014. graf, tab
Artigo em Inglês | LILACS | ID: lil-741288

RESUMO

Mycobacterium tuberculosis is the major cause of tuberculosis in humans. This bacillus gained prominence with the occurrence of HIV, presenting itself as an important opportunistic infection associated with acquired immunodeficiency syndrome (AIDS). The current study aimed to develop a real-time PCR using Eva Green technology for molecular identification of M. tuberculosis isolates. The primers were designed to Rv1510 gene. Ninety nine samples of M. tuberculosis and sixty samples of M. bovis were tested and no sample of the bovine bacillus was detected by the qPCR. Statistical tests showed no difference between the qPCR and biochemical tests used to identify the Mycobacterium tuberculosis. The correlation between tests was perfect with Kappa index of 1.0 (p < 0.001, CI = 0.84 - 1.0). The diagnostic sensitivity and specificity were 100% (CI = 95.94% - 100%) and 100% (CI = 93.98% - 100%). This qPCR was developed with the goal of diagnosing the bacillus M. tuberculosis in samples of bacterial suspension. TB reference laboratories (health and agriculture sectors), public health programs and epidemiological studies probably may benefit from such method.


Assuntos
Humanos , Mycobacterium tuberculosis/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real/métodos , Tuberculose/diagnóstico , Primers do DNA/genética , Mycobacterium tuberculosis/genética , Sensibilidade e Especificidade
10.
Folia Microbiol (Praha) ; 59(5): 433-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24744007

RESUMO

Mycobacterium tuberculosis complex (MTC) comprises a group of bacteria that have a high degree of genetic similarity. Two species in this group, Mycobacterium tuberculosis and Mycobacterium bovis, are the main cause of human and bovine tuberculosis, respectively. M. bovis has a broader host range that includes humans; thus, the differentiation of mycobacterium is of great importance for epidemiological and public health considerations and to optimize treatment. The current study aimed to evaluate primers and molecular markers described in the literature to differentiate M. bovis and M. tuberculosis by PCR. Primers JB21/22, frequently cited in scientific literature, presented in our study the highest number of errors to identify M. bovis or M. tuberculosis (73%) and primers Mb.400, designed to flank region of difference 4 (RD4), were considered the most efficient (detected all M. bovis tested and did not detect any M. tuberculosis tested). Although also designed to flank RD4, primers Mb.115 misidentified eight samples due to primer design problems. The results showed that RD4 is the ideal region to differentiate M. bovis from other bacteria classified in MTC, but primer design should be considered carefully.


Assuntos
Técnicas de Diagnóstico Molecular/métodos , Mycobacterium bovis/classificação , Mycobacterium bovis/genética , Mycobacterium tuberculosis/classificação , Mycobacterium tuberculosis/genética , Reação em Cadeia da Polimerase/métodos , Tuberculose/diagnóstico , Técnicas Bacteriológicas/métodos , Primers do DNA/genética , Erros de Diagnóstico , Marcadores Genéticos , Humanos , Mycobacterium bovis/isolamento & purificação , Mycobacterium tuberculosis/isolamento & purificação
11.
Braz J Microbiol ; 45(4): 1363-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25763042

RESUMO

Mycobacterium tuberculosis is the major cause of tuberculosis in humans. This bacillus gained prominence with the occurrence of HIV, presenting itself as an important opportunistic infection associated with acquired immunodeficiency syndrome (AIDS). The current study aimed to develop a real-time PCR using Eva Green technology for molecular identification of M. tuberculosis isolates. The primers were designed to Rv1510 gene. Ninety nine samples of M. tuberculosis and sixty samples of M. bovis were tested and no sample of the bovine bacillus was detected by the qPCR. Statistical tests showed no difference between the qPCR and biochemical tests used to identify the Mycobacterium tuberculosis. The correlation between tests was perfect with Kappa index of 1.0 (p < 0.001, CI = 0.84 - 1.0). The diagnostic sensitivity and specificity were 100% (CI = 95.94% - 100%) and 100% (CI = 93.98% - 100%). This qPCR was developed with the goal of diagnosing the bacillus M. tuberculosis in samples of bacterial suspension. TB reference laboratories (health and agriculture sectors), public health programs and epidemiological studies probably may benefit from such method.


