Evaluation of the GeneXpert MTB/RIF to diagnose tuberculosis in a public health laboratory

OBJECTIVES: To evaluate the performance of geneXpert MTB/Rif versus conventional methods (bacilloscopy and culture) in the diagnosis of tuberculosis in a Central Public Health Laboratory (LACEN, Tocantins), Northern Brazil. METHODS: Retrospective study, with information from 1,973 suspected cases of tuberculosis from patients treated from January 2015 to December 2020. RESULTS: From the culture (reference standard), the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the geneXpert MTB/Rif were 100%, 97%, 74%, 100%, and 97%, respectively, against 85%, 98%, 80%, 98%, and 97% of bacilloscopy. CONCLUSIONS: The geneXpert MTB/Rif performed similarly to culture and better than bacilloscopy. Although positive cases with negative culture should be evaluated with caution, its routine use is important for the early detection of tuberculosis

Análise computacional da interação da isoniazida com as formas selvagem (wt) e mutante (g68r) da n-acetiltransferase de Mycobacterium tuberculosis

A tuberculose (TB) é a principal causa de morte no mundo por um agente infeccioso. A forma mais comum de tratamento da tuberculose é com o fármaco isoniazida (INH). Estudos recentes têm sugerido que a acetilação da INH pela N-acetiltransferase de Mycobacterium tuberculosis (TBNAT) possa ser uma possível causa de inativação do fármaco resultando, assim, em cepas resistentes. Neste trabalho, métodos de modelagem por homologia, docking e de simulações por dinâmica molecular foram utilizados para avaliar o efeito da mutação G68R na interação da TBNAT com a INH. Os resultados obtidos sugerem que mutações pontuais na TBNAT podem originar resistência do bacilo TB ao fármaco

a multicenter study

(1) Background: The Commercial Kit SIRE Nitratase® PlastLabor, is a drug susceptibility test kit used to detect Mycobacterium tuberculosis resistance to first-line TB treatment drugs. The present study aimed at evaluating its performance in a multicenter study. (2) Methods: To determine its accuracy, the proportion methods in Lowenstein Jensen medium or the BACTECTMMGITTM960 system was used as a gold standard. (3) Results: The study revealed that the respective accuracies of the kit with 190 M. tuberculosis clinical isolates, using the proportion methods in Lowenstein Jensen medium or BACTECTMMGITTM960 system as a gold standard, were 93.9% and 94.6%, 96.9% and 94.6%, 98.0% and 97.8%, and 98.0% and 98.9%, for streptomycin, isoniazid, rifampicin, and ethambutol, respectively. (4) Conclusion: Thus, the kit can rapidly screen resistance to streptomycin, isoniazid, rifampicin, and ethambutol. Additionally, it does not require sophisticated equipment; hence, it can be easily used in the laboratories of low and middle income countries.publishersversionpublishe

Nursing Activities Score: nursing work load in a burns Intensive Care Unit

OBJECTIVE: to evaluate the nursing work load in a Burns Intensive Care Unit according to the Nursing Activities Score.METHOD: an exploratory, descriptive cross-sectional study with a quantitative approach. The Nursing Activities Score was used for data collection between October 2011 and May 2012, totalling 1,221 measurements, obtained from 50 patients' hospital records. Data for qualitative variables was described in tables; for the quantitative variables, calculations using statistical measurements were used.RESULTS: the mean score for the Nursing Activities Score was 70.4% and the median was 70.3%, corresponding to the percentage of the time spent on direct care to the patient in 24 hours.CONCLUSION: the Nursing Activities Score provided information which involves the process of caring for patients hospitalized in a Burns Intensive Care Unit, and indicated that there is a high work load for the nursing team of the sector studied

Tuberculosis across the seas: CPLP-TB - a joint effort in cataloguing mycobacterium tuberculosis genetic diversity in the lusophone space

The Community of Portuguese Language Speaking Countries (CPLP) comprises nine countries across four continents, accounting for 7.2% of the world’s land area, and where tuberculosis (TB) is still a cause of public health concern. A marked variation in TB incidence (23 to 551 cases per 100 000 habitants) can be observed across the different member-states and, despite of this, a considerable gap in the knowledge on the Mycobacterium tuberculosis population structure and country-level geospatial distribution still exists. To address this we have gathered a comprehensive set of molecular and phenotypic drug susceptibility data on approximately 1150 different clinical isolates, from different partners, across 5 distinct portuguesespeaking countries. This initial dataset comprises molecular genotypic data obtained by either 12, 15 or 24-loci Mycobacterial Interspersed Repetitive Unit – Variable Number of Tandem repeat (MIRU-VNTR) and/or Spoligotyping. The complete dataset therefore includes M. tuberculosis clinical isolates from Portugal (n≈370), Angola (n≈80), Guinea-Bissau (n≈13), Mozambique (n≈14) and Brazil (n≈680). To make this data available to the scientific community and public health authorities we have developed CPLP-TB, an online database coupled with webbased tools that enable exploratory data analysis. This new tool specifically directed at CPLP countries include advanced data analysis capability together with graphical visualization tools (e.g. dendrogram and choropleth mapping). As a public health tool, it is expected to contribute for a deeper knowledge on the combined population structure and strain circulation between countries, thus enabling the assessment of strain specific trends in a broader macroepidemiological context. Furthermore, this new tool provides a new framework for interlaboratory cooperation on TB molecular epidemiology.N/

Clonal expansion across the seas as seen through CPLP-TB database: A joint effort in cataloguing Mycobacterium tuberculosis genetic diversity in Portuguese-speaking countries.

Tuberculosis (TB) remains a major health problem within the Community of Portuguese Language Speaking Countries (CPLP). Despite the marked variation in TB incidence across its member-states and continued human migratory flux between countries, a considerable gap in the knowledge on the Mycobacterium tuberculosis population structure and strain circulation between the countries still exists. To address this, we have assembled and analysed the largest CPLP M. tuberculosis molecular and drug susceptibility dataset, comprised by a total of 1447 clinical isolates, including 423 multidrug-resistant isolates, from five CPLP countries. The data herein presented reinforces Latin American and Mediterranean (LAM) strains as the hallmark of M. tuberculosis populational structure in the CPLP coupled with country-specific differential prevalence of minor clades. Moreover, using high-resolution typing by 24-loci MIRU-VNTR, six cross-border genetic clusters were detected, thus supporting recent clonal expansion across the Lusophone space. To make this data available to the scientific community and public health authorities we developed CPLP-TB (available at http://cplp-tb.ff.ulisboa.pt), an online database coupled with web-based tools for exploratory data analysis. As a public health tool, it is expected to contribute to improved knowledge on the M. tuberculosis population structure and strain circulation within the CPLP, thus supporting the risk assessment of strain-specific trends