title: Contribution of the Ogawa-Kudoh swab culture method to the diagnosis of pulmonary tuberculosis in Brazil.
abstract: OBJECTIVE
  To analyse the contribution of the Ogawa-Kudoh (O-K) swab culture method to the diagnosis of pulmonary tuberculosis (PTB) in four different regions of Brazil.
  
  
  METHODS
  This study was carried out in two phases. Phase 1 was designed to compare the direct swab culture method (O-K) with the culture concentrated method (N-acetyl-L-cysteine-sodium hydroxide [NALC-NaOH]); for this purpose, 569 sputum samples were cultured by both methods. Phase 2 was carried out to assess the contribution of the O-K method to the diagnosis of PTB in four different regions in Brazil, based on the evaluation of 19,163 sputum samples.
  
  
  RESULTS
  In the first phase of the study, O-K culture had a sensitivity of 94.8% and specificity of 99.8% in cases confirmed by NALC-NaOH/Löwenstein-Jensen (LJ) culture. In the second phase of the study, the overall contribution of O-K culture compared to acid-fast bacilli (AFB) examination (AFB-/culture+) to the diagnosis of PTB was 29.8%.
  
  
  CONCLUSIONS
  O-K culture contributes significantly to the diagnosis of smear-negative PTB. Importantly, this method allows the recovery of clinical isolates in areas where use of the standard culture centrifuge is impossible, indicating that the O-K swab culture method should become a standard method for TB diagnosis in these regions.
authors.affiliation: Nucleo de Doenças Infecciosas, Federal University of Espírito Santo, Vitória, Espirito Santo, Brazil. mpalaci@ndi.ufes.br
authors.forename: M
authors.initials: M
authors.lastname: Palaci
authors.forename: R L
authors.initials: RL
authors.lastname: Peres
authors.forename: R
authors.initials: R
authors.lastname: Maia
authors.forename: E A T
authors.initials: EA
authors.lastname: Cunha
authors.forename: M O
authors.initials: MO
authors.lastname: Ribeiro
authors.forename: R
authors.initials: R
authors.lastname: Lecco
authors.forename: C
authors.initials: C
authors.lastname: de Souza Ribeiro
authors.forename: R R
authors.initials: RR
authors.lastname: Ferro E Silva
authors.forename: S A
authors.initials: SA
authors.lastname: Vinhas
authors.forename: R
authors.initials: R
authors.lastname: Dietze
authors.forename: S
authors.initials: S
authors.lastname: Vianna
authors.forename: C G V
authors.initials: CG
authors.lastname: de Morais
mesh_terms: D000111:Acetylcysteine / Q000737:chemistry; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001431:Bacteriological Techniques / Q000379:methods; D001938:Brazil / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012972:Sodium Hydroxide / Q000737:chemistry; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D012972:Sodium Hydroxide; D000111:Acetylcysteine