Palavras-chave
prisões
baciloscopia
técnicas de cultura
escarro
Como Citar
Resumo
Cultura de micobactérias proporciona o crescimento de bacilos viáveis, mesmo presentes em escassa quantidade e não detectados pela baciloscopia. Neste estudo foram analisadas as amostras de escarro que apresentaram baciloscopia negativa e cultura positiva. As amostras foram coletadas de 2008 a 2013, de indivíduos detidos em Centros de Detenção Provisória de Santo André, Mauá e Diadema, Estado de São Paulo. As metodologias utilizadas foram baciloscopia por coloração Ziehl-Neelsen e cultura pelo Sistema BACTEC MGIT 960 e Ogawa-Kudoh. Dos 11.529 exames realizados, 221 (1,9 %) apresentaram baciloscopias negativas e culturas positivas. Dos 221 isolados, 166 (75,1 %) pertenciam ao Complexo Mycobacterium tuberculosis, 21 (9,5 %) micobactérias não membros do Complexo Mycobacterium tuberculosis (MNT), 33 (14,9 %) Mycobaterium sp e uma cultura mista do Complexo M. tuberculosis e M. avium. MNT mais frequentes foram M. avium (23,8 %) e M. fortuitum (19,0 %). A maioria dos isolados do Complexo M. tuberculosis (155/166 - 93,4 %) foi sensível aos antimicrobianos. Sete amostras apresentaram resistência à isoniazida e uma apresentou multirresistência à isoniazida e rifampicina. Este estudo mostra a importância da realização da cultura em escarros que apresentam baciloscopia negativa no diagnóstico da TB e micobacteriose. O tratamento tardio causa a continuidade da transmissão da doença e agravamento do quadro clínico.
Referências
1. Brasil. Ministério da Saúde. Manual de Recomendações para o Controle da tuberculose no Brasil. Secretaria de Vigilância em Saúde. Programa Nacional de Controle da Tuberculose. Brasília. 2010.
2. Bergmann JS, Yuoh G, Fish G, Woods GL. Clinical evaluation of the enhanced Gen-Probe Amplified Mycobacterium tuberculosis Direct Test for rapid diagnosis of tuberculosis in prison inmates. J Clin Microbiol. 1999;37:1419-25.
3. Banu S, Hossain A, Uddin MK, Uddin MR, Ahmed T, Khatun R, et al. Pulmonary tuberculosis and drug resistance in Dhaka central jail, the largest prison in Bangladesh. PLoS One. 2010;5:e10759. [DOI: 10.1371/journal.pone.0010759].
4. Chigbu LN, Iroegbu CU. Incidence and spread of Mycobacterium tuberculosis-associated infection among Aba Federal prison inmates in Nigeria. J Health Popul Nutr. 2010;28:327-32.
5. Global Tuberculosis Report. WHO/HTM/TB/2015.11. Geneva, World Health Organization, 2015.
6. Fournet N, Sanchez A, Massari V, Penna L, Natal S, Biondi E, et al. Development and evaluation of tuberculosis screening scores in Brazilian prisons. Public Health. 2006;120(10):976-83. [DOI: 10.1016/j.puhe.2006.06.004]
7. Sanchez A, Larouzé B, Espinola AB, Pires J, Capone D, Gerhardt G, et al. Screening for tuberculosis on admission to highly endemic prisons? The case of Rio de Janeiro State prisons. Int J Tuberc Lung Dis. 2009;13:1247-52.
8. Falkinham JO 3rd. Epidemiology of Infection by Nontuberculous Mycobacteria. Clin Microbiol Rev. 1996; 9(2):177-215.
9. Maruthai K, Ravibalan T, Vallayyachari K, Kesavan S, Samrot AV, Muthaiah M. Molecular typing and differentiation of Mycobacterium tuberculosisclinical isolates using Double Repetitive Element PCR and Duplex PCR. Int J Mycobacteriol. 2015;4(1):60-6. [DOI: 10.1016/j.ijmyco.2014.11.061].
