QUALITY-CONTROL IN TUBERCULOSIS BACTERIOLOGY .2. THE ORIGIN OF ISOLATED POSITIVE CULTURES FROM THE SPUTUM OF PATIENTS IN 4 STUDIES OF SHORT COURSE CHEMOTHERAPY IN AFRICA
QUALITY-CONTROL IN TUBERCULOSIS BACTERIOLOGY .2. THE ORIGIN OF ISOLATED POSITIVE CULTURES FROM THE SPUTUM OF PATIENTS IN 4 STUDIES OF SHORT COURSE CHEMOTHERAPY IN AFRICA
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DOI：
10.1016/0041-3879(80)90002-1
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发表时间：
1980-01-01
期刊：
影响因子：
--
通讯作者：
NUNN, AJ
中科院分区：
文献类型：
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作者：
MITCHISON, DA;KEYES, AB;NUNN, AJ
在非洲4项对照临床试验中，对2123名接受短程化疗方案且未发生细菌学复发的患者进行了强化细菌学随访，从3个东非实验室的37，429份痰标本中获得了405份分离阳性培养物。这些培养物可能是由于文书错误、实验室中杆菌从阳性样本转移到阴性样本或患者病变所致。标本标签或结果记录中的文书错误似乎不是常见原因，因为分离的阳性培养物所含菌落数比同时处理的其他阳性标本的培养物少得多。几条证据表明，一些分离的阳性培养物来自患者的病变：在化疗后的连续时间段内，其发生率下降;每个患者分离的阳性培养物数量显著偏离泊松分布;它们比当时处理的其他培养物更经常耐药;插入研究标本中的已知高压灭菌标本获得阳性培养物的频率低于研究标本本身;分离阳性的发生率和含有大量活M的标本之间没有发现关联。肺结核与此同时其中一些培养物可能是通过实验室转移产生的，因为已知3个实验室的转移率不同，并且与获得分离阳性培养物的比率相对应。
During intensive bacteriological follow-up of 2123 patients who received short course chemotherapy regimens in 4 controlled clinical trials in Africa and had not had a bacteriological relapse, 405 isolated positive cultures were obtained from 37,429 sputum specimens in 3 East African laboratories. These cultures might have arisen as a result of clerical error, of transfer of bacilli from positive to negative specimens in the laboratory or from the lesions of the patients. Clerical error in the labeling of specimens or the recording of results did not seem a frequent cause, since isolated positive cultures contained many fewer colonies than cultures from other positive specimens being processed at the same time. Several lines of evidence suggested that some isolated positive cultures arose from the lesions of patients: a decrease in their incidence occurred in successive time periods after chemotherapy; the number of isolated positives per patient departed significantly from the Poisson distribution; they were more often drug resistant than other cultures processed at the time; positive cultures were obtained less frequently from known autoclaved specimens inserted among the study specimens than from the study specimens themselves; no association was found between the incidence of isolated positives and of specimens containing numerous viable M. tuberculosis being processed at the same time. Some of these cultures probably arose by transfer in the laboratory, since the rates at which transfers were known to occur differed in the 3 laboratories and corresponded to the rates of obtaining isolated positive cultures.