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de Almeida Marques DP, Andrade LAF, Reis EVS, Clarindo FA, Moraes TDFS, Lourenço KL, De Barros WA, Costa NEM, Andrade LMD, Lopes-Ribeiro Á, Coêlho Maciel MS, Corrêa-Dias LC, de Almeida IN, Arantes TS, Litwinski VCV, de Oliveira LC, Serafim MSM, Maltarollo VG, Guatimosim SC, Silva MM, Tsuji M, Ferreira RS, Barreto LV, Barbosa-Stancioli EF, da Fonseca FG, De Fátima Â, Coelho-Dos-Reis JGA. New anti-SARS-CoV-2 aminoadamantane compounds as antiviral candidates for the treatment of COVID-19. Virus Res 2024; 340:199291. [PMID: 38065303 PMCID: PMC10733093 DOI: 10.1016/j.virusres.2023.199291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023]
Abstract
Here, the antiviral activity of aminoadamantane derivatives were evaluated against SARS-CoV-2. The compounds exhibited low cytotoxicity to Vero, HEK293 and CALU-3 cells up to a concentration of 1,000 µM. The inhibitory concentration (IC50) of aminoadamantane was 39.71 µM in Vero CCL-81 cells and the derivatives showed significantly lower IC50 values, especially for compounds 3F4 (0.32 µM), 3F5 (0.44 µM) and 3E10 (1.28 µM). Additionally, derivatives 3F5 and 3E10 statistically reduced the fluorescence intensity of SARS-CoV-2 protein S from Vero cells at 10 µM. Transmission microscopy confirmed the antiviral activity of the compounds, which reduced cytopathic effects induced by the virus, such as vacuolization, cytoplasmic projections, and the presence of myelin figures derived from cellular activation in the face of infection. Additionally, it was possible to observe a reduction of viral particles adhered to the cell membrane and inside several viral factories, especially after treatment with 3F4. Moreover, although docking analysis showed favorable interactions in the catalytic site of Cathepsin L, the enzymatic activity of this enzyme was not inhibited significantly in vitro. The new derivatives displayed lower predicted toxicities than aminoadamantane, which was observed for either rat or mouse models. Lastly, in vivo antiviral assays of aminoadamantane derivatives in BALB/cJ mice after challenge with the mouse-adapted strain of SARS-CoV-2, corroborated the robust antiviral activity of 3F4 derivative, which was higher than aminoadamantane and its other derivatives. Therefore, aminoadamantane derivatives show potential broad-spectrum antiviral activity, which may contribute to COVID-19 treatment in the face of emerging and re-emerging SARS-CoV-2 variants of concern.
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Affiliation(s)
- Daisymara Priscila de Almeida Marques
- Laboratório de Virologia Básica e Aplicada (LVBA), Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Luis Adan Flores Andrade
- Laboratório de Virologia Básica e Aplicada (LVBA), Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Centro Tecnológico de Vacinas (CT Vacinas), Belo Horizonte, MG, Brazil
| | - Erik Vinicius Sousa Reis
- Laboratório de Virologia Básica e Aplicada (LVBA), Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Felipe Alves Clarindo
- Laboratório de Virologia Básica e Aplicada (LVBA), Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Thaís de Fátima Silva Moraes
- Laboratório de Virologia Básica e Aplicada (LVBA), Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Karine Lima Lourenço
- Laboratório de Virologia Básica e Aplicada (LVBA), Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Centro Tecnológico de Vacinas (CT Vacinas), Belo Horizonte, MG, Brazil
| | - Wellington Alves De Barros
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Nathália Evelyn Morais Costa
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lídia Maria de Andrade
- Departamento de Física, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ágata Lopes-Ribeiro
- Laboratório de Virologia Básica e Aplicada (LVBA), Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Mariella Sousa Coêlho Maciel
- Laboratório de Virologia Básica e Aplicada (LVBA), Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Laura Cardoso Corrêa-Dias
- Laboratório de Virologia Básica e Aplicada (LVBA), Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Isabela Neves de Almeida
- Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil; Laboratório de Micobacterioses, Faculdade de Medicina, Universidade Federal de, Minas Gerais, Belo Horizonte, MG, Brazil
| | - Thalita Souza Arantes
- Centro de Microscopia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Vivian Costa Vasconcelos Litwinski
- Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, MG, Brazil
| | - Leonardo Camilo de Oliveira
- Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, MG, Brazil
| | - Mateus Sá Magalhães Serafim
- Laboratório de Virus, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, MG, Brazil
| | - Vinicius Gonçalves Maltarollo
- Departamento de Produtos Farmacêuticos da Faculdade de Farmácia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, MG, Brazil
| | - Silvia Carolina Guatimosim
- Departamento de Fisiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, MG, Brazil
| | - Mário Morais Silva
- Departamento de Fisiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, MG, Brazil
| | - Moriya Tsuji
- Aaron Diamond AIDS Research Center, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Rafaela Salgado Ferreira
- Laboratório de Modelagem Molecular e Planejamento de Fármacos, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, MG, Brazil
| | - Luiza Valença Barreto
- Laboratório de Modelagem Molecular e Planejamento de Fármacos, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, MG, Brazil
| | - Edel Figueiredo Barbosa-Stancioli
- Laboratório de Virologia Básica e Aplicada (LVBA), Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Flávio Guimarães da Fonseca
- Laboratório de Virologia Básica e Aplicada (LVBA), Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Centro Tecnológico de Vacinas (CT Vacinas), Belo Horizonte, MG, Brazil
| | - Ângelo De Fátima
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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2
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de Medeiros RL, Moreira ADSR, Neves ACDOJ, Leite VDJ, de Almeida IN, Mello FCDQ, Kritski A. Analysis of catastrophic costs incurred by patients with multidrug-resistant tuberculosis in an outpatient clinic in the state of Rio de Janeiro. Rev Soc Bras Med Trop 2023; 56:e01482023. [PMID: 37909505 PMCID: PMC10615334 DOI: 10.1590/0037-8682-0148-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/04/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Multidrug-resistant tuberculosis (MDR-TB) is a serious global public health concern associated with social vulnerability. In Brazil, the Unified Health System (SUS, Portuguese) provides free diagnosis and treatment for MDR-TB; however, other expenses may still be incurred for patients and their families which, according to the World Health Organization (WHO), can be catastrophic when these costs surpass 20.0% of the annual household income. This study aimed to assess the extent of catastrophic costs related to the diagnostic and therapeutic aspects of MDR-TB among patients receiving care at an outpatient clinic in Rio de Janeiro. METHODS This prospective study used convenience sampling from July 2019 to June 2021. Data regarding direct and indirect costs were collected using a standardized questionnaire endorsed by the WHO. To analyze any impoverishment occurred from MDR-TB, a threshold established by the Brazilian Institute of Geography and Statistics for 2019 and 2020 of US$ 79,562 and US$ 94,5273, respectively, was applied. Descriptive statistics were used for data analysis, including mean; standard deviation; variation coefficient; median; and maximum, minimum, and interquartile ranges. RESULTS A total of 65 patients were interviewed. Among the participants, 73.8% experienced catastrophic costs, with indirect costs exerting the most significant impact (median: US$ 3,825.9), in contrast to direct costs (median: US$ 542.7). When comparing the periods before and after diagnosis, the prevalence of poverty increased from 12.0% to 28.0%. CONCLUSIONS Despite the support from the SUS in Brazil, diagnostic and therapeutic cascades incur additional costs, exacerbating social vulnerability among patients with MDR-TB.
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Affiliation(s)
- Regielle Luiza de Medeiros
- Universidade Federal do Rio de Janeiro, Programa Acadêmico de Tuberculose, Escola de Medicina, Rio de Janeiro, RJ, Brasil
| | | | | | - Viviane de Jesus Leite
- Universidade Federal do Rio de Janeiro, Programa de Pós-Graduação em Ensino de Matemática, Instituto de Matemática, Rio de Janeiro, RJ, Brasil
| | - Isabela Neves de Almeida
- Universidade Federal de Ouro Preto, Programa de Pós-Graduação em Biotecnologia, Núcleo de Pesquisa em Ciências Biológicas, Ouro Preto, MG, Brasil
| | | | - Afrânio Kritski
- Universidade Federal do Rio de Janeiro, Programa Acadêmico de Tuberculose, Escola de Medicina, Rio de Janeiro, RJ, Brasil
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Barboza GCS, Almeida IND, Santos LBD, Augusto CJ, Leal ÉA, Pádua CAMD, Cesar ALA, Kritski AL, Carvalho WDS, Miranda SSD, Figueredo LJDA. Nontuberculous mycobacteria in patients of a specialty hospital. Rev Inst Med Trop Sao Paulo 2023; 65:e42. [PMID: 37403880 DOI: 10.1590/s1678-9946202365042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/22/2023] [Indexed: 07/06/2023] Open
Abstract
The incidence and clinical characteristics of NTM diseases in Brazil remain relatively unknown. The present study describes the diagnosis of NTM isolates, the clinical presentation and treatment outcomes. We analyzed NTM isolates in patients of a tertiary hospital in the Southeast region of Brazil, from January 2008 to July 2019. The ATS/IDSA criteria for diagnosis and treatment of these patients was applied. Mycobacterium kansasii were identified in 13/113 (11.5%) patients. In 59/113 (52.2%) patients who met the ATS criteria for disease, 29/59 (49.1%) received treatment, and 22/29 (75.8%) were cured. The major species identified was M. kansasii. The most frequent symptoms among the treated patients were dyspnea and cough, and the proportion of cured patients was high.
