Universidad Peruana Cayetano Heredia

Evaluation of Microscopic Observation Drug Susceptibility (MODS) and the string test for rapid diagnosis of pulmonary tuberculosis in HIV/AIDS patients in Bolivia

Mostrar el registro sencillo del ítem

dc.contributor.author Lora, Meredith H.
dc.contributor.author Reimer-McAtee, Melissa J.
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Lozano, Daniel
dc.contributor.author Saravia, Ruth
dc.contributor.author Pajuelo Travezaño, Monica Jhenny
dc.contributor.author Bern, Caryn
dc.contributor.author Castro, Rosario
dc.contributor.author Espinoza, Magaly
dc.contributor.author Vallejo, Maya
dc.contributor.author Solano, Marco
dc.contributor.author Challapa, Roxana
dc.contributor.author Torrico, Faustino
dc.date.accessioned 2019-02-06T14:52:14Z
dc.date.available 2019-02-06T14:52:14Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5284
dc.description.abstract Background: Tuberculosis (TB) is the most common opportunistic infection and the leading cause of death in HIV-positive people worldwide. Diagnosing TB is difficult, and is more challenging in resource-scarce settings where culture-based diagnostic methods rely on poorly sensitive smear microscopy by Ziehl-Neelsen stain (ZN). Methods: We performed a cross-sectional study examining the diagnostic utility of Microscopic Observation Drug Susceptibility liquid culture (MODS) versus traditional Ziehl-Neelsen staining (ZN) and Lowenstein Jensen culture (LJ) of pulmonary tuberculosis (TB) and multidrug-resistant tuberculosis (MDRTB) in HIV-infected patients in Bolivia. For sputum scarce individuals we assessed the value of the string test and induced sputum for TB diagnosis. The presence of Mycobacterium tuberculosis (Mtb) in the sputum of 107 HIV-positive patients was evaluated by ZN, LJ, and MODS. Gastric secretion samples obtained by the string test were evaluated by MODS in 102 patients. Results: The TB-HIV co-infection rate of HIV patients with respiratory symptoms by sputum sample was 45 % (48/107); 46/48 (96 %) were positive by MODS, 38/48 (79 %) by LJ, and 30/48 (63 %) by ZN. The rate of MDRTB was 9 % (4/48). Median time to positive culture was 10 days by MODS versus 34 days by LJ (p < 0.0001). In smear-negative patients, MODS detected TB in 17/18 patients, compared to 11/18 by LJ (94.4 % vs 61.0 %, p = 0.03 %). In patients unable to produce a sputum sample without induction, the string test cultured by MODS yielded Mtb in of 9/11 (82 %) TB positive patients compared to 11/11 (100 %) with induced sputum. Of the 10 patients unable to produce a sputum sample, 4 were TB-positive by string test. Conclusion: MODS was faster and had a higher Mtb detection yield compared to LJ, with a greater difference in yield between the two in smear-negative patients. The string test is a valuable diagnostic technique for HIV sputum-scarce or sputum-absent patients, and should be considered as an alternative test to induced sputum to obtain sample for Mtb in resource-limited settings. Nine percent of our TB+ patients had MDRTB, which reinforces the need for rapid detection with direct drug susceptibility testing in HIV patients in Bolivia. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartofseries BMC Infectious Diseases
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Sensitivity and Specificity en_US
dc.subject Cross-Sectional Studies en_US
dc.subject Middle Aged en_US
dc.subject Urinalysis en_US
dc.subject Bolivia en_US
dc.subject Antitubercular Agents/pharmacology en_US
dc.subject Sputum/microbiology en_US
dc.subject Microscopy/methods en_US
dc.subject Acquired Immunodeficiency Syndrome/complications/diagnosis en_US
dc.subject Microbial Sensitivity Tests/methods en_US
dc.subject Mycobacterium tuberculosis/drug effects/isolation & purification en_US
dc.subject Tuberculosis, Multidrug-Resistant/complications/diagnosis/microbiology en_US
dc.subject Tuberculosis, Pulmonary/complications/diagnosis/microbiology en_US
dc.title Evaluation of Microscopic Observation Drug Susceptibility (MODS) and the string test for rapid diagnosis of pulmonary tuberculosis in HIV/AIDS patients in Bolivia en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s12879-015-0966-0
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1471-2334


Ficheros en el ítem

Ficheros Tamaño Formato Ver

No hay ficheros asociados a este ítem.

Este ítem aparece en la(s) siguiente(s) colección(ones)

Mostrar el registro sencillo del ítem

info:eu-repo/semantics/restrictedAccess Excepto si se señala otra cosa, la licencia del ítem se describe como info:eu-repo/semantics/restrictedAccess

Buscar en el Repositorio


Listar

Panel de Control

Estadísticas