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Epidemiologia y resultados diagnósticos en un grupo de pacientes con sospecha clínica de tuberculosis pleural, sometidos a evaluación con pruebas fenotípicas y moleculares en cuatro hospitales de la Ciudad de Bogotá, Colombia

Authors: Sierra Angulo, Hector Enrique;

Epidemiologia y resultados diagnósticos en un grupo de pacientes con sospecha clínica de tuberculosis pleural, sometidos a evaluación con pruebas fenotípicas y moleculares en cuatro hospitales de la Ciudad de Bogotá, Colombia

Abstract

El diagnóstico de Tuberculosis pleural (TBPL), constituye un reto diagnóstico para el clínico dado el bajo rendimiento o poca disponibilidad de pruebas tradicionales. A pesar de esto, pocos estudios describen el comportamiento de pruebas moleculares como alternativa diagnóstica en la práctica clínica. En este estudio descriptivo de corte trasversal, se obtuvieron datos epidemiológicos y muestras de líquido pleural de 80 pacientes adultos con sospecha de tuberculosis pleural sometidos a pruebas fenotípicas (baciloscopia y cultivo), determinación de niveles de Adenosina desminase (ADA) y a múltiples pruebas moleculares (PCR- IS6110, GenotypeMTBDRplus 2.0, PCR multiplex IS6110-hsp65 y qPCR- IS6110) de forma simultánea y descritos en relación con datos epidemiológicos. TBPL fue diagnosticada en 17 de 80 pacientes, más frecuentemente en hombres (82.4%), menores de 50 años (47.1%), pacientes con VIH (58.8%) y con antecedente de TB (35.3%). Cultivo y baciloscopia fueron positivos en 2 de 17 pacientes, ADA fue positivo en 8 de 17 pacientes y las pruebas moleculares en 10 de 17 pacientes. Adicionalmente 7 pacientes sin diagnóstico de TBPL presentaron resultado positivo para prueba molecular. Existe utilidad de las pruebas moleculares en el diagnóstico diferencial del derrame pleural, permitiendo confirmación rápida y adecuada toma de decisiones clínicas. Abstract: The diagnosis of pleural tuberculosis (PT) is a diagnostic for the clinician due to the poor performance or limited availability of traditional tests. Despite this, few studies describe the behavior of molecular testing as alternative diagnosis in clinical practice. In this cross-sectional descriptive study, the epidemiological data and pleural fluid samples were obtained from 80 adult patients with suspicion of pleural tuberculosis who simultaneously underwent phenotypic tests (bacilloscopy and culture), determination of levels of adenosine deminase (ADA) and multiple molecular tests (IS6110 PCR, GenoType MTBDRplus 2.0, hsp65/IS6110 multiplex PCR and IS6110 qPCR) described in relation to epidemiological data. Seventeen out of the 80 patients were diagnosed with PT, more frequently in men (82.4%) less than 50 years old (47.1%), patients with HIV (58.8%) and with TB history (35.3%). Culture and bacilloscopy were positive in 2 of the 17 patients, ADA was positive in 8 of the 17 patients and molecular tests in 10 out of 17 patients. In addition, 7 patients without PT diagnosis had a positive molecular test result. Molecular testing is useful in the differential diagnosis of pleural effusion, allowing rapid confirmation and appropriate clinical decision-making. Otra

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Keywords

qPCR-IS6110, Tuberculosis pleural, 61 Ciencias médicas; Medicina / Medicine and health, Culture, Pleural fluid, Pleural tuberculosis, Bacilloscopy, Baciloscopia, Genotype MTBDRplus, Cultivo, PCR multiplex IS6110-hsp65, Líquido pleural

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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