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2018, Number 4

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Rev Med Inst Mex Seguro Soc 2018; 56 (4)

Identification of risk factors and diagnostic methodology in serositis by M. tuberculosis

Hernández-Solis A, González-Villa M, Ramírez-González E, Reding-Bernal A, Sánchez-Valadez T, de la Torriente-Mata R, González-González H, Cícero-Sabido R

Language: Spanish
References: 30
Page: 364-370
PDF size: 1305.73 Kb.


ABSTRACT

Background: Tuberculosis is a public health problem, extrapulmonary presentations have increased, it is difficult to diagnose because of the low bacillary load.
Objective: To identify risk factors and to evaluate the efficiency of diagnostic methods in pleural, meningeal, peritoneal and pericardial tuberculosis.
Methods: Prospective study of cases and controls. A multiple conditional logistic regression model was used to identify risk factors. Biopsy was performed and 7 mL of fluid was extracted from the affected site, Löwestein- Jensen and MGITI960 culture, Ziehl-Neelsen staining, adenosine deaminase and endpoint PCR directed to the insertion sequence 1S6110 for M. tuberculosis were performed.
Results: 116 patients were included, in 58 M. tuberculosis was confirmed by positive culture (meningeal Tb 34 cases, pleural 14, peritoneal 8, pericardial 2 cases) and 58 serositis of non-tuberculous etiology. Being a carrier of HIV and living with people infected with tuberculosis were the main risk factors OR = 3.6 and OR = 6.8. The staining had sensitivity of 25.9%, PCR of 65.5% and adenosine deaminase with 82.8%.
Conclusions: Conventional diagnostic methods had low efficacy, adenosine deaminase and molecular biology techniques are the most useful, in our environment these tests should be performed immediately in patients with risk factors and suspected serositis of tuberculous origin.


REFERENCES

  1. Dirección General de Epidemiologia, CENAPRECE. Epidemiología y Determinantes Sociales en Tuberculosis, Hospital General de México. México; 2014. Disponible en: http://www.cenaprece.salud.gob.mx/programas/interior/mic obacteriosis/descargas/pdf/TByDSSMexicoCursoTB2014.p df

  2. Baumann MH, Nolan R, Petrini M, Lee YC, Light RW, Schneider E. Pleural tuberculosis in the United States: incidence and drug resistance. Chest. 2007;131(4):1125- 32.

  3. Pasipanodya JG, Mubanga M, Ntsekhe M, Pandie S, Magazi BT, Gumedze F, et al. Tuberculous Pericarditis is Multibacillary and BacterialBurden Drives High Mortality. EBioMedicine. 2015;2(11):1634-9.

  4. Christensen AS, Andersen AB, Thomsen VO, Andersen PH, Johansen IS. Tuberculous meningitis in Denmark: a review of 50 cases. BMC Infect Dis. 2011;22(11):47.

  5. Verma SK, Dubey AL, Singh PA, Tewerson SL, Sharma D. Adenosine Deaminase (ADA) Level in Tubercular Pleural Effusion. Lung India. 2008;25(3):109-10.

  6. Cho BH, Kim BC, Yoon GJ, Choi SM, Chang J, Lee SH, et 2 al. Adenosine deaminase activity in cerebrospinal fluid and serum for the diagnosis of tuberculous meningitis. Clin Neurol Neurosurg. 2013;115(9):1831-6.

  7. Mehta PK, Raj A, Singh N, Khuller GK. Diagnosis of extrapulmonary tuberculosis by PCR. FEMS Immunol Med Microbiol. 2012;66(1):20-36.

  8. Wiener RS, Della-Latta P, Schluger NW. Effect of nucleic acid amplificationfor Mycobacterium tuberculosis on clinical decision making in suspectedextrapulmonary tuberculosis. Chest. 2005;128(1):102-7.

  9. Takahashi T, Tamura M, Takasu T, Kamei S. Current advancement of the PCR-based molecular diagnosis for tuberculousmeningitis. Rinsho Shinkeigaku. 2013;53(11):1187-90.

  10. Caws M, Dang TM, Torok E, Campbell J, Do DA, Tran TH, et al. Evaluation of the MODS culture technique for the diagnosis of tuberculous meningitis. PLoSOne. 2007;2(11):e1173.

  11. Giusti G, Galanti B. Adenosinedeaminase. Methods of Enzymatic Analysis. New York: Academic Press; 1974. p. 1092-1099.

  12. Dirección General de Epidemiologia – CENSIDA. Vigilancia Epidemiológica de casos de VIH/SIDA en México. Registro Nacional de Casos de SIDA. México, D.F.: Secretaría de Salud; 2014. Disponible en: http://www.censida.salud.gob.mx/descargas/epidemiologia/ RN_CIERRE_2014.pdf

  13. Brancusi F, Farrar J, Heemskerk D. Tuberculous meningitis in adults: a review of a decade of developments focusing on prognostic factors for outcome. Future Microbiol. 2012;7(9):1101-16.