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Affiliation(s)
- Grazielle Conceição Sousa Barboza
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
| | | | - Lucas Benício Dos Santos
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
| | - Claudio José Augusto
- Fundação Ezequiel Dias, Laboratório de Serviço de Doenças Bacterianas e Fúngicas, Belo Horizonte, Minas Gerais, Brazil
| | - Élida Aparecida Leal
- Fundação Ezequiel Dias, Laboratório de Serviço de Doenças Bacterianas e Fúngicas, Belo Horizonte, Minas Gerais, Brazil
| | - Cristiane Aparecida Menezes de Pádua
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Laboratório de Saúde Pública e Biologia Molecular, Belo Horizonte, Minas Gerais, Brazil
| | - Aina Liz Alves Cesar
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
| | - Afrânio Lineu Kritski
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Wânia da Silva Carvalho
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Laboratório de Saúde Pública e Biologia Molecular, Belo Horizonte, Minas Gerais, Brazil
| | - Silvana Spíndola de Miranda
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
| | - Lida Jouca de Assis Figueredo
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
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Peruhype-Magalhães V, de Araújo FF, de Morais Papini TF, Wendling APB, Campi-Azevedo AC, Coelho-Dos-Reis JG, de Almeida IN, do Valle Antonnelli LR, Amaral LR, de Souza Gomes M, Brito-de-Sousa JP, Elói-Santos SM, Augusto VM, Pretti Dalcolmo MM, Carneiro CM, Teixeira-Carvalho A, Martins-Filho OA. Serum biomarkers in patients with unilateral or bilateral active pulmonary tuberculosis: Immunological networks and promising diagnostic applications. Cytokine 2023; 162:156076. [PMID: 36417816 DOI: 10.1016/j.cyto.2022.156076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 10/08/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022]
Abstract
The present observational study was designed to characterize the integrative profile of serum soluble mediators to describe the immunological networks associated with clinical findings and identify putative biomarkers for diagnosis and prognosis of active tuberculosis. The study population comprises 163 volunteers, including 84 patients with active pulmonary tuberculosis/(TB), and 79 controls/(C). Soluble mediators were measured by multiplexed assay. Data analysis demonstrated that the levels of CCL3, CCL5, CXCL10, IL-1β, IL-6, IFN-γ, IL-1Ra, IL-4, IL-10, PDGF, VEGF, G-CSF, IL-7 were increased in TB as compared to C. Patients with bilateral pulmonary involvement/(TB-BI) exhibited higher levels of CXCL8, IL-6 and TNF with distinct biomarker signatures (CCL11, CCL2, TNF and IL-10) as compared to patients with unilateral infiltrates/(TB-UNI). Analysis of biomarker networks based in correlation power graph demonstrated small number of strong connections in TB and TB-BI. The search for biomarkers with relevant implications to understand the pathogenetic mechanisms and useful as complementary diagnosis tool of active TB pointed out the excellent performance of single analysis of IL-6 or CXCL10 and the stepwise combination of IL-6 → CXCL10 (Accuracy = 84 %; 80 % and 88 %, respectively). Together, our finding demonstrated that immunological networks of serum soluble biomarkers in TB patients differ according to the unilateral or bilateral pulmonary involvement and may have relevant implications to understand the pathogenetic mechanisms involved in the clinical outcome of Mtb infection.
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Affiliation(s)
- Vanessa Peruhype-Magalhães
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Fortes de Araújo
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil
| | - Tatiane Figueiredo de Morais Papini
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil; Pós-graduação em Ciências Farmacêuticas (CIPHARMA), Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Ana Paula Barbosa Wendling
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Carolina Campi-Azevedo
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil
| | - Jordana Grazziela Coelho-Dos-Reis
- Laboratório de Virologia Básica e Aplicada, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Isabela Neves de Almeida
- Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Lis Ribeiro do Valle Antonnelli
- Laboratório de Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou - FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Laurence Rodrigues Amaral
- Rede Multidisciplinar de Pesquisa, Ciência e Tecnologia, Laboratório de Bioinformática e Análises Moleculares, Universidade Federal de Uberlândia, Campus Patos de Minas, Patos de Minas, MG, Brazil
| | - Matheus de Souza Gomes
- Rede Multidisciplinar de Pesquisa, Ciência e Tecnologia, Laboratório de Bioinformática e Análises Moleculares, Universidade Federal de Uberlândia, Campus Patos de Minas, Patos de Minas, MG, Brazil
| | - Joaquim Pedro Brito-de-Sousa
- Pós-graduação em Imunologia e Parasitologia Aplicadas (PPIPA), Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Silvana Maria Elói-Santos
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil; Departamento de Propedêutica Complementar, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Valéria Maria Augusto
- Departamento de Propedêutica Complementar, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Margareth Maria Pretti Dalcolmo
- Escola Nacional de Saúde Pública, Centro de Referência Professor Hélio Fraga, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cláudia Martins Carneiro
- Pós-graduação em Ciências Farmacêuticas (CIPHARMA), Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil; Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Andréa Teixeira-Carvalho
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil.
| | - Olindo Assis Martins-Filho
- Grupo Integrado de Pesquisa em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, Minas Gerais, Brazil.
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de Oliveira Jeronymo Neves AC, Gomes dos Santos AP, de Medeiros RL, de Oliveira Jeronymo AJ, Coelho Neves G, de Almeida IN, Carvalho de Queiroz Mello F, Lineu Kritski A. Sociodemographic and Clinical Factors Associated with Treatment Outcomes for Drug-resistant Tuberculosis. Am J Trop Med Hyg 2022; 107:1295-1301. [PMID: 36316000 PMCID: PMC9768274 DOI: 10.4269/ajtmh.22-0294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/30/2022] [Indexed: 12/15/2022] Open
Abstract
Drug-resistant tuberculosis (DR-TB) continues to be a serious public health problem. The objective of this study was to evaluate the sociodemographic, radiological, clinical, and outcome characteristics and assess the determinants of unfavorable outcomes in DR-TB. The descriptive-analytical study was carried out in a reference outpatient clinic in Rio de Janeiro, Brazil, among DR-TB cases that received treatment between February 2016 and October 2020, using descriptive statistics, χ2 test, and logistic regression multivariate. Of the 148 cases, 12.2% were resistant to rifampicin, 12.2% were resistant to isoniazid, 18.2% were polyresistant, 56.1% multidrug resistant, and 1.3% were extensively drug resistant. Most of the patients were men, aged up to 44 years, with brown or black skin, having up to 8 years of schooling, unemployed or working in the informal economy, and of low income. Presenting with acquired resistance or positive sputum smear microscopy in the diagnosis, taking more than four drugs, and being unemployed were associated with unfavorable outcomes. Having no income or acquired resistance doubled the chances of unfavorable outcomes. There was a high proportion of unfavorable outcomes, thereby highlighting the need to concentrate efforts on planning and executing public policies that include the severity of DR-TB and its risk factors.
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Affiliation(s)
| | - Ana Paula Gomes dos Santos
- Medical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Regielle Luiza de Medeiros
- Medical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | | | - Afrânio Lineu Kritski
- Medical School and Institute of Thorax Diseases of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Libório MP, Kritski A, Almeida IND, Miranda PFC, Mesquita JRLD, Mota RMS, Sousa GJB, Pires Neto RDJ, Leitão TDMJS. Impact of a computer system as a triage tool in the management of pulmonary tuberculosis in a HIV reference center in Brazil. Rev Soc Bras Med Trop 2022; 55:e0451. [PMID: 35946632 PMCID: PMC9344949 DOI: 10.1590/0037-8682-0451-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/15/2022] [Indexed: 11/22/2022] Open
Abstract
Background: The Neural Clinical Score for tuberculosis (NCS-TB) is a computer system developed to improve the triage of presumed pulmonary TB (pPTB). Methods: A study was performed with cohorts of pPTB patients cared for at a reference hospital in Northeast Brazil. Results: The NCS-TB sensitivity was 76.5% for TB diagnosis, which shortened the time from triage to smear microscopy results (3.3 to 2.5 days; p<0.001) and therapy initiation (6.7 to 4.1 days; p=0.045). Conclusions: Although the NCS-TB was not suitable as a screening tool, it was able to optimize laboratory diagnosis and shorten the time to treatment initiation.
