Amplification of Mycobacterium tuberculosis from peripheral blood.
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Biomedical subjects
Publications and source records attributed to E Palenque.
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We used a test based on the polymerase chain reaction (PCR) for the detection of Mycobacterium tuberculosis DNA in 11 CSF samples from 10 HIV-seropositive patients in whom tuberculous meningitis was suspected. PCR was positive in nine samples from eight patients in whom clinical data, CSF findings, evidence of tuberculosis at an extraneural site, and response to antituberculous drug therapy supported the diagnosis, whereas cultures were positive in five of these nine samples and staining in only one. The PCR was negative in 14 CSF samples from the control group.
We have evaluated the polymerase chain reaction for detection of Mycobacterium tuberculosis in clinical samples from patients with tuberculous infection. Two simple methods for mycobacterial DNA release have been compared: sonication and lysis with nonionic detergents and proteinase K. The more effective method was the enzymatic technique. By using this protocol with 75 specimens we detected M. tuberculosis DNA in all of the samples, whereas only 48 and 71 samples were positive by acid-fast staining and culture, respectively.
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Over a period of two years, 1364 clinical samples from pulmonary sources, were studied in order to compare the Bactec-TB system with the Löwenstein-Jensen medium, for isolation of mycobacteria. Within this period of time, 93 strains of Mycobacterium tuberculosis were isolated, 71 (76%) were isolated by the Bactec system, and 69 (74%) were isolated by the Löwenstein-Jensen. The number of contaminations was lower for the Bactec system (3.2%) than for the Löwenstein-Jensen medium (5.3%). The mean time of isolation with the Bactec was 16.4 days. The mean time of isolation with Löwenstein-Jensen medium was 21.9 days. Identification of the strains with the Bactec system by the p-nitro-a-acetilamin-beta-hidroxipropiphenone inhibition test gave a 100% correlation with the conventional biochemical methods used for the identification of the same strains growth of Löwenstein-Jensen.
Four hundred and forty-five patients diagnosed of active thoracic or extrathoracic tuberculosis during a 6 year period were retrospectively reviewed. An increase in the rate of cases was found through the surveyed period. Less than 20% of patients were over 60 years of age at the time of diagnosis. Although the most common localizations were pulmonary and pleural, the disease was exclusively extrathoracic in one fifth of patients. Ten patients died of tuberculosis; 9.6% of patients had untoward side effects of tuberculostatic drugs and 14% did not comply with the scheduled follow up.
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There is a clear difference between TB infection and TB. Transition from the former to the latter involves host factors and perhaps environmental elements. Currently, more individuals with immunosuppressive situations caused by aging, debilitating diseases, immunosuppressive therapies, and HIV-III infection are predisposed to secondary forms of TB. Different patterns of clinical presentation, at variance with those previously described, could result from these changes in the host. PTBA is a good example. In the present review of 52 patients, we found that patient age is rising, as has been reported in other western countries. We also found that oligoarthritis and involvement of non-weight-bearing joints is becoming more common. From the diagnostic point of view, histological studies and cultures of synovial tissue remain the most reliable tests. Awareness of these factors, recognition of changing patterns, proper use of diagnostic procedures, and early treatment should improve the outcome of patients.
The diagnostic yields of bronchial washings, bronchial brushings and lung biopsy specimens were compared in 50 patients with positive Mycobacterium tuberculosis cultures. The number of positive results obtained with cultures of bronchial brushings was significantly higher than that with bronchial washings (p less than 0.001). The histological study of biopsy lung material improved the rate of immediate or rapid diagnosis of tuberculosis (p less than 0.001).
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The in vitro susceptibilities of 83 clinical isolates of Brucella melitensis to seven cephalosporins and a monobactam were determined. Ceftizoxime, ceftriaxone, and cefotaxime were the most effective agents tested, with MICs ranging from 0.25 to 2 micrograms/ml. Moxalactam, cefoperazone, cefuroxime, and ceftazidime showed MICs between 4 and 64 micrograms/ml, with moxalactam being the most active agent in this group. Aztreonam showed poor activity, with MICs higher than 64 micrograms/ml.
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A simple method for carrying out the Coombs test with U-shaped microtiter plates instead of tubes is described. This technique provides reliable and more rapid testing of large numbers of sera in suspected cases of human brucellosis.
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