Difficulties of Tuberculosis Diagnosis

Borodulina, Elena; Skoptsova, N.; Borodulin, B. E.; Amosova, E.A.; Povalyaeva, L.

doi:10.29296/25877305-2018-02-07

Cited by 9 publications

(2 citation statements)

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“…При рутинном исследовании мокроты методом микроскопии микобактерии туберкулеза обнаружены не были, лишь при исследовании промывных вод молекулярно-генетическим методом у 33,3% пациентов (от числа обследованных данным методом) выявлена ДНК микобактерий туберкулеза, что позволило подтвердить диагноз туберкулез на этапе пульмонологического отделения. Отсутствие обнаружения КУМ при микроскопии с окраской по Цилю -Нильсену на этапе лабораторий стационаров общей лечебной сети диктует необходимость совершенствования обучения персонала соответствующих лабораторий [13,14,15]…”

Section: Discussionunclassified

Identification of tuberculosis in patients of pulmonology department, including patients with HIV infection

Dubrovskaya

Игоревна²,

Зенкова

et al. 2021

Science and Innovations in Medicine

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Objectives to define the possibilities of diagnosing tuberculosis in patients of pulmonology hospital, including patients with HIV infection. Material and methods. During this retrospective one-step study, we analyzed 103 medical records of patients in pulmonology departments who had received a full range of laboratory and instrumental examinations, including the Mantoux test and the test with a recombinant tuberculosis allergen (Diaskintest). The patients were divided into two groups depending on their HIV status: Group 1 included 78 HIV-negative patients, Group 2 consisted of 25 HIV-positive patients. Results. A microscopy of sputum and bronchial lavage did not reveal acid-resistant mycobacteria in all patients. PCR test for M. tb DNA was positive in three patients in Group 1 (33.3 13.9% of the total number of examined patients) and in one patient in Group 2 (25.0 13.9%) (2 = 0.01; p = 0.931). According to the results of immunodiagnostics, a positive normergic reaction to the Mantoux test was observed in 24 patients in Group 1 and in 7 patients in Group 2 (30.8 5.2% and 28.9 9.0% respectively), 2 = 0.04; p = 0.846. The reaction for recombinant tuberculosis allergen (Diaskintest) was positive in 9 patients in Group 1 (11.5 3.6%) and in 5 patients in Group 2 (20.0 8.0%), 2 = 0.85; p = 0.358. Based on clinical, laboratory, instrumental and immunological examinations by a TB doctor, in total 12 patients (11.7%) were diagnosed with tuberculosis. These patients were distributed among the study groups as follows: 9 people (11.5 3.6%) in Group 1 and 3 people (12.0 6.5%) in Group 2 (2 = 0.0; p = 0.956). Conclusion. The inclusion of the Mantoux test and the reaction for recombinant tuberculosis allergen (Diaskintest) in the set of diagnostic tests for patients of the pulmonology department of the general hospital simplified the differential diagnosis of tuberculosis and pneumonia, both for a pulmonologist and a TB specialist.

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Section: Discussionunclassified

Identification of tuberculosis in patients of pulmonology department, including patients with HIV infection

Dubrovskaya

Игоревна²,

Зенкова

et al. 2021

Science and Innovations in Medicine

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“…Therefore, molecular methods could be used in patients highly suspected for TB. ентировочных результатов при обязательном параллельном применении классических микробиологических методов диагностики ТБ [14,16]. В последние годы возросло число случаев применения внутрикожной пробы с аллергеном туберкулезным рекомбинантным (Диаскинтест) для диагностики ТБ и оценки активности процесса, дифференциальной диагностики ТБ, поствакцинальной и инфекционной аллергии.…”

Section: Introductionunclassified

New possibilities to diagnose pulmonary tuberculosis at a pulmonology inpatient department

Borodulina¹,

Бородулин²,

Инькова³

et al. 2019

Pulʹmonologiâ (Mosk.)