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Affiliation(s)
- Mariana Pitombeira Libório
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Mestrado em Saúde Pública, Fortaleza, CE, Brasil.,Secretaria da Saúde do Estado do Ceará, Hospital São José de Doenças Infecciosas, Fortaleza, CE, Brasil.,Universidade de Fortaleza, Faculdade de Medicina, Fortaleza, CE, Brasil
| | - Afrânio Kritski
- Universidade Federal do Rio de Janeiro, Programa Acadêmico de Tuberculose, Faculdade de Medicina, Rio de Janeiro, RJ, Brasil
| | - Isabela Neves de Almeida
- Universidade Federal de Ouro Preto, Escola de Farmácia, Departamento de Análises Clínicas, Ouro Preto, MG, Brasil
| | | | | | - Rosa Maria Salani Mota
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Mestrado em Saúde Pública, Fortaleza, CE, Brasil
| | - George Jó Bezerra Sousa
- Universidade Estadual do Ceará, Programa de Pós-Graduação em Cuidados Clínicos em Enfermagem e Saúde, Fortaleza, CE, Brasil
| | - Roberto da Justa Pires Neto
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Mestrado em Saúde Pública, Fortaleza, CE, Brasil.,Secretaria da Saúde do Estado do Ceará, Hospital São José de Doenças Infecciosas, Fortaleza, CE, Brasil
| | - Terezinha do Menino Jesus Silva Leitão
- Universidade Federal do Ceará, Faculdade de Medicina, Programa de Mestrado em Saúde Pública, Fortaleza, CE, Brasil.,Secretaria da Saúde do Estado do Ceará, Hospital São José de Doenças Infecciosas, Fortaleza, CE, Brasil
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7
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Lima ACDOD, Schmid KB, Melo HFD, Athayde RC, Monte RL, Almeida IND, Miranda SSD, Kritski A, Rossetti ML, Cordeiros-Santos M. Molecular characterization of nontuberculous Mycobacteria in a tuberculosis and HIV reference unit in the State of Amazonas, Brazil. Rev Soc Bras Med Trop 2022; 55:e0613. [PMID: 35946635 PMCID: PMC9344947 DOI: 10.1590/0037-8682-0613-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/13/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND In recent years, the prevalence of nontuberculous mycobacterial (NTM) infections has increased in different regions of the world. The American Thoracic Society (ATS) recommends standardized identification criteria, reinforcing the need for faster and less complicated clinical and laboratory techniques. METHODS In this retrospective study, NTM species isolated from pulmonary, extrapulmonary, and disseminated samples from patients treated at a TB/HIV reference unit in the State of Amazonas from 2011 to 2014 were identified through a combination of molecular techniques. RESULTS To identify the molecular technique, 50 cryopreserved NTM cultures were recovered and subcultivated in culture medium. The potentially pathogenic NTM species identified were M. avium, M. intracellulare, M. kansasii, M. chelonae, M. abscessus, M. fortuitum, and M. peregrinum. Results of GenoType® showed moderate agreement with those of genomic sequencing (kappa = 0.60), whereas the results obtained by the PRA-hsp65 technique disagreed with the results obtained by sequencing (kappa = 0.49). CONCLUSIONS Our findings highlight that GenoType CM is a good method for the identification of NTM, as well as the need for the application of standardized criteria, such as those set forth by the ATS.
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Affiliation(s)
- Ana Carolina de Oliveira de Lima
- Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.,Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil
| | - Karen Barros Schmid
- Secretaria de Estado da Saúde do Rio Grande do Sul, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil
| | | | | | | | - Isabela Neves de Almeida
- Universidade Federal de Ouro Preto, Escola de Farmácia, Departamento de Análises Clínicas, Ouro Preto, MG, Brasil
| | - Silvana Spíndola de Miranda
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica/Pneumologia/Tisologia, Belo Horizonte, MG, Brasil
| | - Afrânio Kritski
- Universidade Federal do Rio de Janeiro, Escola de Medicina, Programa Acadêmico de Tuberculose, Rio de Janeiro, RJ, Brasil
| | - Maria Lucia Rossetti
- Universidade Luterana do Brasil, Programa de Pós-Graduação em Biologia Molecular e Celular, Canoas, RS, Brasil
| | - Marcelo Cordeiros-Santos
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brasil
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Kritski A, Oliveira MM, Almeida IND, Ramalho D, Andrade MKDN, Carvalho M, Miranda PFC, Dalcolmo MP, Braga JU, Brígido T, Mesquita E, Dias C, Gambirasio A, Souza Filho JB, Detjen A, Phillips PPJ, Langley I, Fujiwara P, Squire SB. Clinical Impact of the Line Probe Assay and Xpert® MTB/RIF Assay in the Presumptive Diagnosis of Drug-Resistant Tuberculosis in Brazil: A Pragmatic Clinical Trial. Rev Soc Bras Med Trop 2022; 55:e0191. [PMID: 35239898 PMCID: PMC8932318 DOI: 10.1590/0037-8682-0191-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 11/23/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Rapid molecular methods such as the line probe assay (LPA) and Xpert® MTB/RIF assay (Xpert) have been recommended by the World Health Organization for drug-resistant tuberculosis (DR-TB) diagnosis. We conducted an interventional trial in DR-TB reference centers in Brazil to evaluate the impact of the use of LPA and Xpert. Methods: Patients with DR-TB were eligible if their drug susceptibility testing results were available to the treating physician at the time of consultation. The standard reference MGITTM 960 was compared with Xpert (arm 1) and LPA (arm 2). Effectiveness was considered as the start of the appropriate TB regimen that matched drug susceptibility testing (DST) and the proportions of culture conversion and favorable treatment outcomes after 6 months. Results: A higher rate of empirical treatment was observed with MGIT alone than with the Xpert assay (97.0% vs. 45.0%) and LPA (98.2% vs. 67.5%). Patients started appropriate TB treatment more quickly than those in the MGIT group (median 15.0 vs. 40.5 days; p<0.01) in arm 1. Compared to the MGIT group, culture conversion after 6 months was higher for Xpert in arm 1 (90.9% vs. 79.3%, p=0.39) and LPA in arm 2 (80.0% vs. 83.0%, p=0.81). Conclusions: In the Xpert arm, there was a significant reduction in days to the start of appropriate anti-TB treatment and a trend towards greater culture conversion in the sixth month.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Claudia Dias
- Secretaria de Estado de Saúde do Rio Grande do Sul, Brasil
| | | | | | | | | | - Ivor Langley
- Liverpool School of Tropical Medicine, United Kingdom
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9
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Vater MC, Maximo MM, Silva Rezende Moreira AD, Alves da Silva SC, de Almeida IN, Kritski AL. Cost analysis for patients with presumed pulmonary tuberculosis attended in the public health system of rio de janeiro, Brazil. Int J Mycobacteriol 2021; 10:136-141. [PMID: 34558464 DOI: 10.4103/ijmy.ijmy_58_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background In last years, few attention has given to the patient's prediagnostic costs when evaluating the introduction of new technologies for tuberculosis (TB) and in this context, this study evaluated patient's costs and cost-effectiveness incurred with TB diagnosis comparing BactecTMMGITTM960 system (MGIT) to the Löwestein-Jensen (LJ) culture in a health center and in a university hospital, in Rio de Janeiro City, Brazil. Methods Patient's mean costs were evaluated during the diagnosis process and cost-effectiveness based on mean time in days for the adoption of appropriate clinical anti-TB treatment in two health units comparing culture by means LJ and MGIT. Results The mean cost of LJ and MGIT in the health center was U. S. dollars (US$) 26.6 and US$ 45.13, respectively, and in university hospital was US$ 206.87 and US$ 285.48, respectively. Comparing the two approaches for TB diagnosis incurred by the patients, the incremental cost-effectiveness of MGIT compared to LJ was US$ 0.88 and US$ 4.03 per patient, respectively, to reduce the average time to adopt appropriate treatment. Conclusions The culture method directly impacts patient costs while waiting for the correct diagnosis and contributing to aggravating costs with patients with TB.
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Affiliation(s)
- Maria Claudia Vater
- Tuberculosis Research Center, Faculty of Medicine, Federal University of Rio de Janeiro; Nucleus of Bioethics and Applied Ethics, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mário Motta Maximo
- Department of Economic, Multidisciplinary Institution, Rural Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Isabela Neves de Almeida
- Department of Clinical Analysis, School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Afrânio Lineu Kritski
- Academic Tuberculosis Program Center, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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10
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Navarro PDD, Haddad JPA, Rabelo JVC, Silva CHDLE, Almeida IND, Carvalho WDS, Miranda SSD. The impact of the stratification by degree of clinical severity and abandonment risk of tuberculosis treatment. J Bras Pneumol 2021; 47:e20210018. [PMID: 34495173 PMCID: PMC8979663 DOI: 10.36416/1806-3756/e20210018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/30/2021] [Indexed: 12/01/2022] Open
Abstract
Objective: Evaluate the impact of the instrument of the “Stratification by Degree of Clinical Severity and Abandonment Risk of Tuberculosis Treatment” (SRTB) on the tuberculosis outcome. Methods: This study was a pragmatic clinical trial involving patients with a confirmed diagnosis of tuberculosis treated at one of the 152 primary health care units in the city of Belo Horizonte, Brazil, between May of 2016 and April of 2017. Cluster areas for tuberculosis were identified, and the units and their respective patients were divided into intervention (use of SRTB) and nonintervention groups. Results: The total sample comprised 432 participants, 223 and 209 of whom being allocated to the nonintervention and intervention groups, respectively. The risk of treatment abandonment in the nonintervention group was significantly higher than was that in the intervention group (OR = 15.010; p < 0.001), regardless of the number of risk factors identified. Kaplan-Meier curves showed a hazard ratio of 0.0753 (p < 0.001). Conclusions: The SRTB instrument was effective in reducing abandonment of tuberculosis treatment, regardless of the number of risk factors for that. This instrument is rapid and easy to use, and can be adapted to different realities. Its application showed characteristics predisposing to a non-adherence to the treatment and established bases to mitigate its impact.
