Laboratório de Micobatérias e Biologia Molecular, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, RS, Brasil.
Rev Soc Bras Med Trop. 2012 Jul-Aug;45(4):491-5. doi: 10.1590/s0037-86822012005000004. Epub 2012 Jul 5.
Tuberculosis (TB) control is linked to the availability of qualified methods for microbiological diagnostics; however, microscopy with limited sensitivity is the only method available in many locations. The objective of this study was to evaluate the introduction of culture, drug susceptibility testing (DST), and genotyping in the routine of a Municipal Program of Tuberculosis Control.
Direct microscopy of sputum and culture in Ogawa-Kudoh were performed on 1,636 samples from 787 patients. DST of positive cultures was performed by resazurin microtiter assay and genotyping by mycobacterial interspersed repetitive units-variable number tandem repeat.
A total 91 patients with TB were identified. The culture increased case detection by 32% compared with the microscopy; acquired resistance was 3.3% and the genotyping showed high genetic diversity.
Ogawa-Kudoh contributed significantly to the increase in case detection and is suitable for implementation in poor-resource locations. The acquired resistance rate was lower than that reported in a recent Brazilian survey. The high genetic diversity is possibly related to the high TB prevalence in the population, as well as to early detection and suitable treatment of patients. The interaction between research and health care is important for reorienting the practice, transferring technology, and improving TB control.
结核病（TB）控制与微生物诊断的合格方法的可用性有关；然而，在许多地方，灵敏度有限的显微镜检查仍然是唯一可用的方法。本研究的目的是评估培养物、药敏试验（DST）和基因分型在市结核病控制规划常规中的引入。
对 787 名患者的 1636 份样本进行了直接痰涂片显微镜检查和 Ogawa-Kudoh 培养。阳性培养物的 DST 通过 Resazurin 微量滴定法进行，基因分型通过分枝杆菌插入重复单元-可变数串联重复进行。
共发现 91 例结核病患者。与显微镜检查相比，培养物使病例检出率增加了 32%；获得性耐药率为 3.3%，基因分型显示遗传多样性高。
Ogawa-Kudoh 对提高病例检出率有重要贡献，适合在资源匮乏的地区实施。获得性耐药率低于最近巴西调查的报告。高遗传多样性可能与人群中结核病高患病率、早期发现和适当治疗患者有关。研究与卫生保健之间的相互作用对于重新调整实践、转移技术和改善结核病控制非常重要。