10. Colebunders R, Bastian I. A review of the diagnosis and treatment of smear-negative pulmonary tuberculosis. Int J Tuberc Lung Dis. 2000;4(2):97-107.
11. Affolabi D, Akpona R, Odoun M, Alidjinou K, Wachinou P, Anagonou S, et al. Smear-negative, culture-positive pulmonary tuberculosis among patients with chronic cough in Cotonou, Benin. Int J Tuberc Lung Dis. 2011;15(1):67-70.
12. Alavi-Naini R, Cuevas LE, Squire SB, Mohammadi M, Davoudikia AA. Clinical and laboratory diagnosis of the patients with sputum smear-negative pulmonary tuberculosis. Arch Iran Med. 2012;15(1):22-6. [DOI: 012151/AIM.007].
13. Assael R, Cervantes J, Barrera G. Smears and cultures for diagnosis of pulmonary tuberculosis in an asymptomatic immigrant population. Int J Gen Med. 2013;6:777-9. [DOI: 10.2147/IJGM.S48964].
14. Shah NS, Cavanaugh JS, Pratt R, Cain KP, Wells C, Laserson K, et al. Epidemiology of smear-negative pulmonary tuberculosis in the United States, 1993-2008. Int J Tuberc Lung Dis. 2012;16(9):1234-40. [DOI: 10.5588/ijtld.11.0794].
15. Abebe G, Deribew A, Apers L, Abdissa A, Kiflie Y, Koole O, et al. Evaluation of the 2007 WHO guideline to diagnose smear negative tuberculosis in an urban hospital in Ethiopia. BMC Infect Dis. 2013;13:427. [DOI: 10.1186/1471-2334-13-427]
16. David HL. Bacteriology of mycobacterioses. US Department of Health, Education and Welfare, Public Health Service, Communicable Disease Centre, Atlanta, USA, 1996.
17. Rieder HL, Van Deun A, Kam KM, Kim SJ, Chond TM, Trébucq A, et al. Priorities for Tuberculosis Bacteriology Services in Low-Income Countries. Second edition. International Union Agaisnt Tuberculosis and Lung Disease (The Union). Paris, France. 2007.
18. WHO/World Health Organization. Toman’s Tuberculosis. Case detection, treatment, and monitoring. Questions and answers. 2nd edition. Edited by T. Frieden. WHO/ HTM/TB2004.334. Geneva, Switzerland. 2004.
19. Brasil. Ministério da Saúde. Manual Nacional de Vigilância Laboratorial da Tuberculose e outras Micobactérias / Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância Epidemiológica. – Brasília. Ministério da Saúde, 2008. 436 p. : il. (Série A. Normas e Manuais Técnicos).
20. Instituto Brasileiro de Geografia e Estatística – IBGE. 2010. [acesso: 201 Set 30]. Disponível em: [http://www.ibge.gov.br/home/].
21. Becton Dickinson and Company. 7 Loveton Circle, Sparks, MD 21152 USA. Folheto da BD BBLTMMGITTM, versão: MAI_08_001.
22. Kudoh S, Kudoh T. A simple technique for culturing tubercle bacilli. Bull World Health Organ. 1974; 51(1): 71-82.
23. Telenti A, Marchesi F, Balz M, Bally F, Böttger EC, Bodmer T. Rapid identification of mycobacteria to the species level by polymerase chain reaction and restriction enzyme analysis. J Clin Microbiol. 1993;31(2):175-8.
24. Chimara E, Ferrazoli L, Ueky SY, 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. [DOI: 10.1186/1471-2180-8-48].
25. Andrade FEM, Londoño CA, Acevedo CS, Echeverri AQ, Montaño CEB, Navas MAM, et al. Características clínicas, factores de riesgo y perfi de susceptibilidad de las infecciones por micobacterias documentadas por cultivo, en un hospital universitario de alta complejidad en Medellín (Colombia). Rev Chil Infectol. 2014;31(6):735-42. [DOI: 10.4067/S0716-10182014000600015].
26. Maurya AK, Nag VL, Kant S, Kushwaha RAS, Kumar M, Singh AK, et al. Prevalence of Nontuberculous Mycobacteria among Extrapulmonary Tuberculosis Cases in Tertiary Care Centers in Northern India. BioMed Res Int. 2015:2015:465403. [DOI: 10.1155/2015/465403].
