Costa Ronaldo Rodrigues da, Silva Suzane Fernandes da, Fochat Romário Costa, Macedo Raquel Leite, Pereira Thamiris Vilela, Silva Marcio Roberto, Pinto Carmen Perches Gomide, Leite Isabel Cristina Gonçalves
Hospital Regional João Penido, Fundação Hospitalar do Estado de Minas Gerais,Juiz de Fora, MG, Brazil.
Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
Einstein (Sao Paulo). 2018 Jun 11;16(2):eAO4214. doi: 10.1590/S1679-45082018AO4214.
To compare the performance of the Ogawa-Kudoh method with the modified Petroff technique in diagnosis of pulmonary tuberculosis.
A total of 205 sputum samples from 166 patients with clinical suspicion or under pulmonary tuberculosis follow-up, seen at a public tertiary care hospital, from July 2014 to July 2016 were used. All samples were simultaneously processed using the Ogawa-Kudoh and modified Petroff decontamination methods, according to the recommendations of the Ministry of Health. In the statistical analysis, the McNemar test and the Kappa index were used, respectively, to compare proportions and verify agreement between data.
The Ogawa-Kudoh and modified Petroff methods were efficient in mycobacteria detection, with no significant differences in results (p=0.549) and contamination rate of the cultures (p=0.065). The agreement between techniques was considered excellent (Kappa index of 0.877) and Ogawa-Kudoh, as compared to the modified Petroff technique, showed sensitivity of 90.4%, specificity of 96.6%, positive predictive value of 94.3% and negative predictive value of 94.2%.
The Ogawa-Kudoh technique proved to be sufficiently sensitive and specific for diagnosis of pulmonary tuberculosis, and, therefore, suitable for routine laboratory application. Since it is simple, low-cost and has less technical requirements for biosafety and professional training, Ogawa-Kudoh is an alternative for managers and healthcare professionals to promote the expansion of bacteriological diagnostic coverage of pulmonary tuberculosis.
比较小川-久道方法与改良彼得罗夫技术在肺结核诊断中的性能。
使用了2014年7月至2016年7月期间在一家公立三级护理医院就诊的166例临床疑似或正在接受肺结核随访患者的205份痰标本。根据卫生部的建议，所有标本同时采用小川-久道和改良彼得罗夫去污方法进行处理。在统计分析中，分别使用麦克尼马尔检验和卡帕指数来比较比例并验证数据之间的一致性。
小川-久道方法和改良彼得罗夫方法在分枝杆菌检测方面均有效，结果（p = 0.549）和培养物污染率（p = 0.065）无显著差异。技术之间的一致性被认为是极好的（卡帕指数为0.877），与改良彼得罗夫技术相比，小川-久道方法的灵敏度为90.4%，特异性为96.6%，阳性预测值为94.3%，阴性预测值为94.2%。
小川-久道技术被证明对肺结核诊断具有足够的敏感性和特异性，因此适用于常规实验室应用。由于其简单、成本低且对生物安全和专业培训的技术要求较低，小川-久道方法是管理人员和医疗保健专业人员促进扩大肺结核细菌学诊断覆盖范围的一种选择。
