This study aimed to learn the recurrence rate in the retreatment TB patients with sputum smear and/or culture positive （ss＋ and/or c＋） two years after they were declared cured, and to explore causes of recurrence ...This study aimed to learn the recurrence rate in the retreatment TB patients with sputum smear and/or culture positive （ss＋ and/or c＋） two years after they were declared cured, and to explore causes of recurrence in order to improve long-time treatment outcome. 5 cities were selected as research locations. Recurrence of TB was judged by chest X-ray examination together with sputum smear and culture examination.展开更多
Introduction: Tuberculosis remains a public health problem in Zimbabwe. Understanding the treatment outcomes is an important proxy indicator on the performance of the tuberculosis program. This study analyzed treatmen...Introduction: Tuberculosis remains a public health problem in Zimbabwe. Understanding the treatment outcomes is an important proxy indicator on the performance of the tuberculosis program. This study analyzed treatment outcomes of new sputum smear positive tuberculosis patients in Kwekwe district. Materials and Methods: A retrospective records review of new sputum smear positive tuberculosis patients registered in the district tuberculosis register in Kwekwe was conducted. Treatment outcomes were categorized according to the national tuberculosis control program and multivariate logistic regression model was used. P values less than 0.05 were considered statistically significant. Results: From a total of 1115 new sputum smear positive tuberculosis patients, cure rate ranged from 40.8% to 62.8% and death rate of patients decreased from 11 (8.0%) in 2007 to 17 (5.3%) in 2011 (p = 0.016). However, defaulter rate increased from 10 (7.3%) in 2007 to 30 (9.3%) in 2011. In multivariate logistic model, HIV positive tuberculosis patients were more likely to experience (adjusted RR = 1.84, 95% CI: 1.10 - 3.08) unfavorable treatment outcome when compared to negative counterparts. Urban residents were also at risk 1.91 (95% CI: 1.14 - 3.20) unfavorable outcome compared to rural residents. Conclusion: The cure rate was low (ranged from 40.8% to 62.8%) and the defaulter rate needed urgent attention. The district should conduct defaulter tracing and follow up.展开更多
The SSM （sputum smear microscopy） and five immunochromatographic tuberculosis antibody detection tests （DiaSpot TB, Spodex TB, SD Rapid TB, Clinotech TB Screen and Precious One-step TB） were compared for diagnosis...The SSM （sputum smear microscopy） and five immunochromatographic tuberculosis antibody detection tests （DiaSpot TB, Spodex TB, SD Rapid TB, Clinotech TB Screen and Precious One-step TB） were compared for diagnosis of active TB at the Leprosy and Tuberculosis Referral Hospital, Uzuakoli, Abia State, Nigeria. Sputum specimens from 150 study participants （male/female ratio, 0.81） were cultured on Lowenstein-Jensen slopes and direct smears were stained by Ziehl-Neelsen technique and examined by light microscopy. Sera were tested for anti-TB antibodies using the rapid TB tests. A total of 91 participants were culture positive, 79 （86.8%） for M. tuberculosis and 12 （13.2%） for nontuberculous mycobacteria. The sensitivity of SSM was 50% （95% CI： 39.0-61.0） and specificity was 92.3% （95% CI： 86.4-98.2） in those culture positive for M. tuberculosis. The sensitivity and specificity of the Rapid TB tests ranged from 24.1-39.2% and 78.4-87.8%, respectively. None of the five rapid TB tests had acceptable level of accuracy for diagnosis of active TB. The sensitivity of SSM though moderate is inadequate for long term TB control in this setting.展开更多
Objective:Simple tests like direct smear of the acid fast bacilli(AFB) and Mycobacterium culture could assist the diagnosis of tuberculosis.This study is aimed at reviewing the outcome of smears,culture results and co...Objective:Simple tests like direct smear of the acid fast bacilli(AFB) and Mycobacterium culture could assist the diagnosis of tuberculosis.This study is aimed at reviewing the outcome of smears,culture results and contamination rate among specimens requested for AFB smear and Mycobacterium culture.Methods:Retrospective laboratory data analysis requesting for Mycobacterium culture from January 2005 till December 2006 was done in a tertiary teaching hospital of Universiti Sains Malaysia,Kubang Kerian,Kelantan,Malaysia.Results: Four hundred and sixty seven(36.6%) isolates grew from 1 277 specimens.Of these isolates,314 (67.2%) grew Mycobacterium tuberculosis,23(4.9%) grew Mycobacterium other than tuberculosis and 38 (8.1%) grew contaminants.Among the M.tuberculosis cultures,165(52.5%) had growth of