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Start Over Descriptor "Sputum/microbiology" Journal bmc infectious diseases
2 results on '"Sputum/microbiology"'

1. A randomized controlled trial of standard versus intensified tuberculosis diagnostics on treatment decisions by physicians in Northern Tanzania.

Author

Reddy, Elizabeth A., Njau, Boniface N., Morpeth, Susan C., Lancaster, Kathryn E., Tribble, Alison C., Maro, Venance P., Msuya, Levina J., Morrissey, Anne B., Kibiki, Gibson S., Thielman, Nathan M., Cunningham, Coleen K., Schimana, Werner, Shao, John F., Shein-Chung Chow, Stout, Jason E., Crump, John A., Bartlett, John A., and Hamilton, Carol D.

Subjects
*RANDOMIZED controlled trials, *TUBERCULOSIS diagnosis, *TUBERCULOSIS treatment, *PHYSICIANS, *MORTALITY
Abstract

Background Routine tuberculosis culture remains unavailable in many high-burden areas, including Tanzania. This study sought to determine the impact of providing mycobacterial culture results over standard of care [unconcentrated acid-fast (AFB) smears] on management of persons with suspected tuberculosis. Methods Adults and children with suspected tuberculosis were randomized to standard (direct AFB smear only) or intensified (concentrated AFB smear and tuberculosis culture) diagnostics and followed for 8 weeks. The primary endpoint was appropriate treatment (i.e. antituberculosis therapy for those with tuberculosis, no antituberculous therapy for those without tuberculosis). Results Seventy participants were randomized to standard (n = 37, 52.9%) or intensive (n = 33, 47.1%) diagnostics. At 8 weeks, 100% (n = 22) of participants in follow up randomized to intensive diagnostics were receiving appropriate care, vs. 22 (88.0%) of 25 participants randomized to standard diagnostics (p = 0.14). Overall, 18 (25.7%) participants died; antituberculosis therapy was associated with lower mortality (9% who received antiuberculosis treatment died vs. 26% who did not, p = 0.04). Conclusions Under field conditions in a high burden setting, the impact of intensified diagnostics was blunted by high early mortality. Enhanced availability of rapid diagnostics must be linked to earlier access to care for outcomes to improve. [ABSTRACT FROM AUTHOR]

Published
2014
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2. Evaluation of Microscopic Observation Drug Susceptibility (MODS) and the string test for rapid diagnosis of pulmonary tuberculosis in HIV/AIDS patients in Bolivia

Author

Magaly Espinoza, Maya Vallejo, Roxana Challapa, Rosario Castro, Faustino Torrico, Robert H. Gilman, Melissa J. Reimer-McAtee, Meredith Holtz Lora, Marco Solano, Monica J. Pajuelo, Caryn Bern, Ruth Saravia, and Daniel Lozano

Subjects
Male, Pathology, Opportunistic infection, Antitubercular Agents, Sputum/microbiology, MODS, Gastroenterology, fluids and secretions, Medical microbiology, Tuberculosis, Multidrug-Resistant, Cause of death, Microscopy, medicine.diagnostic_test, biology, Acquired Immunodeficiency Syndrome/complications/diagnosis, Middle Aged, 3. Good health, AIDS, Infectious Diseases, Female, Tuberculosis, Pulmonary/complications/diagnosis/microbiology, medicine.symptom, Microscopy/methods, Research Article, Resource-scarce, Adult, Bolivia, medicine.medical_specialty, Tuberculosis, Multidrug-Resistant/complications/diagnosis/microbiology, Tuberculosis, Urinalysis, Microbial Sensitivity Tests, purl.org/pe-repo/ocde/ford#3.03.08 [https], Sensitivity and Specificity, Mycobacterium tuberculosis, Acquired immunodeficiency syndrome (AIDS), Internal medicine, medicine, Humans, String test, Tuberculosis, Pulmonary, Antitubercular Agents/pharmacology, Acquired Immunodeficiency Syndrome, business.industry, Sputum, HIV, medicine.disease, biology.organism_classification, Cross-Sectional Studies, Mycobacterium tuberculosis/drug effects/isolation & purification, Microbial Sensitivity Tests/methods, business
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

Published
2015
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