ABSTRACT

Background: Tuberculosis is an infectious-contagious disease, mainly caused by Mycobacterium tuberculosis, which can be manifested in pulmonary (PTB) in 85% of cases and the rest in extra pulmonary form (EPTB), currently it is a public health problem and the best laboratory diagnosis is the culture (standard reference for diagnosis). Material and methods: An observational and retrospective study was carried out, based on the isolation of M. tuberculosis, in extrapulmonary samples by culture using the BACTEC MGIT-960 equipment, as well as the identification and drug-sensitivity tests for each of the isolates. Results: 654 samples were cultured, obtaining a positivity of 5.5% (36 isolations), 7 of them in patients younger than 15 years old and 3 in patients older than 60 years old, according to the organ/tissue affected: 30.6% skin, 27.8% renal, 11.1% thoracic cavity (except lung), digestive system and joints, respectively, and 8.3% CNS (central nervous system). From the total isolates of the M. tuberculosis complex includes a strain of M. bovis. Regarding the results of drug-sensitivity, 100% sensitivity was obtained for etambutol and rifampicin, 94.5% for isoniacin and 44.0% for pirazinamide. Conclusions: The importance of culture for the diagnosis and tests of drug-sensitivity in patients with suspected EPTB was demonstrated.

KEYWORDS

Culture, M. tuberculosis, drug sensitivity, extrapulmonary tuberculosis.

REFERENCES

1. Müller B, Dürr S, Alonso S, et al. Zoonotic Mycobacterium bovis–induced tuberculosis in humans. Emerg Infect Dis 2013;19(6):899-908. doi: 10.3201/eid1906.120543.

2. WHO. Global Tuberculosis Report 2014. World Health Organization: Geneva; 2014.

3. Alcaide F, Esteban J. Infecciones cutáneas y de partes blandas por micobacterias no tuberculosas. Enferm Infecci Microbiol Clin 2010;28 supl 1:46-50. doi: 10.1016/S0213-005X(10)70008-2.

4. Secretaría de Salud. Boletín epidemiológico 2011-2015. CENAVECE /SSA.

5. González-Martín J, García-García JM, Anibarro L, et al. Documento de consenso sobre el diagnóstico, tratamiento y prevención de la tuberculosis. Enferm Infecc Microbiol Clin 2010;28(5):297.e1-20. doi: 10.1016/j.eimc.2010.02.006.

6. Ramírez-Lapausa M, Menéndez-Saldaña A, Noguerado-Asensio A. Tuberculosis extrapulmonar, una revisión. Rev Esp Sanid Penit 2015;17(1):3-11.

7. Llaca-Díaz JM, Flores-Aréchiga A, Martínez-Guerra MG, Cantú-Martínez PC. La baciloscopia y el cultivo en el diagnóstico de la tuberculosis extrapulmonar. Rev Salud Pub Nutric 2003;4(3):34-35.

8. Tadesse M, Abebe G, Abdissa K, et al. Concentration of lymph node aspirate improves the sensitivity of acid fast smear microscopy for the diagnosis of tuberculous lymphadenitis in Jimma, southwest Ethiopia. PLoS One 2014;9(9):e106726. doi: 10.1371/journal.pone.0106726.

9. Shenoy V, Chakradhar V, Munim F, Mukhopadhyay C. An integrated approach using liquid culture system can it make an impact for clinical diagnosis of genitourinary tuberculosis? Ann Med Health Sci Res 2014;2014:4(Suppl 2):S144-S146. doi: 10.4103/2141-9248.138037.

10. Derese Y, Hailu E, Assefa T, et al. Comparison of PCR with standard culture of fine needle aspiration samples in the diagnosis of tuberculosis lymphadenitis. J Infect Dev Ctries 2016;6(1):53-57.

11. Secretaría de Salud. Norma Oficial Mexicana para la Prevención y Control de la Tuberculosis NOM-006-SSA2-2013. Diario Oficial de la Federación: 13/11/2013.

12. SSA, InDRE. Lineamientos para la vigilancia epidemiológica de la tuberculosis por laboratorio. 2015.

13. WHO. Global tuberculosis control-surveillance, planning, financing. WHO Report, 2009.

14. Hopewell PC. International standards for tuberculosis care. 3ra rd. USAID/WHO, USA: Tb Care I; 2014. p. 20-23.

15. Solovic I, Jonsson J, Korzeniewska-Koseła M, et al. Challenges in diagnosing extrapulmonary tuberculosis in the European Union, 2011. Euro Surveill 2013;18(12). pii: 20432.

16. Medina-Morales F, Rufino-Echegoyen C, Medina-Zarco LE. Tuberculosis extrapulmonar. Neumol Cir Torax 2003;62(2):92-95.

17. Maurya AK, Nag VL, Kant S, et al. Prevalence of nontuberculous mycobacteria among extrapulmonary tuberculosis cases in tertiary care centers in Northern India. Biomed Res Int 2015;2015:465403. doi: 10.1155/2015/465403.

18. Orozco-Andrade I, Nesbitt-Falomir C, González-Ortíz S. Tuberculosis en pediatría: epidemiología. Revista de Enfermedades Infecciosas en Pediatría 2009;22(87):83-90.

19. Donald PR. Childhood tuberculosis: out of control? Curr Opin Pulm Med 2002;8(3):178-182.

20. Milburn H. Key issues in the diagnosis and management of tuberculosis. J R Soc Med 2007;100(3):134-141.

21. Yaramiş A, Gurkan F, Elevli M, et al. Central nervous system tuberculosis in children: a review of 214 cases. Pediatrics 1998;102(5):e49.