more than 100 confluent colonies,whereas 39 cultures(12.4%) had growth of less than 19 colonies.Direct smear for AFB among smear positive cases showed presence of more than 50 bacilli/line in 231(49.5%) cases and smear negative cases accounted for 63(13.5%).Among smear positive cases,291(94.5%) cultures grew Mycobacterium species and another 17(5.5%) cultures grew contaminants.In smear negative cases,32(62.7%) cultures grew Mycobacterium species and 19(37.3%) cultures grew contaminants.Conclusion:The results from data analysis of the Mycobacterium cultures should be critically utilized in order to review the laboratory performance and to improve its services in the future.Some of the data is also useful to the administrators of the hospital in terms of estimating the risk of occupational hazard faced by the health care workers.展开更多
Deaths due to Tuberculosis （TB） are high among the TB-HIV co-infected patients. Among PLHIV most of the instances the sputum smear is found to be negative for MTb. Chest X-rays also don＇t yield much diagnostic valu...Deaths due to Tuberculosis （TB） are high among the TB-HIV co-infected patients. Among PLHIV most of the instances the sputum smear is found to be negative for MTb. Chest X-rays also don＇t yield much diagnostic value mainly due to the advanced immune suppressed condition. This study makes an attempt to find out the utility of alternate staining methods such as Light Emitting Diode （LED）, Fluorescent Microscopy （FM） and solid culture in resource limited settings for effective diagnosis of TB among PLHIV. 2 sputum samples were collected from 102 successive presumptive TB cases, whose smear microscopy and X-Ray were negative for MTb among PLHIVs visiting ICTC at MGM hospital, Warangal, Telangana State, India. All the 102 samples were repeated with ZN microscopy and X-ray. Additionally LED and FM microscopy procedures were conducted with the NALC-NAOH concentration method. All the samples were inoculated on LJ medium for solid culture and all the positive cultures were subjected for biochemical test to identify phenotypic appearance, nitrate reduction, niacin and PNB susceptibility test for all the first line anti TB drugs as per standard guidelines. Samples found positive on microscopy were cross checked with Line probe assay （LPA）. All the 102 samples collected showed negative for MTb on ZN technique and negative for pulmonary TB on chest X-rays. 15 samples were positive for MTb both on LED and FM. LPA reconfirmed the MTb in all the 15 samples tested with 11 sensitive for both INH and Rifampicin, 3 INH mono resistant and I Rifmono resistance patterns. Of the 102 inoculations in LJ medium, 25 culture inoculations were positive for MTb growth and also were confirmed as MTb strains based on morphological, biochemical test and growth was seen after 4th week of inoculation. Of the 25 culture positives 20 were sensitive for INH and Rif, 4 INH mono resistant and 1 resistant to all first line anti TB drugs. In smear negative and chest X-ray negative presumptive TB cases, especially in immune compromised groups such as PLHIV, it is found to be useful to subject the sputum samples to LED and FM methods and at least solid culture wherever available. These methods clearly demonstrated additional yield over conventional ZN staining which can be recommended especially in the settings where high throughput equipment such as Xpert MTB/RIFor liquid culture is not available. These proactive measures can help in early diagnosis of TB which in turn can reduce mortality due to TB among PLHIV and break the chain of transmission of TB. Recommendations： Technology such as LED or FM microscopy can be advised for effective diagnosis of TB among Presumptive TB cases in PLHIV in settings where Xpert MTB/RIF is not available.展开更多
Objective:To compare the sensitivity and specificity of direct fecal smear microscopy,culture,and polymerase chain reaction in the detection of Blastocystis sp.in human stool.Methods:Human stool samples were collected...Objective:To compare the sensitivity and specificity of direct fecal smear microscopy,culture,and polymerase chain reaction in the detection of Blastocystis sp.in human stool.Methods:Human stool samples were collected from a community in San Isidro,Rodriguez,Rizal,Philippines.These samples were subjected to direct fecal smear microscopy,culture and polymerase chain reaction to detect the presence of Blastocystis sp.Results:Of the 110 stool samples collected,28(25%)were detected positive for the presence of Blastocystis sp.by two or more tests.Culture method detected the highest number of Blastocystis-positive stool samples(n=36),followed by PCR of DNA extracted from culture(n=26),PCR of DNA extracted from stool(n=10),and direct fecal smear(n=9).Compared to culture,the sensitivity of the other detection methods were 66.7%for PCR from culture and 19.4%for both PCR from stool and direct fecal smear.Specificity of the methods was high,with PCR from culture and direct fecal smear having97.3%,while PCR from stool at 95.9%.Conclusions:In this study,in vitro culture is the best method for detecting Blastocystis sp.in human stool samples.展开更多