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Affiliation(s)
- Pedro Daibert de Navarro
- . Secretaria Municipal de Saúde, Prefeitura de Belo Horizonte, Belo Horizonte (MG) Brasil.,. Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
| | - João Paulo Amaral Haddad
- . Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
| | | | | | - Isabela Neves de Almeida
- . Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil.,. Faculdade de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto (MG) Brasil
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11
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Nishi MP, Mancuzo EV, Sulmonett N, Almeida IND, César ALA, Miranda SSD. Pulmonary functional assessment: longitudinal study after treatment of pulmonary tuberculosis. Rev Inst Med Trop Sao Paulo 2021; 63:e65. [PMID: 34406290 PMCID: PMC8376278 DOI: 10.1590/s1678-9946202163065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 07/19/2021] [Indexed: 11/22/2022] Open
Abstract
Even when treated adequately, pulmonary tuberculosis can lead to pulmonary sequelae. Patients treated for PTB between 2012 and 2016 answered a standardized questionnaire and underwent chest radiography and spirometry, measurement of absolute pulmonary volume, Diffusing Capacity for Carbon Monoxide (DLCO) and the 6-min walk test (6MWT) on two occasions: within the first year after the end of treatment (follow-up 1), and one and two years after follow-up 1 (follow-up 2). A total of 55 patients they underwent spirometry, 23 (41.82%) had obstructive ventilatory disorder (OVD) and eight (14.5%) had moderate OVD. In total, 29 patients underwent pulmonary function tests (PFTs) and 24 patients underwent the 6MWT on two occasions. The functional changes after PTB treatment appear not to have varied between one and two years of follow-up. There was a correlation between low FEV1 and low DLCO (p<0.001); low DLCO and low 6MWT (p<0.001) and radiographic abnormalities and low FEV1 (p=0.033). The most frequently observed change in spirometry was found in patients with OVD.
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Affiliation(s)
- Marina Pires Nishi
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação das Ciências Aplicadas à Saúde do Adulto, Belo Horizonte, Minas Gerais, Brazil
| | - Eliane Viana Mancuzo
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, Minas Gerais, Brazil
- Universidade Federal de Minas Gerais, Hospital das Clínicas, Laboratório de Função Pulmonar, Belo Horizonte, Minas Gerais, Brazil
| | - Nara Sulmonett
- Universidade Federal de Minas Gerais, Hospital das Clínicas, Laboratório de Função Pulmonar, Belo Horizonte, Minas Gerais, Brazil
| | - Isabela Neves de Almeida
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
- Universidade Federal de Ouro Preto, Escola de Farmácia, Departamento de Análises Clínicas, Ouro Preto, Minas Gerais, Brazil
| | - Aina Liz Alves César
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
| | - Silvana Spindola de Miranda
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, Minas Gerais, Brazil
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, Minas Gerais, Brazil
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Rabelo JVC, Navarro PDD, Carvalho WDS, Almeida IND, Oliveira CSF, Haddad JPA, Miranda SSD. [Performance assessment of primary healthcare services in tuberculosis control in a city in Southeast Brazil]. CAD SAUDE PUBLICA 2021; 37:e00112020. [PMID: 33852663 DOI: 10.1590/0102-311x00112020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/31/2020] [Indexed: 11/22/2022] Open
Abstract
The World Health Organization highlights the importance of health services organization and performance in tuberculosis (TB) control activities. This study aimed to assess the performance of primary healthcare services in Belo Horizonte, Minas Gerais State, Brazil, in TB control activities in the dimensions Structure and Process, before and after the use of a validated instrument called Stratification by Degree of Clinical Risk and Tuberculosis Treatment Dropout (ERTB). This was a descriptive and prospective study with two interviews (455 professionals), the second of which after the ERTB. Performance classification was: ≤ 49.9%, critical; 50-79.9%, unsatisfactory, and ≥ 80%, satisfactory. The comparative assessment used the McNemar statistical test with p < 0.05. After risk stratification, most of the variables in each dimension improved significantly. The authors conclude that it was possible to identify satisfactory performance in most of the variables assessed in the Structure and Process dimensions in primary healthcare services in Belo Horizonte in relation to TB control activities, using a standardized questionnaire.
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da Silva SCA, Vater MC, Ramalho DMDP, de Almeida IN, de Miranda SS, Kritski A. Cost-effectiveness of Xpert®MTB/RIF in the diagnosis of tuberculosis: pragmatic study. Rev Soc Bras Med Trop 2021; 54:e07552020. [PMID: 33605382 PMCID: PMC7891564 DOI: 10.1590/0037-8682-0755-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/15/2021] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION The intensification of research and innovation with the creation of networks of rapid and effective molecular tests as strategies for the end of tuberculosis are essential to avoid late diagnosis and for the eradication of the disease. We aimed to evaluate the cost-effectiveness of Xpert®MTB/RIF (Xpert) in the diagnosis of drug-resistant tuberculosis in reference units, in scenarios with and without subsidies, and the respective cost adjustment for today. METHODS The analyses were performed considering as criterion of effectiveness, negative culture or clinical improvement in the sixth month of follow-up. The comparison was performed using two diagnostic strategies for the drug susceptibility test (DST), BactecTMMGITTM960 System, versus Xpert. The cost effectiveness and incremental cost-effectiveness ratio (ICER) were calculated and dollar-corrected for American inflation (US$ 1.00 = R$ 5,29). RESULTS Subsidized Xpert had the lowest cost of US$ 33.48 (R$67,52) and the highest incremental average efficiency (13.57), thus being a dominated analysis. After the inflation was calculated, the mean cost was DST-MGIT=US$ 74.85 (R$ 396,73) and Xpert = US$ 37.33 (R$197,86) with subsidies. CONCLUSIONS The Xpert in the diagnosis of TB-DR in these reference units was cost-effective with subsidies. In the absence of a subsidy, Xpert in TB-DR is not characterized as cost effective. This factor reveals the vulnerability of countries dependent on international organizations' subsidy policies.
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Affiliation(s)
| | - Maria Claudia Vater
- Universidade Federal do Rio de Janeiro, Programa Acadêmico de Tuberculose, Rio de Janeiro, RJ, Brasil
- Universidade Federal do Rio de Janeiro, Núcleo de Bioética e Ética Aplicada, Rio de Janeiro, RJ, Brasil
| | | | - Isabela Neves de Almeida
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Departamento de Clínica Médica, Belo Horizonte, MG, Brasil
- Universidade Federal de Ouro Preto, Escola de Farmácia, Departamento de Análises Clínicas, Ouro Preto, MG, Brasil
| | - Silvana Spíndola de Miranda
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Departamento de Clínica Médica, Belo Horizonte, MG, Brasil
| | - Afrânio Kritski
- Universidade Federal do Rio de Janeiro, Programa Acadêmico de Tuberculose, Rio de Janeiro, RJ, Brasil
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Assis Figueredo LJD, de Almeida IN, Augusto CJ, Soares VM, Suffys PN, Carvalho WDS, de Miranda SS. Characterization of Mycobacterium tuberculosis heteroresistance by genotyping. Int J Mycobacteriol 2020; 9:368-372. [PMID: 33323651 DOI: 10.4103/ijmy.ijmy_132_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Heteroresistance is the coexistence of susceptible and resistant strains in the same individual, considered the preliminary step for total resistance, and can stem from mixed infection or clonal heterogeneity. The aim of this study was to evaluate the heteroresistance of Mycobacterium tuberculosis to rifampicin and isoniazid and its characterization. Method GenoType MTBDRplus®; Sanger sequencing of the rpoB, katG, and inhA genes; and Mycobacterial Interspersed Repetitive Unit - Variable Number Tandem Repeat (MIRU-VNTR) were performed. Results In a total of 654 isolates, 530 were resistant, 124 were susceptible, and 29 were heteroresistant to a first-line drug. GenoType MTBDRplus® detected heteroresistance in the rpoB gene in 26/29 (89.6%), as compared to 5/29 (17.2%) in the katG gene and 2/29 (6.8%) in the inhA gene. Four isolates showed heteroresistance in these genes. The Sanger sequencing detected heteroresistance in the rpoB gene in 7/29 (24.1%), as compared to 3/29 (10.3%) in the katG gene. In one isolate, heteroresistance was concomitant in both the rpoB and katG genes. MIRU-VNTR detected mixed infection in three heteroresistant isolates, while four isolates showed clonal heterogeneity. Conclusions GenoType MTBDRplus® detected more cases of heteroresistance when compared to sequencing. It was also possible to characterize mixed infection and clonal heterogeneity by MIRU-VNTR.
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Affiliation(s)
- Lida Jouca de Assis Figueredo
- Mycobacteria Research Laboratory, Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Isabela Neves de Almeida
- Mycobacteria Research Laboratory, Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Claudio José Augusto
- Mycobacteria Laboratory, Central Laboratory of Public Health of Minas Gerais, Ezequiel Dias Foundation, Minas Gerais, Brazil
| | - Valéria Martins Soares
- Júlia Kubitschek Hospital, Hospital Federation of the State of Minas Gerais, Minas Gerais, Brazil
| | - Philip Noel Suffys
- Oswaldo Cruz Institute,Molecular Biology Laboratory Applied to Mycobacteria, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Wânia da Silva Carvalho
- Department of Social Pharmacy, Faculty of Pharmacy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Silvana Spíndola de Miranda
- Mycobacteria Research Laboratory, Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Minas Gerais, Brazil
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Figueredo LJDA, Miranda SSD, Santos LBD, Manso CGG, Soares VM, Alves S, Vater MC, Kritski AL, Carvalho WDS, Pádua CMD, Almeida IND. Cost analysis of smear microscopy and the Xpert assay for tuberculosis diagnosis: average turnaround time. Rev Soc Bras Med Trop 2020; 53:e20200314. [PMID: 32997053 PMCID: PMC7523521 DOI: 10.1590/0037-8682-0314-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/24/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Rapid and accurate tuberculosis detection is critical for improving patient diagnosis and decreasing tuberculosis transmission. Molecular assays can significantly increase laboratory costs; therefore, the average time and economic impact should be evaluated before implementing a new technology. The aim of this study was to evaluate the cost and average turnaround time of smear microscopy and Xpert assay at a university hospital. METHODS The turnaround time and cost of the laboratory diagnosis of tuberculosis were calculated based on the mean cost and activity based costing (ABC). RESULTS The average turnaround time for smear microscopy was 16.6 hours while that for Xpert was 24.1 hours. The Xpert had a mean cost of USD 17.37 with an ABC of USD 10.86, while smear microscopy had a mean cost of USD 13.31 with an ABC of USD 6.01. The sensitivity of smear microscopy was 42.9% and its specificity was 99.1%, while the Xpert assay had a sensitivity of 100% and a specificity of 96.7%. CONCLUSIONS The Xpert assay has high accuracy; however, the turnaround time and cost of smear microscopy were lower than those of Xpert.
