# 43. 103 INSTITUTO DE INFECTOLOGIA EMÍLIO RIBAS Identification of Mycobacterium tuberculosis complex in clinical specimens of HIV-infected patients at Instituto de Infectologia Emilio Ribas, São Paulo-Brazil 1, M. Eira 1, Boccardo 2, Silva E. R. J. Costa U. I. S. A. F. I. Oliveira Junior 4; 1 Instituto de Infectologia Emílio Ribas, Ambulatory, São Paulo, 2 Instituto de Infectologia Emílio Ribas, Centro de Estudos, Sao Paulo/BR, SP/BR, 3 Instituto de Infectologia Emilio Ribas, Clinical Laboratory, São Paulo/BR, 4 Instituto de Infectologia Emilio Ribas, Ambulatory, São Paulo/BR Background Tuberculosis (TB) remains the most common infection among HIV patients. Currently, the TB diagnosis is still based on the clinical presentation, radiographic findings and microbiological results. Considering the complexities of treating HIV/TB co-infection, TB diagnosis requires the availability of diagnostic tools that allow the rapid detection of Mycobacterium tuberculosis complex (MTBC) and drug resistance in clinical samples. Methods & Materials In this retrospective study conducted at the Instituto de Infectologia Emílio Ribas, São Paulo/BR, we analized a total of 5350 clinical specimens (respiratory and extrapulmonary) collected from patients with signs and symptoms suggestive of TB from January/14 to December/14. All samples were processed by conventional diagnostic techniques, including smear examination for acid-fast bacillus (AFB) and cultured in MGITF-960 automated system. Blood and bone marrow were cultured in BACTECFX. Identification of MTBC and non-tuberculous mycobacteria (NTM) was performed by rapid immunochromatographic assay. The average time needed for detection of mycobacteria was 15 days. Suscetibility testing for MTBC and PCR for NTM was performed by Adolfo Lutz Institute, S. Paulo. 2, Barbosa 1, Moreira 3, Souza Results Table 1: Clinical and laboratory features in patients with clinical suspicion of tuberculosis at the Instituto de Infectologia Emílio Ribas. Characteristic Culture for MT Sociodemographic characteristics Male Tuberculosis Pulmonary Extrapulmonary Laboratory features HIV-infected patients Positive rapid test for MTBC Positive rapid test for NTM Mycobacterium avium complex Mycobacterium kansasii Mycobacterium fortuitum Others Mycobacterium Resistance for MTBC Rifampicin Isoniazid No. Subjects (%) 554/5350 (10. 35) 342/554 (61. 73) 398/554 (71. 84) 156/554 (28. 15) 428/554 (77. 25) 391/554 (70. 57) 95/554 (17. 14) 50/95 (52. 48) 15/95 (15. 78) 5/95 (5. 26) 25/95 (26. 31) 25/391 (6. 30) 11/25 (44. 00) 8/25 (32. 00) Conclusion TB is a important public health problem and the diagnosis in HIV-infected patients is challenging. The use of mycobacterial culture remains an important diagnostic tool. The immediate future involves rapid molecular techniques, in particular Gene. Xpert which is also able to detect rifampicin resistance. In order to improve diagnosis and detect as early as possible resistance to rifampin, it was introduced earlier this year the Gene. Xpert MTB/RIF in our hospital which proposes to be a strong diagnostic tool for pulmonary TB Keywords: Tuberculosis Mycobacterial disease Drug resistance. E-mail: margaeira@uol. com. br
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