To establish the rapid and accurate methods for detecting cancer cells from the sputum of patients with lung cancer. Methods: Sputum sediment section examination and sputum smear examination were performed. For 142 ca...To establish the rapid and accurate methods for detecting cancer cells from the sputum of patients with lung cancer. Methods: Sputum sediment section examination and sputum smear examination were performed. For 142 cases of lung cancer patients diagnosed by bronchia fibrous lens and confirmed by pathologic diagnosis. Results: (a) The positive diagnosis rate of lung cancer cell was 71.83% (102/142) when using sputum sediment examination while that was 32.39% (46/142) when using sputum smear examination, when using sputum sediment examination jointly with sputum smear examination, the positive diagnosis rate of lung cancer was 91.55% (130/142). According to the positive diagnosis rate of lung cancer, the sputum sediment examination was significantly higher than sputum smear examination (P<0.001), joint examination of both of them was significantly higher than the single sputum sediment examination (P<0.001); (b) As to the histopathological types of lung cancers, 66 cases could be identified among 102 cases whom were confirmed by sputum sediment examination, the identification rate was 64.71%; and 8 cases could be identified among 46 cases whom were confirmed by sputum smear examination, with an identification rate of 17.39%, it was significantly lower than that by sputum sediment examination (P<0.001); (c) Immunohistochemistry technique could be used in the sections of sputum sediment to identify some histopathological types which could not be identified by routine HE stain, with an identification rate of 94.44% (34/36). Conclusion: the sputum sediment examination has some advantages compared to the sputum smear examination such as the specimen may include more materials, the higher cancer cell identification positive rate and immunohistochemistry method can be used to identify the histopathological type.展开更多
Introduction: Bronchoscopy with bronchial washing is useful for the diagnosis of pulmonary tuberculosis (TB) when sputum smears are negative. However, its indication has not been standardized. Therefore, we conducted ...Introduction: Bronchoscopy with bronchial washing is useful for the diagnosis of pulmonary tuberculosis (TB) when sputum smears are negative. However, its indication has not been standardized. Therefore, we conducted a retrospective study to assess the diagnostic value of bronchial washing in patients suspected with pulmonary TB. Methodology: A retrospective analysis was performed on patients diagnosed with pulmonary TB in Kosin university gospel hospital, a tertiary hospital with 969 beds in South Korea, from March 2017 to December 2018. We obtained three serial sputum samples for acid-fast bacilli (AFB) smear and culture, and all patients underwent bronchoscopy with bronchial washing for AFB smear and culture. Results: Fifty-six patients were enrolled in the study. Smear-negative pulmonary TB (SNPT) was diagnosed in 42/56 (75%) patients. Among the patients with smear-positive sputum, 14/14 (100%) showed culture-positive sputum, while smear- and culture-positive bronchial washing were seen in 7/14 (50%) and 12/14 (85.7%) patients, respectively. Among the patients with SNPT, 17/42 (40.47%) had culture-negative sputum and were diagnosed using the bronchoscopic washing. Conclusions: For patients with smear-negative sputum, it is necessary to perform bronchoscopic washing to increase the diagnostic rate of pulmonary TB. To control the transmission of pulmonary TB, it is necessary to use a fast and accurate examination method.展开更多
基金supported by ‘Follow-up Study of Retreatment TB Patients with Sputum Smear Positive Two Years after Declared Cured’(TB10-002)
文摘This study aimed to learn the recurrence rate in the retreatment TB patients with sputum smear and/or culture positive （ss＋ and/or c＋） two years after they were declared cured, and to explore causes of recurrence in order to improve long-time treatment outcome. 5 cities were selected as research locations. Recurrence of TB was judged by chest X-ray examination together with sputum smear and culture examination.
