Keywords
Culture media
Diagnosis
Tuberculosis
Laboratory techniques procedures
How to Cite
Abstract
Mycobacteria culture is of fundamental importance to the diagnosis of tuberculosis because presents sensitivity higher than the acid-fast smear. The purpose of this study is to evaluate the performance of the culture media Ogawa-Kudoh (OK) and manual Mycobacteria Growth Indicator Tube (MGIT-Becton & Dickinson) in relation the positivity, speed of the results, contamination and the increase of the diagnosis by the culture in a public health laboratory in São Paulo state. The samples from patients with suspected tuberculosis were doubly processed for the culture: one by the conventional method of swab and inoculated onto OK medium, and another by the Petroff 's method and inoculated in MGIT liquid medium. Of these 490 cultures performed, 45 (9.2%) were positive in the OK medium and 58 (11.8%) in MGIT. The percentage of the contamination in OK medium was 6 (1.2%) and 1 (0.2%) in MGIT. The increase of the diagnosis by the culture in OK was 11 (17.7%) and in MGIT was 20 (28.2%). The growth in MGIT medium was faster than OK in the positive results (value-p=0.02). The agreement/reliability of the results was 95.2% (n=483). Of these 64 isolates obtained by OK or MGIT, the identification was performed in 45 (70.3%): 37 (57.8%) were identified as Mycobacterium tuberculosis, 4 (6.3%) M. intraellulare/M. chimaera, 2 (3.1%) M. abcessus and 2 (3.1%) M. avium. The MGIT medium showed better results than OK medium in relation of the positivity, the rapidity of the diagnosis, rates of contamination and in the increase of the diagnosis by the culture.
References
Brito RC, Gounder C, Lima DB, Siqueira H, Cavalcanti HR, Pereira MM, et al. Resistência aos medicamentos antituberculose de cepas de Mycobacterium tuberculosis isoladas de pacientes atendidos em hospital geral de referência para tratamento de AIDS no Rio de Janeiro. J Bras Pneumol. 2004;30(4):425-32.
Oplustil CP, Teixeira SR, Osugui SK, Mendes CF. Impacto da automação no diagnóstico de infecções por micobactérias. J Bras Patol Med Lab. 2002;38(3):167-73.
Brasil. Ministério da Saúde. Fundação Nacional de Saúde. Manual de bacteriologia da tuberculose. Centro de Referência Professor Hélio Fraga. Rio de Janeiro; 1994.
Brodie D, Schluger NW. The diagnosis of tuberculosis. Clin Chest Med. 2005;26(2):247-71.
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância Epidemiológica. Manual nacional de vigilância laboratorial da tuberculose e outras micobacterioses [monografia na internet]. Brasília, 2008 [acesso em 2011 fev 9]. Disponível em: http:// portal.saude.gov.br/portal/arquivos/pdf/ manual_laboratorio_tb_3_9_10.pdf.
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Programa Nacional de Controle da Tuberculose. Manual de recomendações para o controle da tuberculose no Brasil [monografia na internet]. Brasília, 2010 [acesso em 2010 nov 9]. Disponível em: http:// www.crf-rj.org.br/crf/arquivos/ Manual_Recomendacoes_Controle_TB.pdf.
Ribeiro FH, Dantas MCS, Maia R, Lecco R, Luchi BMM, Bussular JL, et al. Comparação do método de Ogawa Kudoh com os métodos de Lauril sulfato de sódio e fosfato trisódico para cultivo de micobactérias [periódico na internet]. [acesso em 2010 set 24]. Disponível em: http:// www.jornaldepneumologia.com.br/ portugues/suplementos_detalhe.asp? id_cap=64.
Fadzilah MN, Kee Peng NG, Yun Fong N. The manual MGIT system for the detection of M.tuberculosis in respiratory specimens: an experience in the University Malaya Medical Centre. J Pathol. 2009;31(2):93-7.
Collins CH, Grange JM, Yates MD. Identification of species. In: Tuberculosis bacteriology: organization and practice. 2. ed. Butterworth- Heinemann, Oxford, 1997.
Chimara E, Ferrazoli L, Ueki SYM, Martins MC, Durham AM, Arbeit RD, et al. 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. BMC Microbiol. 2008;8:48.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-74.
Boffo MMS, Mattos IG, Ribeiro MO, Jardim S, Souza VC. Diagnóstico laboratorial da tuberculose na cidade do Rio Grande, RS, Brasil. Rev Bras Anal Clin. 2003;35(1):35- 8.
Kudoh S, Kudoh T. A simple technique for culturing tubercle bacilli. Bull World Health Organ. 1974;51(1):71-82.
Almeida EA, Santos MAA, Afiune JB, Spada DTA, Melo FAF. Rendimento da cultura de escarro na comparação de um sistema de diagnóstico automatizado com o meio de Lowenstein-Jensen para o diagnóstico da tuberculose pulmonar. J Bras Pneumol. 2005;31(3):231-6.
Machado AMO. Avaliação do meio de cultura líquido BBL mycobacteria growth indicator tube (MGIT) em rotina de detecção de micobactérias em amostras de escarro de pacientes com suspeita de tuberculose pulmonar [tese de doutorado]. São Paulo: Universidade Federal de São Paulo. Escola Paulista de Medicina; 1998.
Oplustil CP, Sinto SI, Martins M, Mendes CMF. Avaliação de um novo sistema para detecção de micobactérias: "mycobacterium growth indicator tube" (MIGIT). J Bras Patol. 1997;33(2):70-5.
Delurce TAE. Detecção de bactérias do complexo M.tuberculosis em saliva/muco ou escarro em centro de referência ambulatorial para tuberculose na cidade de São Paulo: baciloscopia, cultura convencional e automatizada [tese de doutorado]. São Paulo: Universidade de São Paulo; 2009.
Palaci M, Ueki SYM, Sato DN, Telles MAS, Curcio M, Silva EAM. Evaluation of mycobacteria growth indicator tube for recovery and drug susceptibility testing of Mycobacterium tuberculosis isolates from respiratory specimens. J Clin Microbiol. 1996;34(3):762-4.
Chien HP, Yu MC, Wu MH, Lin TP, Luh KT. Comparison of the Bactec MGIT 960 with Löwenstein-Jensen medium for recovery of mycobacteria from clinical specimens. Int j tuberc lung dis. 2000;4(9):866-70.
Kritski AlL, Rufino-Neto A. Health scetor reform in Brazil: impact on tuberculosis control. Int J Tuberc Lung Dis. 2000;4(7):622-6.
López LM, Vélez CI, Zuluaga LM, Mejía GI, Estrada S, Posada P, et al. Evaluación de medios de cultivo alternativos para el diagnóstico de la tuberculosis pulmonar. Infectio. 2001;5(4):235-40.
Pedro HSP, Pereira MIF, Goloni MRA, Ueki SYM, Chimara E. Isolamento de micobactérias não-tuberculosas em São José do Rio Preto entre 1996 e 2005. J Bras Pneumol. 2008;34(11):950-5.
Pedro HSP, Pereira MIF, Goloni MRA, Pires FC, Oliveira RS, Rocha MAB, et al. Mycobacterium tuberculosis in a HIV-Iinfected population from Southeastern Brazil in the HAART era. Trop Med Int Health. 2011;16(1):67-73. Correspondência/correspondence to: Heloisa da Silveira Par
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2011 Heloisa da Silveira Paro Pedro, Susilene Maria Tonelli Nardi, Máira Gazzola Arroyo, Maria Izabel Pereira Ferreira, Maria do Rosário Assad Goloni, Lucilaine Ferrazoli