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The aim of the study was to investigate new methods for pulmonary tuberculosis (TB) detection at a pulmonology inpatient department.Methods. Pulmonary TB cases (n = 49) newly diagnosed at a pulmonology department of a hospital were involved in the study; among them, 69.4% of patients were infected with human immunodeficiency virus (HIV). All patients were asked if he/she had previously contacted with other TB patients, and if he/she was diagnosed with TB previously. The patients were also about family history. Posteroanterior and lateral chest X-ray and laboratory analyses were performed in all patients. Mycobacteria tuberculosis (MBT) were searched using smear microscopy, GeneXpert MTB/RIF molecular method and culturing (BACTEC MGIT) of sputum and bronchoalveolar lavage fluid (BALF) obtained during bronchoscopy. Patients with positive results only were included in the analysis in order to investigate and to compare diagnostic value of the methods.Results. Questioning patients at admission was useful to diagnose TB in 4% of patients. Sputum smears were positive in 12 patients (27.3%). BALF was obtained in 18 patients (36.7%); among them, MBT was identified in 52 (5%). Molecular testing was positive in all 49 patients (100%); among them, BACTEC MGIT culturing yielded MBT in 48 patients (97.9%). In patients with negative sputum smears during the first 3 days after admission, GeneXpert required 10.4 ± 5.3 days.Conclusion. GeneXpert method was highly useful to diagnose TB and was comparable with BACTEC. Routine sputum and BALF smear microscopy was significantly less rapid and less sensitive method. The diagnostic accuracy could be increased with the use of molecular methods in patients with negative sputum smears obtained at a general hospital. Therefore, molecular methods could be used in patients highly suspected for TB.

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Iron Metabolism and Indicators Reflecting Its Changes in Pulmonary Tuberculosis (Review of Literature)

Borodulina

Яковлева

2020

RCLD

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Iron is an essential element for human and bacteria, including mycobacterium tuberculosis. Over review includesthe literature on the problem of iron metabolism in patients with tuberculosis and with comorbid pathology HIV infection and tuberculosis. The literature was searched for when writing this review using the RSCI, CyberLeninka, Scopus, Web of Science, MedLine, PubMed databases using the following keywords: iron, ferritin, hepsidin, lactoferrin, tuberculosis, pneumonia, HIV infection. Iron compounds are involved in many redox reactions: oxygen transport, cellular respiration, the trichloroacetic acid cycle, DNA biosynthesis, and others. The ratio of intracellular and extracellular iron in the body is regulated by the low molecular weight hormone hepcidin, the mechanism of action of which is to block the function of ferroportin, an exporter of iron from cells, which leads to the accumulation of the intracellular iron pool and the prevention of the toxic effect of free iron. The role of iron in the interaction of the human body with ferro-dependent bacteria has been established. Iron is necessary for the growth and development of bacterial cells, and the methods for its production from the host are different. Information on the effect of iron metabolism on pulmonary tuberculosis is scarce and contradictory: some authors have identified a decrease in hemoglobin and transferrin in combination with elevated levels of ferritin in patients with tuberculosis; according to other sources, hyperferritinemia in tuberculosis cannot be predictive, but is a marker inflammation. At the same time, there are studies that indicate a significant increase in ferritin in patients with disseminated tuberculosis relative to other clinical forms. Currently, the incidence of tuberculosis in patients with HIV infection is increasing, while diagnostic tests are not very informative. The search for diagnostic markers in terms of iron metabolism may open up new possibilities for the diagnosis of pulmonary tuberculosis.

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Difficulties of Tuberculosis Diagnosis

Cited by 9 publications

References 0 publications

Identification of tuberculosis in patients of pulmonology department, including patients with HIV infection

Identification of tuberculosis in patients of pulmonology department, including patients with HIV infection

New possibilities to diagnose pulmonary tuberculosis at a pulmonology inpatient department

Iron Metabolism and Indicators Reflecting Its Changes in Pulmonary Tuberculosis (Review of Literature)

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