文摘Introduction: Tuberculosis remains a public health problem in Zimbabwe. Understanding the treatment outcomes is an important proxy indicator on the performance of the tuberculosis program. This study analyzed treatment outcomes of new sputum smear positive tuberculosis patients in Kwekwe district. Materials and Methods: A retrospective records review of new sputum smear positive tuberculosis patients registered in the district tuberculosis register in Kwekwe was conducted. Treatment outcomes were categorized according to the national tuberculosis control program and multivariate logistic regression model was used. P values less than 0.05 were considered statistically significant. Results: From a total of 1115 new sputum smear positive tuberculosis patients, cure rate ranged from 40.8% to 62.8% and death rate of patients decreased from 11 (8.0%) in 2007 to 17 (5.3%) in 2011 (p = 0.016). However, defaulter rate increased from 10 (7.3%) in 2007 to 30 (9.3%) in 2011. In multivariate logistic model, HIV positive tuberculosis patients were more likely to experience (adjusted RR = 1.84, 95% CI: 1.10 - 3.08) unfavorable treatment outcome when compared to negative counterparts. Urban residents were also at risk 1.91 (95% CI: 1.14 - 3.20) unfavorable outcome compared to rural residents. Conclusion: The cure rate was low (ranged from 40.8% to 62.8%) and the defaulter rate needed urgent attention. The district should conduct defaulter tracing and follow up.
文摘The SSM （sputum smear microscopy） and five immunochromatographic tuberculosis antibody detection tests （DiaSpot TB, Spodex TB, SD Rapid TB, Clinotech TB Screen and Precious One-step TB） were compared for diagnosis of active TB at the Leprosy and Tuberculosis Referral Hospital, Uzuakoli, Abia State, Nigeria. Sputum specimens from 150 study participants （male/female ratio, 0.81） were cultured on Lowenstein-Jensen slopes and direct smears were stained by Ziehl-Neelsen technique and examined by light microscopy. Sera were tested for anti-TB antibodies using the rapid TB tests. A total of 91 participants were culture positive, 79 （86.8%） for M. tuberculosis and 12 （13.2%） for nontuberculous mycobacteria. The sensitivity of SSM was 50% （95% CI： 39.0-61.0） and specificity was 92.3% （95% CI： 86.4-98.2） in those culture positive for M. tuberculosis. The sensitivity and specificity of the Rapid TB tests ranged from 24.1-39.2% and 78.4-87.8%, respectively. None of the five rapid TB tests had acceptable level of accuracy for diagnosis of active TB. The sensitivity of SSM though moderate is inadequate for long term TB control in this setting.
