Ways to Optimize Detection of Tuberculosis in a Pulmonology Unit

Borodulina, Elena; Инькова, А. Т.; Бородулин, Б. Е.; Поваляева, Л. В.

doi:10.21292/2075-1230-2018-96-5-22-26

Cited by 8 publications

(2 citation statements)

References 11 publications

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“…Кожная туберкулиновая проба Манту еще довольно широко используется в современной диагностике туберкулезной инфекции, несмотря на то что ей уже более ста лет. Однако ее диагностические возможности в настоящее время характеризуются низкой специфичностью и чувствительностью (менее 50%) [15,16]. На современном этапе диагностики туберкулезной инфекции предложена новая кожная проба с препаратом Диаскинтест [17].…”

Section:  введениеunclassified

Immunodiagnosis of Tuberculosis: Advantages and Disadvantages

Будрицкий¹,

Серёгина²,

Правада³

et al. 2023

Клиническая Инфектология И Паразитология

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Одним из приоритетных направлений в борьбе с туберкулезом является своевременная и достоверная диагностика туберкулеза легких. Для диагностики туберкулеза легких на современном этапе широко используются иммунологические методы. Оценка результатов пробы Манту и кожной пробы с препаратом Диаскинтест (АТР – аллерген туберкулезный рекомбинантный) носит субъективный характер, а также различается в разных странах и поэтому не всегда может быть достоверным критерием установления диагноза туберкулеза. Иммунодиагностика туберкулеза стала более информативной на современном этапе благодаря разработке и внедрению иммунологических тестов нового поколения IGRA (Interferon Gamma Release Assay). IGRA-тесты автоматизированы, и поэтому их результаты более объективны. Эти тесты позволяют выявить активные и латентные формы туберкулеза и характеризуются высокой специфичностью и чувствительностью. Все методы иммунологической диагностики, используемые на современном этапе, имеют как преимущества, так и недостатки. Поэтому они могут использоваться в зависимости от цели и возможностей лечебного учреждения и обязательно должны интерпретироваться в комплексе с другими диагностическими методами. One of the priorities in the fight against tuberculosis is the timely and reliable diagnosis of pulmonary tuberculosis. For the diagnosis of pulmonary tuberculosis at the present stage, immunological methods are widely used. Evaluation of the results of the Mantoux test and skin test with the drug Diaskintest (ATP) is subjective, and also varies in different countries and therefore may not always be a reliable criterion for establishing a diagnosis of tuberculosis. The immunodiagnosis of tuberculosis has become more informative at the present stage due to the development and implementation of a new generation of immunological tests IGRA (Interferon Gamma Release Assay). IGRA-tests are automated and therefore their results are more objective. These tests can detect active and latent forms of tuberculosis and are characterized by high specificity and sensitivity. All methods of immunological diagnostics used at the present stage have both advantages and disadvantages. Therefore, they can be used depending on the purpose and capabilities of the medical institution and must be interpreted in conjunction with other diagnostic methods.

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Section:  введениеunclassified

Immunodiagnosis of Tuberculosis: Advantages and Disadvantages

Будрицкий¹,

Серёгина²,

Правада³

et al. 2023

Клиническая Инфектология И Паразитология

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“…The most likely diagnoses for HIV infection and pulmonary dissemination are pneumonia caused by Pneumocystis jirovecii and disseminated pulmonary tuberculosis [10,11]. Verification of these diagnoses presents substantial difficulty because the results of specific diagnostic tests are often negative [12].…”

Section: Introductionmentioning

confidence: 99%

Features Of Iron Metabolism In Patients With HIV Infection And Pulmonary Dissemination In Tuberculosis And Pneumonia: An Exploratory Case-Control Study

Borodulina

Яковлева

2022

Russ Open Med J

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Background — Differential diagnosis of pneumonia vs. tuberculosis in patients with HIV infection and pulmonary dissemination syndrome is an important problem in contemporary clinical medicine. The goal of our study was to determine the features of iron metabolism in patients with HIV infection and pulmonary dissemination in tuberculosis and pneumonia. Methods — The case-control study was conducted on 42 cases (patients with tuberculosis, hereinafter referred to as Group 1) and 44 control subjects (patients with pneumonia, hereinafter referred to as Group 2). All of them had HIV infection and syndrome of pulmonary dissemination. For subjects in both groups, we analyzed clinical and social characteristics, along with laboratory data. We also examined hepcidin content, iron concentration, and ferritin level in blood serum, and performed statistical data processing. Findings — There were significant differences between cases and controls in terms of iron metabolism. Hepcidin and hemoglobin levels were statistically significantly higher (p <0·001), whereas iron concentration was lower (p=0·0002) in patients with tuberculosis (cases). Furthermore, there were statistically significant differences between groups in CD4+ T-cell count, viral load, and RBC and WBC counts in complete blood count tests; in duration of complaints prior to hospital admission; and in terms of job stability. Conclusion — The quantitative parameters with the greatest statistical significance of the differences between the groups were iron concentration, hepcidin level, RBC count, WBC count, and CD4+ T-cell count.

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Test with recombinant tuberculosis allergen (Diaskintest®) in the diagnosis of pulmonary tuberculosis in pulmonological practice

Шубина

Borodulina

Kudlаy

et al. 2022

Pulʹmonologiâ (Mosk.)

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Differential diagnosis of pulmonary tuberculosis and community-acquired pneumonia remains an urgent problem in primary health care despite the improvement of radiological and laboratory diagnostic methods.The aim of study was to evaluate the possibility of using a skin test with recombinant tuberculosis allergen (Diaskintest®, Generium, Russia) for the differential diagnosis of pulmonary tuberculosis and pneumonia.Methods. 119 cases of pulmonary tuberculosis first detected in the pulmonology department during differential diagnosis were analyzed. The diagnosis was verified by a liquid media culture in the BACTEC MGIT 960 system (BD, USA). All patients with suspected tuberculosis had a skin test with recombinant tuberculosis allergen upon admission. Statistical analysis was carried out using the statistical software package IBM SPSS Statistics 22.0. The differences were considered statistically significant at p < 0.05.Results. Most patients were of working age and had aggravating social risk factors 49 (41.2%), HIV-infection 75 (63.0%), drug addiction 44 (36.9%), or viral hepatitis C 33 (24.2%). As for the clinical forms, infiltrative and disseminated tuberculosis prevailed. Evaluation of the results of the «fast» methods of the diagnostic minimum showed that a positive result of the test with Diaskintest® was almost three times more likely than the positive result of bacterioscopy of a sputum smear with Ziehl–Neelsen staining. Mycobacterium tuberculosis DNA was detected in sputum using the GeneXpert MTB/RIF cartridge technology in 92.6% patients with a positive result of Diaskintest® skin test and a negative sputum bacterioscopy analysis.Conclusion. Is advisable to use Diaskintest® skin test in patients of a pulmonological hospital in the early stages and confirm the positive result with GeneXpert MTB/RIF to reduce the time for diagnosing tuberculosis and the patient’s bed-days in a non-specialized medical institution.

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Ways to Optimize Detection of Tuberculosis in a Pulmonology Unit

Cited by 8 publications

References 11 publications

Immunodiagnosis of Tuberculosis: Advantages and Disadvantages

Immunodiagnosis of Tuberculosis: Advantages and Disadvantages

Features Of Iron Metabolism In Patients With HIV Infection And Pulmonary Dissemination In Tuberculosis And Pneumonia: An Exploratory Case-Control Study

Test with recombinant tuberculosis allergen (Diaskintest®) in the diagnosis of pulmonary tuberculosis in pulmonological practice

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