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Affiliation(s)
| | - Silvana Spíndola de Miranda
- Universidade Federal de Minas Gerais, Grupo de Pesquisa em Micobacterioses, Faculdade de Medicina, Belo Horizonte, MG, Brasil
| | - Lucas Benício Dos Santos
- Universidade Federal de Minas Gerais, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, MG, Brasil
| | | | - Valéria Martins Soares
- Fundação Hospitalar do Estado de Minas Gerais, Hospital Júlia Kubistchek, Laboratório de Microbiologia, Belo Horizonte, MG, Brasil
| | - Suely Alves
- Universidade Federal do Rio de Janeiro, Programa Acadêmico de Tuberculose, Rio de Janeiro, RJ, Brasil
| | - Maria Cláudia Vater
- Universidade Federal do Rio de Janeiro, Programa Acadêmico de Tuberculose, Rio de Janeiro, RJ, Brasil
| | - Afrânio Lineu Kritski
- Universidade Federal do Rio de Janeiro, Programa Acadêmico de Tuberculose, Rio de Janeiro, RJ, Brasil
| | | | | | - Isabela Neves de Almeida
- Universidade Federal de Minas Gerais, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, MG, Brasil
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de Almeida IN, da Silva SC, Junior HADO, Figueredo LJDA, Soares VM, Carvalho WDS, Kritski A, da Costa Fiori MCDSV, de Miranda SS. The activity-based cost of drug-susceptibility test of Mycobacterium tuberculosis through Kit SIRE Nitratase ® Plastlabor. Int J Mycobacteriol 2020; 9:24-28. [PMID: 32474484 DOI: 10.4103/ijmy.ijmy_8_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Drug-resistant tuberculosis (TB) is an ongoing health threat, and the greatest challenge to adequate control of TB in many countries lies in the lack of proper laboratory drug-susceptibility test. The aim of this study was to evaluate the activity-based costs (ABC) of Kit SIRE Nitratase® (Kit SIRE) and compare its values with the conventional drug-susceptibility test. Methods The ABC was calculated for three different approaches: Kit SIRE (clinical samples and cultures), proportion methods in Lowenstein Jensen (PM-LJ), and the Bactec™ MGIT™ 960 system based on Mycobacterial Research Laboratory's routine. Results The ABC of Kit SIRE from cultures was US$ 148.54, while from clinical samples was US$ 136.12. In the case of conventional tests, the ABC of Bactec™ MGIT™ 960 was US$ 227.63 and of the PM-LJ was US$ 132.64. The Kit SIRE has a lower ABC when clinical samples are used instead of cultures. Compared to conventional tests, the ABC is similar to the PM-LJ and lower the Bactec™ MGIT™ 960. Conclusion The Kit SIRE should be used as a screening method in clinical specimens and in culture for laboratories that do not have Bactec™ MGIT™ 960. Therefore, it can be incorporated into the routine of laboratories in countries with low resources and a high burden of TB and drug-resistant TB.
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Affiliation(s)
- Isabela Neves de Almeida
- Mycobacteria Research Laboratory, Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Suely Conceicão da Silva
- Tuberculosis Research Center, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Lida Jouca de Assis Figueredo
- Mycobacteria Research Laboratory, Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Valéria Martins Soares
- Júlia Kubitschek Hospital, Hospital Federation of the State of Minas Gerais, Minas Gerais, Brazil
| | - Wânia da Silva Carvalho
- Department of Social Pharmacy, Faculty of Pharmacy, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Afrânio Kritski
- Tuberculosis Research Center, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Silvana Spíndola de Miranda
- Mycobacteria Research Laboratory, Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais, Minas Gerais, Brazil
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Bello GL, Morais FCL, de Jesus SP, Wolf JM, Gehlen M, de Almeida IN, Figueiredo LJDA, Soares TDS, Barcellos RB, Dalla Costa ER, de Miranda SS, Rossetti MLR. Rapid detection of Mycobacterium tuberculosis DNA and genetic markers for Isoniazid resistance in Ziehl-Neelsen stained slides. Mem Inst Oswaldo Cruz 2020; 115:e190407. [PMID: 32321155 PMCID: PMC7164399 DOI: 10.1590/0074-02760190407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/06/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Early diagnosis of tuberculosis (TB) and identification of strains of Mycobacterium tuberculosis resistant to anti-TB drugs are considered the main factors for disease control. OBJECTIVES To standardise a real-time polymerase chain reaction (qPCR) assay technique and apply it to identify mutations involved in M. tuberculosis resistance to Isoniazid (INH) directly in Ziehl-Neelsen (ZN) stained slides. METHODS Were analysed 55 independent DNA samples extracted from clinical isolates of M. tuberculosis by sequencing. For application in TB diagnosis resistance, 59 ZN-stained slides were used. The sensitivity, specificity and Kappa index, with a 95% confidence interval (CI95%), were determined. FINDINGS The agreement between the tests was, for the katG target, the Kappa index of 0.89 (CI95%: 0.7-1.0). The sensitivity and specificity were 97.6% (CI95%: 87.7-99.9) and 91.7% (CI95%: 61.5-99.5), respectively. For inhA, the Kappa index was 0.92 (CI95%: 0.8-1.0), the sensitivity and specificity were 94.4% (CI95%: 72.7-99.8) and 97.3% (CI95%: 85.8-99.9), respectively. The use of ZN-stained slides for drug-resistant TB detection showed significant results when compared to other standard tests for drug resistance. MAIN CONCLUSIONS qPCR genotyping proved to be an efficient method to detect genes that confer M. tuberculosis resistance to INH. Thus, qPCR genotyping may be an alternative instead of sequencing.
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Affiliation(s)
- Graziele Lima Bello
- Universidade Luterana do Brasil, Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Canoas, RS, Brasil
| | - Franciele Costa Leite Morais
- Universidade Luterana do Brasil, Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Canoas, RS, Brasil
| | - Sheile Pinheiro de Jesus
- Universidade Luterana do Brasil, Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Canoas, RS, Brasil
| | - Jonas Michel Wolf
- Universidade Luterana do Brasil, Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Canoas, RS, Brasil
| | - Mirela Gehlen
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Pneumologia, Porto Alegre, RS, Brasil
| | - Isabela Neves de Almeida
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, MG, Brasil
| | - Lida Jouca de Assis Figueiredo
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, MG, Brasil
| | | | - Regina Bones Barcellos
- Secretaria do Estado do Rio Grande do Sul, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil
- Universidade Federal do Rio de Janeiro, Programa de Pós-Graduação em Clínica Médica, Rio de Janeiro, RJ, Brasil
| | - Elis Regina Dalla Costa
- Universidade Federal do Rio de Janeiro, Programa de Pós-Graduação em Clínica Médica, Rio de Janeiro, RJ, Brasil
- AstraZeneca do Brasil, Cotia, SP, Brasil
| | - Silvana Spíndola de Miranda
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, MG, Brasil
| | - Maria Lucia Rosa Rossetti
- Universidade Luterana do Brasil, Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Canoas, RS, Brasil
- Universidade Luterana do Brasil, Graduação em Biomedicina, Canoas, RS, Brasil
- Secretaria do Estado do Rio Grande do Sul, Centro de Desenvolvimento Científico e Tecnológico, Porto Alegre, RS, Brasil
- Universidade Federal do Rio de Janeiro, Programa de Pós-Graduação em Clínica Médica, Rio de Janeiro, RJ, Brasil
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Castor K, Mota FB, da Silva RM, Cabral BP, Maciel EL, de Almeida IN, Arakaki-Sanchez D, Andrade KB, Testov V, Vasilyeva I, Zhao Y, Zhang H, Singh M, Rao R, Tripathy S, Gray G, Padayatchi N, Bhagwandin N, Swaminathan S, Kasaeva T, Kritski A. Mapping the tuberculosis scientific landscape among BRICS countries: a bibliometric and network analysis. Mem Inst Oswaldo Cruz 2020; 115:e190342. [PMID: 32187325 PMCID: PMC7066990 DOI: 10.1590/0074-02760190342] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/05/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The five BRICS (Brazil, Russian, Indian, China, and South Africa) countries bear 49% of the world's tuberculosis (TB) burden and they are committed to ending tuberculosis. OBJECTIVES The aim of this paper is to map the scientific landscape related to TB research in BRICS countries. METHODS Were combined bibliometrics and social network analysis techniques to map the scientific publications related to TB produced by the BRICS. Was made a descriptive statistical data covering the full period of analysis (1993-2016) and the research networks were made for 2007-2016 (8,366 records). The bubble charts were generated by VantagePoint and the networks by the Gephi 0.9.1 software (Gephi Consortium 2010) from co-occurrence matrices produced in VantagePoint. The Fruchterman-Reingold algorithm provided the networks' layout. FINDINGS During the period 1993-2016, there were 38,315 peer-reviewed, among them, there were 11,018 (28.7%) articles related by one or more authors in a BRICS: India 38.7%; China 23.8%; South Africa 21.1%; Brazil 13.0%; and Russia 4.5% (The total was greater than 100% because our criterion was all papers with at least one author in a BRICS). Among the BRICS, there was greater interaction between India and South Africa and organisations in India and China had the highest productivity; however, South African organisations had more interaction with countries outside the BRICS. Publications by and about BRICS generally covered all research areas, especially those in India and China covered all research areas, although Brazil and South Africa prioritised infectious diseases, microbiology, and the respiratory system. MAIN CONCLUSIONS An overview of BRICS scientific publications and interactions highlighted the necessity to develop a BRICS TB research plan to increase efforts and funding to ensure that basic science research successfully translates into products and policies to help end the TB epidemic.
