Navegando por Autor "Kritski, Afrânio"

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    Impact of a computer system as a triage tool in the management of pulmonary tuberculosis in a HIV reference center in Brazil.
    (2022) Libório, Mariana Pitombeira; Kritski, Afrânio; Almeida, Isabela Neves de; Miranda, Pryscila Fernandes Campino; Mesquita, Jacó Ricarte Lima de; Mota, Rosa Maria Salani; Sousa, George Jó Bezerra; Neto, Roberto da Justa Pires; Leitão, Terezinha do Menino Jesus Silva
    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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    Molecular characterization of nontuberculous Mycobacteria in a tuberculosis and HIV reference unit in the State of Amazonas, Brazil.
    (2022) Lima, Ana Carolina de Oliveira de; Schmid, Karen Barros; Melo, Hilda Ferreira de; Athayde, Rafaella Christine; Monte, Rossiclea Lins; Almeida, Isabela Neves de; Miranda, Silvana Spíndola de; Kritski, Afrânio; Rossetti, Maria Lucia Rosa; Santos, Marcelo Cordeiro dos
    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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    The activity-based cost of drug-susceptibility test of Mycobacterium tuberculosis through Kit SIRE Nitratase® plastlabor.
    (2020) Almeida, Isabela Neves de; Silva, Suely Conceição Alves da; Oliveira Junior, Haliton Alves de; Figueredo, Lida Jouca de Assis; Soares, Valéria Martins; Carvalho, Wânia da Silva; Kritski, Afrânio; Fiori, Maria Cláudia da Silva Vater da Costa; Miranda, Silvana Spíndola de
    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 BactecTM MGITTM 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 BactecTM MGITTM 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 BactecTM MGITTM 960. Conclusion: The Kit SIRE should be used as a screening method in clinical specimens and in culture for laboratories that do not have BactecTM MGITTM 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.