文摘Objective:Simple tests like direct smear of the acid fast bacilli(AFB) and Mycobacterium culture could assist the diagnosis of tuberculosis.This study is aimed at reviewing the outcome of smears,culture results and contamination rate among specimens requested for AFB smear and Mycobacterium culture.Methods:Retrospective laboratory data analysis requesting for Mycobacterium culture from January 2005 till December 2006 was done in a tertiary teaching hospital of Universiti Sains Malaysia,Kubang Kerian,Kelantan,Malaysia.Results: Four hundred and sixty seven(36.6%) isolates grew from 1 277 specimens.Of these isolates,314 (67.2%) grew Mycobacterium tuberculosis,23(4.9%) grew Mycobacterium other than tuberculosis and 38 (8.1%) grew contaminants.Among the M.tuberculosis cultures,165(52.5%) had growth of more than 100 confluent colonies,whereas 39 cultures(12.4%) had growth of less than 19 colonies.Direct smear for AFB among smear positive cases showed presence of more than 50 bacilli/line in 231(49.5%) cases and smear negative cases accounted for 63(13.5%).Among smear positive cases,291(94.5%) cultures grew Mycobacterium species and another 17(5.5%) cultures grew contaminants.In smear negative cases,32(62.7%) cultures grew Mycobacterium species and 19(37.3%) cultures grew contaminants.Conclusion:The results from data analysis of the Mycobacterium cultures should be critically utilized in order to review the laboratory performance and to improve its services in the future.Some of the data is also useful to the administrators of the hospital in terms of estimating the risk of occupational hazard faced by the health care workers.
文摘Deaths due to Tuberculosis （TB） are high among the TB-HIV co-infected patients. Among PLHIV most of the instances the sputum smear is found to be negative for MTb. Chest X-rays also don＇t yield much diagnostic value mainly due to the advanced immune suppressed condition. This study makes an attempt to find out the utility of alternate staining methods such as Light Emitting Diode （LED）, Fluorescent Microscopy （FM） and solid culture in resource limited settings for effective diagnosis of TB among PLHIV. 2 sputum samples were collected from 102 successive presumptive TB cases, whose smear microscopy and X-Ray were negative for MTb among PLHIVs visiting ICTC at MGM hospital, Warangal, Telangana State, India. All the 102 samples were repeated with ZN microscopy and X-ray. Additionally LED and FM microscopy procedures were conducted with the NALC-NAOH concentration method. All the samples were inoculated on LJ medium for solid culture and all the positive cultures were subjected for biochemical test to identify phenotypic appearance, nitrate reduction, niacin and PNB susceptibility test for all the first line anti TB drugs as per standard guidelines. Samples found positive on microscopy were cross checked with Line probe assay （LPA）. All the 102 samples collected showed negative for MTb on ZN technique and negative for pulmonary TB on chest X-rays. 15 samples were positive for MTb both on LED and FM. LPA reconfirmed the MTb in all the 15 samples tested with 11 sensitive for both INH and Rifampicin, 3 INH mono resistant and I Rifmono resistance patterns. Of the 102 inoculations in LJ medium, 25 culture inoculations were positive for MTb growth and also were confirmed as MTb strains based on morphological, biochemical test and growth was seen after 4th week of inoculation. Of the 25 culture positives 20 were sensitive for INH and Rif, 4 INH mono resistant and 1 resistant to all first line anti TB drugs. In smear negative and chest X-ray negative presumptive TB cases, especially in immune compromised groups such as PLHIV, it is found to be useful to subject the sputum samples to LED and FM methods and at least solid culture wherever available. These methods clearly demonstrated additional yield over conventional ZN staining which can be recommended especially in the settings where high throughput equipment such as Xpert MTB/RIFor liquid culture is not available. These proactive measures can help in early diagnosis of TB which in turn can reduce mortality due to TB among PLHIV and break the chain of transmission of TB. Recommendations： Technology such as LED or FM microscopy can be advised for effective diagnosis of TB among Presumptive TB cases in PLHIV in settings where Xpert MTB/RIF is not available.