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Affiliation(s)
- Kamaiaji Castor
- Fundação Oswaldo Cruz-Fiocruz, Centro de Estudos Estratégicos, Rio de Janeiro, RJ, Brasil
| | - Fabio Batista Mota
- Fundação Oswaldo Cruz-Fiocruz, Centro de Estudos Estratégicos, Rio de Janeiro, RJ, Brasil
| | | | | | - Ethel Leonor Maciel
- Universidade Federal do Espírito Santo, Laboratório de Epidemiologia, Vitória, ES, Brasil
| | - Isabela Neves de Almeida
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, MG, Brasil
| | | | | | - Vadim Testov
- National Medical Research Centre of Pthtisiopulmonology and Infection Diseases, MoH, Moscow, Russian Federation
| | - Irina Vasilyeva
- National Medical Research Centre of Pthtisiopulmonology and Infection Diseases, MoH, Moscow, Russian Federation
| | - Yanlin Zhao
- National Centre for Tuberculosis Control and Prevention, China CDC, Changping District, Beijing, China
| | - Hui Zhang
- National Centre for Tuberculosis Control and Prevention, China CDC, Changping District, Beijing, China
| | - Manjula Singh
- Indian Council of Medical Research, New Delhi, India
| | - Raghuram Rao
- Government of India, Ministry of Health and Family Welfare Central TB Division, New Delhi, India
| | | | - Glenda Gray
- University of KwaZulu-Natal, Doris Duke Medical Research Institute, South African Medical Research Council HIV-TB Pathogenesis and Treatment Research Unit, Congella, South Africa
| | - Nesri Padayatchi
- University of KwaZulu-Natal, Doris Duke Medical Research Institute, South African Medical Research Council HIV-TB Pathogenesis and Treatment Research Unit, Congella, South Africa
| | - Niresh Bhagwandin
- University of KwaZulu-Natal, Doris Duke Medical Research Institute, South African Medical Research Council HIV-TB Pathogenesis and Treatment Research Unit, Congella, South Africa
| | - Soumya Swaminathan
- Phthisiology, Central TB Research Institute, Moscow, Russian Federation.,World Health Organization, Geneva, Switzerland
| | - Tereza Kasaeva
- Phthisiology, Central TB Research Institute, Moscow, Russian Federation.,World Health Organization, Geneva, Switzerland
| | - Afrânio Kritski
- Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Programa Acadêmico de Tuberculose, Rio de Janeiro, RJ, Brasil
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Soares VM, Almeida IND, Vater MC, Alves S, Figueredo LJDA, Scherer L, Kritski AL, Carvalho WDS, Miranda SSD. Genotype®MTBDRplus and Xpert®MTB/RIF in the diagnosis of tuberculosis and resistant tuberculosis: cost analysis in a tertiary referral hospital. Rev Soc Bras Med Trop 2020; 53:e20190175. [PMID: 32049199 PMCID: PMC7083373 DOI: 10.1590/0037-8682-0175-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 01/08/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The present study sought to assess the mean and activity based cost (ABC) of the laboratory diagnosis for tuberculosis through the application of conventional and molecular techniques-Xpert®MTB/RIF and Genotype®MTBDRplus-in a tertiary referral hospital in Brazil. METHODS The mean cost and ABC formed the basis for the cost analysis of the TB laboratory diagnosis. RESULTS The mean cost and ABC were US$ 4.00 and US$ 3.24, respectively, for a bacilloscopy; US$ 6.73 and US$ 5.27 for a Lowenstein-Jensen (LJ) culture; US$ 105.42 and US$ 76.56 for a drug sensitivity test (DST)-proportions method (PM) in LJ; US$ 148.45 and US$ 136.80 for a DST-BACTECTM MGITTM 960 system; US$ 11.53 and US$ 9.89 for an Xpert®MTB/RIF; and US$ 84.21 and US$ 48.38 for a Genotype®MTBDRplus. CONCLUSIONS The mean cost and ABC proved to be good decision-making parameters in the diagnosis of TB and MDR-TB. The effective implementation of algorithms will depend on the conditions at each location.
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Affiliation(s)
- Valéria Martins Soares
- Federação Hospitalar do Estado de Minas Gerais, Hospital Júlia Kubistchek, Laboratório de Microbiologia, Belo Horizonte, MG, Brasil
| | - Isabela Neves de Almeida
- Universidade Federal de Minas Gerais, Laboratório de Pesquisa em Micobactérias, Belo Horizonte, MG, Brasil
| | - Maria Cláudia Vater
- Universidade Federal do Rio de Janeiro, Programa Acadêmico de Tuberculose, Rio de Janeiro, RJ, Brasil
| | - Suely Alves
- Universidade Federal do Rio de Janeiro, Programa Acadêmico de Tuberculose, Rio de Janeiro, RJ, Brasil
| | | | - Luciene Scherer
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Afrânio Lineu Kritski
- Universidade Federal do Rio de Janeiro, Programa Acadêmico de Tuberculose, Rio de Janeiro, RJ, Brasil
| | | | - Silvana Spindola de Miranda
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Grupo de Pesquisa em Micobactérias, Belo Horizonte, MG, Brasil
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20
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Silva SC, Almeida IND, Ribeiro WC, Miranda SSD, Rocha ACH. Mycobacterium abscessus subsp. bolletii keratitis: rare case reported in Brazil. Rev Inst Med Trop Sao Paulo 2020; 62:e6. [PMID: 32049257 PMCID: PMC7014564 DOI: 10.1590/s1678-9946202062006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 12/10/2019] [Indexed: 12/03/2022] Open
Abstract
In this report, we described a rare case of Mycobacterium abscessus subsp. bolletii keratitis in a young healthy male, in the absence of risk factors.
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21
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Soares VM, Almeida IND, Figueredo LJDA, Haddad JPA, Oliveira CSFD, Carvalho WDS, Miranda SSD. Factors associated with tuberculosis and multidrug-resistant tuberculosis in patients treated at a tertiary referral hospital in the state of Minas Gerais, Brazil. J Bras Pneumol 2020; 46:e20180386. [PMID: 32130331 PMCID: PMC7462691 DOI: 10.36416/1806-3756/e20180386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/22/2019] [Indexed: 11/30/2022] Open
Abstract
Objective: To evaluate the risk factors for the development of tuberculosis and multidrug-resistant tuberculosis (MDR-TB) in patients treated at a tertiary referral hospital. Methods: This was a cross-sectional study based on data obtained from patients treated at the Júlia Kubitschek Hospital, located in the city of Belo Horizonte, Brazil, between October of 2012 and October of 2014. We evaluated sociodemographic, behavioral, clinical, and radiological variables. The outcome considered to identify associations between tuberculosis and the explanatory variables was the treatment prescribed. To evaluate the associations between MDR-TB and the same explanatory variables, the change in MDR-TB treatment was considered. Results: The factors associated with tuberculosis were alcoholism, comorbidities, pulmonary cavitations, and a radiological pattern suggestive of tuberculosis. Cavitation and previous treatment for tuberculosis were associated with MDR-TB. Conclusions: Despite the significant progress made in the fight against tuberculosis, there is a need for coordinated actions that include social protection measures and patient support.
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Affiliation(s)
- Valéria Martins Soares
- . Hospital Júlia Kubitschek, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte (MG) Brasil
| | | | | | - João Paulo Amaral Haddad
- . Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Belo Horizonte (MG) Brasil
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22
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Barcellos RB, de Almeida IN, da Silva EC, Gomes HM, de Assis Figueredo LJ, Halon ML, Dalla Costa ER, Dos Santos ÍR, Vater MC, Alves S, da Silva Carvalho W, Suffys P, Sola C, de Miranda SS, Rossetti ML, Kritski A. Multicenter evaluation of TB-SPRINT 59-Plex Beamedex®: accuracy and cost analysis. BMC Infect Dis 2019; 19:1047. [PMID: 31823734 PMCID: PMC6905027 DOI: 10.1186/s12879-019-4646-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/22/2019] [Indexed: 11/12/2022] Open
Abstract
Background Molecular tests can allow the rapid detection of tuberculosis (TB) and multidrug-resistant TB (MDR-TB). TB-SPRINT 59-Plex Beamedex® is a microbead-based assay developed for the simultaneous spoligotyping and detection of MDR-TB. The accuracy and cost evaluation of new assays and technologies are of great importance for their routine use in clinics and in research laboratories. The aim of this study was to evaluate the performance of TB-SPRINT at three laboratory research centers in Brazil and calculate its mean cost (MC) and activity-based costing (ABC). Methods TB-SPRINT data were compared with the phenotypic and genotypic profiles obtained using Bactec™ MGIT™ 960 system and Genotype® MTBDRplus, respectively. Results Compared with MGIT, the accuracies of TB-SPRINT for the detection of rifampicin and isoniazid resistance ranged from 81 to 92% and 91.3 to 93.9%, respectively. Compared with MTBDRplus, the accuracies of TB-SPRINT for rifampicin and isoniazid were 99 and 94.2%, respectively. Moreover, the MC and ABC of TB-SPRINT were USD 127.78 and USD 109.94, respectively. Conclusion TB-SPRINT showed good results for isoniazid and rifampicin resistance detection, but still needs improvement to achieve In Vitro Diagnostics standards.