Assuntos
Mycobacterium tuberculosis/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real/métodos , Tuberculose/diagnóstico , Primers do DNA/genética , Humanos , Mycobacterium tuberculosis/genética , Sensibilidade e Especificidade
12.
Mem. Inst. Oswaldo Cruz ; 108(3): 321-327, maio 2013. tab, graf
Artigo em Inglês | LILACS | ID: lil-676968

RESUMO

In this cross-sectional study, mycobacteria specimens from 189 tuberculosis (TB) patients living in an urban area in Brazil were characterised from 2008-2010 using phenotypic and molecular speciation methods (pncA gene and oxyR pseudogene analysis). Of these samples, 174 isolates simultaneously grew on Löwenstein-Jensen (LJ) and Stonebrink (SB)-containing media and presented phenotypic and molecular profiles of Mycobacterium tuberculosis, whereas 12 had molecular profiles of M. tuberculosis based on the DNA analysis of formalin-fixed paraffin wax-embedded tissue samples (paraffin blocks). One patient produced two sputum isolates, the first of which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, and the second of which only grew on SB media and presented phenotypic profiles of Mycobacterium bovis. One patient provided a bronchial lavage isolate, which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, but had molecular profiles of M. bovis from paraffin block DNA analysis, and one sample had molecular profiles of M. tuberculosis and M. bovis identified from two distinct paraffin blocks. Moreover, we found a low prevalence (1.6%) of M. bovis among these isolates, which suggests that local health service procedures likely underestimate its real frequency and that it deserves more attention from public health officials.


Assuntos
Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Coinfecção/microbiologia , Mycobacterium bovis/isolamento & purificação , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose/microbiologia , Brasil/epidemiologia , Estudos Transversais , Coinfecção/epidemiologia , DNA Bacteriano/análise , Escolaridade , Fenótipo , Reação em Cadeia da Polimerase , Tuberculose/diagnóstico , Tuberculose/epidemiologia , População Urbana
13.
Ciênc. rural ; 40(10): 2135-2140, Oct. 2010. tab
Artigo em Português | LILACS | ID: lil-564148

RESUMO

Esta investigação teve por objetivo validar o teste de polarização fluorescente (TPF) para o diagnóstico sorológico da brucelose bovina, determinando a sensibilidade (SE) e a especificidade relativas (SP) e verificando a reprodutibilidade do teste em quatro laboratórios no Brasil. Foram selecionadas 1.389 amostras de soro sanguíneo, as quais foram inicialmente submetidas aos testes do antígeno acidificado tamponado (AAT) e mercaptoetanol (2-ME). As mesmas amostras foram submetidas à reação de fixação de complemento (RFC) e ao TPF. Para a avaliação do TPF, foi adotada a combinação dos resultados do AAT, da RFC e do 2-ME, utilizados como população de referência (padrão-ouro). Para a determinação do ponto de corte do TPF que proporciona a melhor combinação de sensibilidade e especificidade, foi usada a análise TG-ROC. A concordância entre os resultados dos quatro laboratórios foi determinada com base no indicador kappa e no coeficiente de correlação de Pearson. Os pontos de corte do TPF situaram-se entre 85,2 e 93,6 mP, conforme o laboratório. A sensibilidade variou de 91,7 a 97,3 por cento, e a especificidade situou-se na faixa de 82,6 a 98,3 por cento. Na comparação entre os resultados do TPF dos quatro laboratórios, o indicador kappa ficou entre 0,69 e 0,95, o que indica, na maioria das situações, reprodutibilidade excelente, e o coeficiente de correlação variou entre 0,76 e 0,99. Os resultados indicaram que o TPF apresentou bom desempenho, na maioria das situações, com sensibilidade e especificidade elevadas. Em comparação com os testes convencionais, o TPF apresenta as vantagens de ser de execução mais rápida e mais fácil e não estar sujeito à ocorrência de prozona, como a RFC e o 2-ME, nem de atividade anticomplementar, como a RFC.


The purpose of this research was the interlaboratorial validation of the polarization fluorescence assay (PFA) for the serodiagnosis of bovine brucellosis, verifying the relative sensitivity, the relative specificity and the reproducibility of the test in four Brazilian laboratories. Serum samples from 1,389 bovines were selected and submitted to the rose Bengal (RBT) and 2-mercaptoethanol tests in one of the laboratories. The same samples were tested by the complement fixation (CFT) test and by the PFA in the four laboratories participating of the research. The reference population (golden standard) used to evaluate the PFA was the combination of the results of RBT, CFT and 2-ME. TG-ROC analysis was used to obtain the cut-off that provided the best combination of sensitivity and specificity. The agreement between laboratories was obtained by the kappa statistic and Pearson correlation coefficient (r). The PFA cut-off values were from 85.2 to 93.6. The sensitivity of the PFA assay varied from 91.7 percent to 97.3 percent, and the specificity values varied from 82.6 percent to 98.3 percent. When comparing PFA results from the four laboratories, the kappa values was between 0.69 and 0.95, which indicates, in most situations, excellent reproducibility, and the correlation coefficient varied from 0.76 to 0.99. The results showed that the PFA had a good performance, with high sensitivity and specificity. Compared to the conventional tests, the PFA has the advantages of being easy and quick to perform, and it is not prone to the occurrence of prozone, as the CFT or the 2-ME, nor to the occurrence of anti-complementary effect, as the CFT.

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