  14. Workneh MH, Bjune GA, Yimer SA. Prevalence and Associated Factors of Diabetes Mellitus among Tuberculosis Patients in South-Eastern Amhara Region, Ethiopia: A Cross Sectional Study. PLoS One. 2016;11(1):e0147621.

  15. Gil-Santana L, Almeida-Junior JL, Oliveira CA, Hickson LS, Daltro C, Castro S, et al. Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study. PLoSOne. 2016;11(1):e0146876.

  16. El-Sokkary RH, Abu-Taleb AM, El-Seifi OS, Zidan HE, Mortada EM, El-Hossary D, Farag SE. Assessing the Prevalence of Latent Tuberculosis among Health Care Providers in Zagazig City, Egypt Using Tuberculin Skin Test and QuantiFERON-TB Gold In-Tube Test. Cent Eur J Public Health. 2015;23(4):324-30.

  17. Ruan Q, Zhang S, Ai J, Shao L, Zhang W. Screening of latent tuberculosis infection by interferon-γ release assays in rheumatic patients: a systemic review and meta-analysis. Clin Rheumatol. 2016;35(2):417-25.

  18. Mancuso JD, Diffenderfer JM, Ghassemieh BJ, Horne DJ, Kao TC. The Prevalence of Latent Tuberculosis Infection in the United States. Am J Respir Crit Care Med. 2016;194(4):501-9.

  19. Gunal S, Yang Z, Agarwal M, Koroglu M, Arıcı ZK, Durmaz R. Demographic and microbial characteristics of extrapulmonary tuberculosis cases diagnosed in Malatya, Turkey, 2001-2007. BMC Public Health. 2011;11:154.

  20. Gesesew H, Tsehaineh B, Massa D, Tesfay A, Kahsay H, Mwanri L. The role of social determinants on tuberculosis/co-infection mortality in southwest Ethiopia: a retrospective cohort study. BMC Res Notes. 2016;9:89.

  21. Shen YC, Wang T, Chen L, Yang T, Wan C, Hu QJ, et al. Diagnostic accuracy of adenosine deaminase for tuberculous peritonitis: a meta-analysis. Arch Med Sci. 2013;9(4):601-7.

  22. Farhana A, Ghosh CK, Rehena Z, Ferdousi S, Alam MB, Mahmuduzzaman M, et al. Comparative Study of Adenosine Deaminase and Other Conventional Diagnostic 4 Parameters in Diagnosis of Tuberculous Pleural Effusion. Mymensingh Med J. 2015;24(3):550-7.

  23. Behrsin RF, Junior CT, Cardoso GP, Barillo JL, de Souza JB, de Araújo EG. Combined evaluation of adenosine deaminase level and histopathological findings from pleural biopsy with Cope's needle for the diagnosis of tuberculouspleurisy. Int J Clin Exp Pathol. 2015;8(6):7239- 46.

  24. Kocaman O, Danalioğlu A, İnce AT, Tozlu M, Şentürk H. Diagnosis of tuberculous peritonitis using endoscopic ultrasound-guided fine-needle aspiration biopsy of the peritoneum. Turk J Gastroenterol. 2013;24(1):65-9.

  25. Xie DL, Cheng B, Sheng Y, Jin J. Diagnostic accuracy of adenosine deaminase for tuberculous pericarditis: a metaanalysis. Eur Rev Med Pharmacol Sci. 2015;19(22):4411-8.

  26. Du J, Huang Z, Luo Q, Xiong G, Xu X, Li W, et al. Rapid diagnosis of pleural tuberculosis by Xpert MTB/RIF assay using pleural biopsy and pleural fluid specimens. J Res Med Sci. 2015;20(1):26-31.

  27. Pandie S, Peter JG, Kerbelker ZS, Meldau R, Theron G, Govender U, et al. Diagnostic accuracy of quantitative PCR (Xpert MTB/RIF) for tuberculous pericarditis compared to adenosine deaminase and unstimulated interferon-γ in a high burden setting: a prospective study. BMC Med. 2014;12:101.

  28. Gupta BK, Bharat V, Bandyopadhyay D, Chambial S. Role of cerebrospinal fluid adenosine deaminase level estimation in diagnosis of tuberculous meningitis. J Indian Med Assoc. 2013;111(9):603-5.

  29. Ntsekhe M, Shey Wiysonge C, Commerford PJ, Mayosi BM. The prevalence and outcome of effusive constrictive pericarditis: a systematic review of the literature. Cardiovasc J Afr. 2012;23(5):281-5.

  30. Organización Panamericana de la Salud - Organización Mundial de la Salud: Oficina Regional para las Américas. Tuberculosis. México: OPS; 2010. Disponible en: http://www.paho.org/tuberculosis




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