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Affiliation(s)
- Regina Bones Barcellos
- Centro de Desenvolvimento Científico e Tecnológico (CDCT), Secretaria Estadual da Saúde do Rio Grande do Sul (SES/RS), Porto Alegre, RS, Brazil.
| | - Isabela Neves de Almeida
- Laboratório de Pesquisa em Micobactérias, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Elisangela Costa da Silva
- Centro de Pesquisa em Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Harrison Magdinier Gomes
- Laboratório de Biologia Molecular Aplicada a Micobactérias, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Lida Jouca de Assis Figueredo
- Laboratório de Pesquisa em Micobactérias, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Maria Laura Halon
- Centro de Desenvolvimento Científico e Tecnológico (CDCT), Secretaria Estadual da Saúde do Rio Grande do Sul (SES/RS), Porto Alegre, RS, Brazil
| | - Elis Regina Dalla Costa
- Centro de Desenvolvimento Científico e Tecnológico (CDCT), Secretaria Estadual da Saúde do Rio Grande do Sul (SES/RS), Porto Alegre, RS, Brazil.,AstraZeneca do Brasil, Cotia, SP, Brazil
| | - Ícaro Rodrigues Dos Santos
- Laboratório de Biologia Molecular Aplicada a Micobactérias, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Maria Cláudia Vater
- Centro de Pesquisa em Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Suely Alves
- Centro de Pesquisa em Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | | | - Philip Suffys
- Laboratório de Biologia Molecular Aplicada a Micobactérias, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Christophe Sola
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, 91198, Gif-sur-Yvette cedex, France
| | - Silvana Spíndola de Miranda
- Laboratório de Pesquisa em Micobactérias, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Maria Lucia Rossetti
- Centro de Desenvolvimento Científico e Tecnológico (CDCT), Secretaria Estadual da Saúde do Rio Grande do Sul (SES/RS), Porto Alegre, RS, Brazil
| | - Afrânio Kritski
- Centro de Pesquisa em Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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de Almeida IN, Vasconcellos SEG, de Assis Figueredo LJ, Dantas NGT, Augusto CJ, Hadaad JPA, Suffys PN, da Silva Carvalho W, de Miranda SS. Frequency of the Mycobacterium tuberculosis RD Rio genotype and its association with multidrug-resistant tuberculosis. BMC Infect Dis 2019; 19:556. [PMID: 31238885 PMCID: PMC6593491 DOI: 10.1186/s12879-019-4152-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent decades, Mycobacterium tuberculosis with the RDRio genotype, frequently isolated from tuberculosis patients in Rio de Janeiro, has become part of the Latin American - Mediterranean (LAM) family and has been associated with multidrug-resistant tuberculosis (MDR-TB). The aim of this study was to investigate the frequency of M. tuberculosis RDRio in the state of Minas Gerais, Brazil, and its relationship with MDR-TB. METHODS For convenience, 172 susceptible and 63 MDR M. tuberculosis isolates were taken from pulmonary samples from patients diagnosed between January 2007 and December 2011. The DNA extracted from these isolates was analyzed by spoligotyping, PCR-RFLP to characterize fbpC103/Ag85C103, multiplex PCR to detect RDRio and RD174, and MIRU-VNTR 24 loci. RESULTS Among the 235 isolates, the RDRio pattern was identified in 122 (51.9%) isolates (IC 0.45-0.58), with 100 (42.5%) wild-type and 13 (5.5%) mixed pattern isolates, whereas RD174 was identified in 93 of the 122 RDRio positive samples (76.3%). The LAM family and the LAM9 lineage were the most frequently identified among the isolates in this study. Among the 63 MDR isolates, 41 (65.1%) were RDRio and 28 (44.4%) RD174. CONCLUSION The association of both deletions with MDR proved to be statistically significant, corroborating the few reports that have associated RDRio with MDR.
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Affiliation(s)
- Isabela Neves de Almeida
- Laboratório de Pesquisa em Micobactérias, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Sidra Ezidio Gonçalves Vasconcellos
- Laboratório de Biologia Molecular Aplicada a Micobactérias, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Lida Jouca de Assis Figueredo
- Laboratório de Pesquisa em Micobactérias, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Nayanne Gama Teixeira Dantas
- Laboratório de Pesquisa em Micobactérias, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | | | - Philip Noel Suffys
- Laboratório de Biologia Molecular Aplicada a Micobactérias, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | | | - Silvana Spíndola de Miranda
- Laboratório de Pesquisa em Micobactérias, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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Augusto CJ, Carvalho WDS, Almeida IND, Figueiredo LJDA, Dantas NGT, Suffys PN, Miranda SSD. Comparative study of RFLP-IS6110 and MIRU-VNTR from Mycobacterium tuberculosis isolated in the state of Minas Gerais, Brazil. Braz J Microbiol 2017; 49:641-646. [PMID: 29249565 PMCID: PMC6112052 DOI: 10.1016/j.bjm.2017.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 02/08/2017] [Accepted: 04/06/2017] [Indexed: 11/16/2022] Open
Abstract
DNA genotyping of Mycobacterium tuberculosis has been widely applied in the understanding of disease transmission in many countries. The purpose of this study was to genotype the strains of M. tuberculosis isolated in patients with new tuberculosis (TB) cases in Minas Gerais, as well as to compare the similarity, discriminatory power, and agreement of the clusters between the IS6110 Restriction Fragment Length Polymorfism (RFLP) and 12 loci Variable Number Tandem Repeat – Mycobacterial Interspersed Repetitive Units (MIRU-VNTR) techniques. It was observed that 32% (66/204) of the isolated strains in the RFLP-IS6110 and 50.9% (104/204) of the isolated strains in the MIRU-VNTR presented a similarity of equal to or above 85%. The RFLP-IS6110 and MIRU-VNTR proved to contain a high discriminatory power. The similarity index resulting from the RFLP showed no recent transmission. Good agreement was observed between the techniques when clusters were detected; however, the best epidemiological relationship was found when using the RFLP-IS6110.
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Affiliation(s)
- Cláudio José Augusto
- Fundação Ezequiel Dias, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | | | | | | | - Philip Noel Suffys
- Fundação Oswaldo Cruz Foundation (FIOCRUZ), Instituto Oswaldo Cruz, Laboratório de Biologia Molecular Aplicada a Micobactérias, Rio de Janeiro, RJ, Brazil
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Dantas NGT, Suffys PN, Carvalho WDS, Gomes HM, Almeida IND, Figueiredo LJDA, Gonçalves AD, Gomgnimbou MK, Refregier G, Sola C, Miranda SSD. Correlation between the BACTEC MGIT 960 culture system with Genotype MTBDRplus and TB-SPRINT in multidrug resistant Mycobacterium tuberculosis clinical isolates from Brazil. Mem Inst Oswaldo Cruz 2017; 112:769-774. [PMID: 29091137 PMCID: PMC5661900 DOI: 10.1590/0074-02760170062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/13/2017] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND The accurate detection of multidrug-resistant tuberculosis (MDR-TB) is critical for the application of appropriate patient treatment and prevention of transmission of drug-resistant Mycobacterium tuberculosis isolates. The goal of this study was to evaluate the correlation between phenotypic and molecular techniques for drug-resistant tuberculosis diagnostics. Molecular techniques used were the line probe assay genotype MTBDRplus and the recently described tuberculosis-spoligo-rifampin-isoniazid typing (TB-SPRINT) bead-based assay. Conventional drug susceptibility testing (DST) was done on a BACTECTM MGIT 960 TB. METHOD We studied 80 M. tuberculosis complex (MTC) clinical isolates from Minas Gerais state, of which conventional DST had classified 60 isolates as MDR and 20 as drug susceptible. FINDINGS Among the 60 MDR-TB isolates with MGIT as a reference, sensitivity, specificity, accuracy, and kappa for rifampicin (RIF) resistance using TB-SPRINT and MTBDRplus, were 96.7% versus 93.3%, 100.0% versus 100.0%, 97.5% versus 95.0% and 0.94 versus 0.88, respectively. Similarly, the sensitivity, specificity, accuracy, and kappa for isoniazid (INH) resistance were 85.0% and 83.3%, 100.0% and 100.0%, 88.8% and 87.5% and 0.74 and 0.71 for both tests, respectively. Finally, the sensitivity, specificity, accuracy, and kappa for MDR-TB were 85.0% and 83.3%, 100.0% and 100.0%, 88.8% and 87.5% and 0.74 and 0.71 for both tests, respectively. MAIN CONCLUSIONS Both methods exhibited a good correlation with the conventional DST. We suggest estimating the cost-effectiveness of MTBDRplus and TB-SPRINT in Brazil.