基金supported by a research grant from the Office of the Vice-Chancellor for Research and Development,University of the Philippines-Diliman(Grant No.101007 PNSE)to W.L.R.and H.J.S
文摘Objective:To compare the sensitivity and specificity of direct fecal smear microscopy,culture,and polymerase chain reaction in the detection of Blastocystis sp.in human stool.Methods:Human stool samples were collected from a community in San Isidro,Rodriguez,Rizal,Philippines.These samples were subjected to direct fecal smear microscopy,culture and polymerase chain reaction to detect the presence of Blastocystis sp.Results:Of the 110 stool samples collected,28(25%)were detected positive for the presence of Blastocystis sp.by two or more tests.Culture method detected the highest number of Blastocystis-positive stool samples(n=36),followed by PCR of DNA extracted from culture(n=26),PCR of DNA extracted from stool(n=10),and direct fecal smear(n=9).Compared to culture,the sensitivity of the other detection methods were 66.7%for PCR from culture and 19.4%for both PCR from stool and direct fecal smear.Specificity of the methods was high,with PCR from culture and direct fecal smear having97.3%,while PCR from stool at 95.9%.Conclusions:In this study,in vitro culture is the best method for detecting Blastocystis sp.in human stool samples.
文摘To establish the rapid and accurate methods for detecting cancer cells from the sputum of patients with lung cancer. Methods: Sputum sediment section examination and sputum smear examination were performed. For 142 cases of lung cancer patients diagnosed by bronchia fibrous lens and confirmed by pathologic diagnosis. Results: (a) The positive diagnosis rate of lung cancer cell was 71.83% (102/142) when using sputum sediment examination while that was 32.39% (46/142) when using sputum smear examination, when using sputum sediment examination jointly with sputum smear examination, the positive diagnosis rate of lung cancer was 91.55% (130/142). According to the positive diagnosis rate of lung cancer, the sputum sediment examination was significantly higher than sputum smear examination (P<0.001), joint examination of both of them was significantly higher than the single sputum sediment examination (P<0.001); (b) As to the histopathological types of lung cancers, 66 cases could be identified among 102 cases whom were confirmed by sputum sediment examination, the identification rate was 64.71%; and 8 cases could be identified among 46 cases whom were confirmed by sputum smear examination, with an identification rate of 17.39%, it was significantly lower than that by sputum sediment examination (P<0.001); (c) Immunohistochemistry technique could be used in the sections of sputum sediment to identify some histopathological types which could not be identified by routine HE stain, with an identification rate of 94.44% (34/36). Conclusion: the sputum sediment examination has some advantages compared to the sputum smear examination such as the specimen may include more materials, the higher cancer cell identification positive rate and immunohistochemistry method can be used to identify the histopathological type.
文摘Introduction: Bronchoscopy with bronchial washing is useful for the diagnosis of pulmonary tuberculosis (TB) when sputum smears are negative. However, its indication has not been standardized. Therefore, we conducted a retrospective study to assess the diagnostic value of bronchial washing in patients suspected with pulmonary TB. Methodology: A retrospective analysis was performed on patients diagnosed with pulmonary TB in Kosin university gospel hospital, a tertiary hospital with 969 beds in South Korea, from March 2017 to December 2018. We obtained three serial sputum samples for acid-fast bacilli (AFB) smear and culture, and all patients underwent bronchoscopy with bronchial washing for AFB smear and culture. Results: Fifty-six patients were enrolled in the study. Smear-negative pulmonary TB (SNPT) was diagnosed in 42/56 (75%) patients. Among the patients with smear-positive sputum, 14/14 (100%) showed culture-positive sputum, while smear- and culture-positive bronchial washing were seen in 7/14 (50%) and 12/14 (85.7%) patients, respectively. Among the patients with SNPT, 17/42 (40.47%) had culture-negative sputum and were diagnosed using the bronchoscopic washing. Conclusions: For patients with smear-negative sputum, it is necessary to perform bronchoscopic washing to increase the diagnostic rate of pulmonary TB. To control the transmission of pulmonary TB, it is necessary to use a fast and accurate examination method.