27. Brasil. Ministério da Saúde. Manual de Recomendações para o Controle da Tuberculose no Brasil / Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância Epidemiológica. – Brasília : Ministério da Saúde, 2011. 284 p. : il. – (Série A. Normas e Manuais Técnicos).
28. Oliveira LGD, Natal S, Camacho LAB. Análise da implantação do Programa de Controle da Tuberculose em unidades prisionais no Brasil. Cad Saúde Pública. 2015;31(3):543-54. [DOI: 10.1590/0102-311X00042914].
29. Sanchez A, Larouzé B, Espinola AB, Pires J, Capone D, Gerhardt G, et al. Screening for tuberculosis on admission to highly endemic prisons? The case of Rio de Janeiro State prisons. Int J Tuberc Lung Dis. 2009;13(10):1247-52.
30. Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med, 2007;175(4):367-416. [DOI: 10.1164/rccm.200604-571ST].
31. Gillespie SH. Evolution of drug resistance in Mycobacterium tuberculosis: clinical and molecular perspective. Antimicrob Agents Chemother. 2002;46(2):267-74. [DOI: 10.1128/AAC.46.2.267-274.2002]
32. Aily DCG, Berra JAP, Brandão AP, Chimara E. Tuberculose, HIV e coinfecção por TB/HIV no Sistema Prisional de Itirapina, São Paulo, Brasil. Rev Inst Adolfo Lutz. São Paulo, 2013; 72(4):288-94.
33. Bicmen C, Gunduz AT, Coskun M, Senol G, Cirak AK, Ozsoz A. Molecular detection and identification of Mycobacterium tuberculosisComplex and four clinically important nontuberculous mycobacterial species in smear-negative clinical samples by the genotype mycobacteria direct test. J Clin Microbiol. 2011;49(8):2874-8. [DOI: 10.1128/JCM.00612-11].
34. Ssengooba W, Kiwanuka N, Kateete DP, Katamba A, Joloba ML. Incremental yield of serial sputum cultures for diagnosis of tuberculosis among HIV infected smear negative pulmonary TB suspects in Kampala, Uganda. PLoS One. 2012;7(5):e37650. [DOI: 10.1371/journal.pone.0037650].
35. Kehinde Aderemi O, Dada-Adegbola H. Epidemiology of smear - negative tuberculosis in Ibadan, Nigeria. Afr J Infect Dis. 2013;7(1):14-7.
36. Oliveira HB, Cardoso JC. Tuberculosis among city jail inmates in Campinas, São Paulo, Brazil. Rev Panam Salud Publica. 2004:15(3):185-93. [DOI: 10.1590/S1020-49892004000300008].
37. O’Grady J, Maeurer M, Atun R, Abubakare I, Mwaba P, Bates M, et al. Tuberculosis in prisons: anatomy of global neglect. Eur Respir J. 2011;38(4):752-4. [DOI: 10.1183/09031936.00041211].
38. Global tuberculosis report. 2013. WHO/HTM/TB/2013.11. Geneva, World Health Organization, 2013.
39. Rusovich V, Kumar AM, Skrahina A, Hurevich H, Astrauko A, de Colombani P, et al. High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus. Public Health Action. 2014;4(4):243-8. [DOI: 10.5588/pha.14.0069.].
40. Helb D, Jones M, Story E, Boehme C, Wallace E, Ho K, et al. Rapid detection of Mycobacterium tuberculosis and rifampin resistance by use of on-demand, near-patient technology. J Clin Microbiol. 2010; 48:229-37. [DOI: 10.1128/JCM.01463-09]
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Copyright (c) 2016 Maria Cecilia Cergole-Novella, Andréia Moreira dos Santos Carmo, Alexandra Alves dos Anjos Redondaro, Valéria dos Santos Candido, Mara Cristina de Souza Buzon, Ana Paula da Cunha Gonçalves, Érica Chimara, Regina Ruivo Ferro e Silva