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Affiliation(s)
- Nayanne Gama Teixeira Dantas
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | - Phillip Noel Suffys
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular Aplicada a Micobactéria, Rio de Janeiro, RJ, Brasil
| | - Wânia da Silva Carvalho
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Farmácia Social, Laboratório de Biologia Molecular e Saúde Pública, Belo Horizonte, MG, Brasil
| | - Harrison Magdinier Gomes
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Biologia Molecular Aplicada a Micobactéria, Rio de Janeiro, RJ, Brasil
| | - Isabela Neves de Almeida
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | - Lida Jouca de Assis Figueiredo
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Farmácia Social, Laboratório de Biologia Molecular e Saúde Pública, Belo Horizonte, MG, Brasil
| | | | - Michel Kireopori Gomgnimbou
- Centre Muraz, Bobo-Dioulasso, Burkina Faso.,Institut for Integrative Cell Biology, UMR9198 CEA-CNRS-UPSaclay, Orsay, France.,University Paris-Sud, Beamedex SAS, Orsay, France
| | - Guislaine Refregier
- Institut for Integrative Cell Biology, UMR9198 CEA-CNRS-UPSaclay, Orsay, France.,University Paris-Sud, Beamedex SAS, Orsay, France
| | - Christophe Sola
- Institut for Integrative Cell Biology, UMR9198 CEA-CNRS-UPSaclay, Orsay, France.,University Paris-Sud, Beamedex SAS, Orsay, France
| | - Silvana Spíndola de Miranda
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Programa de Pós-Graduação em Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
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Miranda SSD, Almeida IND, Lopes ML, Figueiredo JDRD, Figueredo LJDA, Kritski AL, Carvalho WDS, Mansur MDFFO. Evaluation of the Commercial Kit SIRE Nitratase for detecting resistant Mycobacterium tuberculosis in Brazil. Rev Soc Bras Med Trop 2017; 50:550-553. [DOI: 10.1590/0037-8682-0447-2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 05/04/2017] [Indexed: 11/22/2022] Open
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Navarro PDD, Almeida IND, Kritski AL, Ceccato MDG, Maciel MMD, Carvalho WDS, Miranda SSD. Prevalence of latent Mycobacterium tuberculosis infection in prisoners. J Bras Pneumol 2017; 42:348-355. [PMID: 27812634 PMCID: PMC5094871 DOI: 10.1590/s1806-37562016000000001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 07/31/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: To determine the prevalence of and the factors associated with latent Mycobacterium tuberculosis infection (LTBI) in prisoners in the state of Minas Gerais, Brazil. Methods: This was a cross-sectional cohort study conducted in two prisons in Minas Gerais. Tuberculin skin tests were performed in the individuals who agreed to participate in the study. Results: A total of 1,120 individuals were selected for inclusion in this study. The prevalence of LTBI was 25.2%. In the multivariate analysis, LTBI was associated with self-reported contact with active tuberculosis patients within prisons (adjusted OR = 1.51; 95% CI: 1.05-2.18) and use of inhaled drugs (adjusted OR = 1.48; 95% CI: 1.03-2.13). Respiratory symptoms were identified in 131 (11.7%) of the participants. Serological testing for HIV was performed in 940 (83.9%) of the participants, and the result was positive in 5 (0.5%). Two cases of active tuberculosis were identified during the study period. Conclusions: Within the prisons under study, the prevalence of LTBI was high. In addition, LTBI was associated with self-reported contact with active tuberculosis patients and with the use of inhaled drugs. Our findings demonstrate that it is necessary to improve the conditions in prisons, as well as to introduce strategies, such as chest X-ray screening, in order to detect tuberculosis cases and, consequently, reduce M. tuberculosis infection within the prison system.
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Affiliation(s)
- Pedro Daibert de Navarro
- . Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil.,. Secretaria de Estado de Saúde de Minas Gerais, Belo Horizonte (MG) Brasil
| | | | - Afrânio Lineu Kritski
- . Programa Acadêmico em Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Maria das Graças Ceccato
- . Departamento de Farmácia Social, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
| | | | - Wânia da Silva Carvalho
- . Departamento de Farmácia Social, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
| | - Silvana Spindola de Miranda
- . Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
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Dantas NGT, Suffys PN, Carvalho WDS, Gomes HM, de Almeida IN, de Assis LJ, Augusto CJ, Gomgnimbou MK, Refregier G, Sola C, de Miranda SS. Genetic diversity and molecular epidemiology of multidrug-resistant Mycobacterium tuberculosis in Minas Gerais State, Brazil. BMC Infect Dis 2015; 15:306. [PMID: 26231661 PMCID: PMC4521345 DOI: 10.1186/s12879-015-1057-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 07/23/2015] [Indexed: 11/22/2022] Open
Abstract
Background We aimed to characterize the genetic diversity of drug-resistant Mycobacterium tuberculosis (MTb) clinical isolates and investigate the molecular epidemiology of multidrug-resistant (MDR) tuberculosis from Minas Gerais State, Brazil. Methods One hundred and four MTb clinical isolates were assessed by IS6110-RFLP, 24-locus mycobacterial interspersed repetitive units variable-number tandem repeats (MIRU-VNTR), TB-SPRINT (simultaneous spoligotyping and rifampicin-isoniazid drug-resistance mutation analysis) and 3R-SNP-typing (analysis of single-nucleotide polymorphisms in the genes involved in replication, recombination and repair functions). Results Fifty-seven different IS6110-RFLP patterns were found, among which 50 had unique patterns and 17 were grouped into seven clusters. The discriminatory index (Hunter and Gaston, HGDI) for RFLP was 0.9937. Ninety-nine different MIRU-VNTR patterns were found, 95 of which had unique patterns and nine isolates were grouped into four clusters. The major allelic diversity index in the MIRU-VNTR loci ranged from 0.6568 to 0.7789. The global HGDI for MIRU-VNTR was 0.9991. Thirty-two different spoligotyping profiles were found: 16 unique patterns (n = 16) and 16 clustered profiles (n = 88). The HGDI for spoligotyping was 0.9009. The spoligotyped clinical isolates were phylogenetically classified into Latin-American Mediterranean (66.34 %), T (14.42 %), Haarlem (5.76 %), X (1.92 %), S (1.92 %) and U (unknown profile; 8.65 %). Among the U isolates, 77.8 % were classified further by 3R-SNP-typing as 44.5 % Haarlem and 33.3 % LAM, while the 22.2 % remaining were not classified. Among the 104 clinical isolates, 86 were identified by TB-SPRINT as MDR, 12 were resistant to rifampicin only, one was resistant to isoniazid only, three were susceptible to both drugs, and two were not successfully amplified by PCR. A total of 42, 28 and eight isolates had mutations in rpoB positions 531, 526 and 516, respectively. Correlating the cluster analysis with the patient data did not suggest recent transmission of MDR-TB. Conclusions Although our results do not suggest strong transmission of MDR-TB in Minas Gerais (using a classical 100 % MDR-TB identical isolates cluster definition), use of a smoother cluster definition (>85 % similarity) does not allow us to fully eliminate this possibility; hence, around 20–30 % of the isolates we analyzed might be MDR-TB transmission cases.
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Affiliation(s)
- Nayanne Gama Teixeira Dantas
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, Department of Internal medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Phillip Noel Suffys
- Laboratory of Molecular Biology Applied to Mycobacteria, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Wânia da Silva Carvalho
- Laboratory of Molecular Biology and Public Health, Department of Social Pharmacy, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Harrison Magdinier Gomes
- Laboratory of Molecular Biology Applied to Mycobacteria, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Isabela Neves de Almeida
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, Department of Internal medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Lida Jouca de Assis
- Laboratory of Molecular Biology and Public Health, Department of Social Pharmacy, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | | | - Michel Kireopori Gomgnimbou
- Institut for Integrative Cell Biology, I2BC, UMR9198 CEA-CNRS-UPSaclay, Orsay, France. .,Centre Muraz, Bobo-Dioulasso, Burkina Faso.
| | - Guislaine Refregier
- Institut for Integrative Cell Biology, I2BC, UMR9198 CEA-CNRS-UPSaclay, Orsay, France.
| | - Christophe Sola
- Institut for Integrative Cell Biology, I2BC, UMR9198 CEA-CNRS-UPSaclay, Orsay, France.
| | - Silvana Spíndola de Miranda
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, Department of Internal medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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de Almeida IN, Aleixo AV, Carvalho WDS, de Miranda SS. In-house PCR with DNA extracted directly from positive slides to confirm or exclude the diagnosis of tuberculosis: focus on biosafety. Rev Argent Microbiol 2015; 47:47-9. [PMID: 25724341 DOI: 10.1016/j.ram.2014.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 12/03/2014] [Accepted: 12/05/2014] [Indexed: 10/23/2022] Open
Abstract
The possibility to obtain DNA from smears is a valuable alternative to remedy the lack of samples when they are totally used for bacilloscopy; this technique solves the biosafety problem related to a possible accident with the transportation of flasks containing potentially transmissible clinical samples. Hence, the purpose of this study was to utilize the insertion sequence IS6110 for amplification of DNA from a smear-positive sample for tuberculosis (TB) diagnosis. Among the 52 positive bacilloscopies, sensitivity, specificity, positive predictive value and negative predictive value were 52.3%, 100%, 100% and 89.7%, respectively whereas accuracy was 90.7%. The IS6110-based PCR for TB diagnosis developed in DNA extracted from a positive smear is a fast, simple, specific, and safe method.
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