Abstract
In order to assess laboratory resources, practices, and biosafety measures during mycobacterial testing and determine the usefulness and scope of mycobacterial techniques, a cross-sectional survey of public laboratories was conducted in Argentina using a structured questionnaire. Sputum smear analysis showed that both smear and culture testing centers are being provided at or above the WHO recommended density for such facilities. The microscopy quality assessment program covered most high-demand laboratories. Mean number of sputum smears per patient was low (1.6). The use of inadequate personal respiratory protection was identified in 25% of culture laboratories. Jurisdictions that cultured a higher proportion of their smear-tested sputa identified a higher proportion of smear-negative cases. The percentage of smear negatives among all bacteriologically confirmed pulmonary cases was 18.9%, while most extrapulmonary cases were confirmed by culture (71.3%). In conclusion, increasing the number of sputa studied by microscopy and culture (while expanding the coverage of the quality assessment program) is a priority; adequate respiratory protection and regular medical evaluation of laboratory staff is still needed in some laboratories.
Highlights
In order to assess laboratory resources, practices, and biosafety measures during mycobacterial testing and determine the usefulness and scope of mycobacterial techniques, a cross-sectional survey of public laboratories was conducted in Argentina using a structured questionnaire
Sputum smear analysis showed that both smear and culture testing centers are being provided at or above the WHO recommended density for such facilities
The use of inadequate personal respiratory protection was identified in 25% of culture laboratories
Summary
Examen microscópico directo para la detección de bacilos ácido-alcohol resistentes. Entre los laboratorios que realizaban cultivo, la cobertura alcanzó al 78% (79/101). Globalmente, considerando la información del censo de población, se podría estimar que los laboratorios participantes cubrían el 90% de la población del país. Los laboratorios participantes enviaron información no sólo acerca del volumen de muestras respiratorias estudiadas por examen microscópico directo, sino también acerca del número de pacientes sintomáticos respiratorios de los que se obtuvieron dichas muestras. El promedio de examen microscópico directo/pacientes sintomáticos respiratorios fue de [1,6], con un rango de [1,1] a 2 entre las distintas provincias. La relación del número de pacientes investigados para encontrar un caso examen microscópico directopositivo (tasa de positividad) varió desde 147:1 a 16:1.
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