Post on 06-Jul-2018
transcript
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 1/66
TINCIÓN DE ZIEHL NEELSEN.
CUBRIR CON FUCSINA FILTRADA.
CALENTAR HASTA OBTENER 3 EMISIÓNES DEVAPOR. APAGAR ANTORCHA Y ESPERAR COMPI FTAR 5 MINIJTOS
LAVAR CON AGUA
CUBRIR CON DECOLORANTE DURANTE 2 MINUTOS
LAVAR CON AGUA
CUBRIR CON AZUL DE METILENO 1 MINUTO
LAVAR CON AGUA
SECAR AL AIRE
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 2/66
33
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 3/66
12. EXAMEN MICROSCÓPICO .
12.1 Obse!"#$%& '$#(s#%)$#" * +e#,-" ee/,e&$(s.
L" (bse!"#$%& '$#(s#%)$#" ebe #-')+$ )$&#$)"+'e&,e (s (b0e,$!(s
De,e'$&" s$ e& e+ e/,e&$( "* BAAR.
S$ +(s "*4#-"&,$5$#" ")(/$'""'e&,e e+ &6'e( e b"#$+( )( #"')(.
C""#,e7s,$#"s '(5(+%8$#"s e+ b"#$+( e +",-be#-+(s$s .
L(s b"#$+(s "#$(es$s,e&,es ,$e&e& e&,e 1 * 19 :J' e +"8(. C(& +" #(+("#$%& e
Z$e+ Nee+se& se (bse!"& #('( b"s,(&#$,(s e+8"(s4 +$8e"'e&,e #-!(s4 (0(
5-#s$"4 es,"#;&(se #+""'e&,e #(&," e+ 5(&( "<-+.
E& +" '-es," e es)-,( )-ee& )ese&,"se "$s+"(s4 ")"e"(s ( "8-)"(s. Es
'-* $57#$+ $s,$&8-$ e+ b"#$+( e +" ,-be#-+(s$s e (,"s '$#(b"#,e$"s )( e/"'e&
'$#(s#%)$#(. A+8-&"s '$#(b"#,e$"s =-e &( s(& M. tuberculosis )-ee& ")"e#e
#('( b"s,(&es '-* +"8(s ( #('( #(#(b"#$+(s.
O,(s '$#((8"&$s'(s )-ee& )ese&," $s,$&,(s 8"(s e ;#$( es$s,e&#$"4
#('(R((#(#-s s).4 N(#"7" s).4 Le8$(&e++" s). * +(s =-$s,es e C7),(s)($$( e +s(s)("
s). Se (bse!"& #('( #(#(s4 b"#,e $"s #(& 5('"s !"$""s >)+e('%5$#"s?. 5$+"'e&,(s
=-e " !e#es es,;& #(,"(s4 ( #('( es5e"s e 8"& ,"'"@( s$ se +"s #(')"" #(&
+"s b"#,e$"s.
De ,("s 5('"s4 es )(#( 5e#-e&,e e&#(&," ';s e 19 '$#((8"&$s'(s ;#$(s
"+#((+es es$s,e&,es $5ee&,es " M.,-be#-+(s$s e& +"s '-es,"s e es)-,( e +(s SR.
C-"&( e+ +"b(",( $s," (bse!" "+8-&( =-e &( ,$e&e 5('" e b"s,%& ebe e&!$" +"
+;'$&" "+ &$!e+ #(es)(&$e&,e.
12.1.1 Lectura de extend i dos coloreados por Ziehl Neelsen.
1. De)(s$," -&" 8(," e "#e$,e e $&'es$%& e& -& e/,e'( e+ 5(,$s4 s$&
,(#" e+ )e)""( #(& e+ 8(,e(.
2. E&5(#" e+ e/,e&$( (&e " #(+(#"( +" 8(," e "#e$,e4 #(& +" +e&,e1OO/
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 4/66
e $&'es$%&
34
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 5/66
3. Obse!" #"" #"')( '$#(s#%)$#( e& s-)e5$#$e y )(5-&$"4
'(!$e&( )e'"&e&,e'e&,e e+ ,('$++( '$#(',$#( 4 "&,es e
es)+"<" se "+ #"')( #(&,$8-( . Se8-$ -& e#($( e& +$&e"
e#,"4 s$s,e';,$#"'e&,e )"" e#( e e+ e/,e&$( e!$,"&(
e)e,$ +" +e#,-" e "+8-&(s #"')(s. E 0 e $<=-$e" " ee#"
.
. Obse!" +" #"+$" e+ e/,e&$( * e +" #(+( "#$%&. S$ &( 5-ese&
b-e&"s4 e)e,$ &-e!"'e&,e +" b"#$+(s#()$" e es" '-es,".
12.1.2 TÉCNICA DE LECTURA.
1. P"" e+ e/"'e& es &e#es"$( '$#(s#()$( b$&(#-+" #(&(b0e,$!( e
$&'es$%& >199 /? * (#-+"es e "-'e&,( '(e "(.
2. E/"'$&" -& '7&$'( e 199 #"')(s '$#(s#%)$#(s. L"
+e#,-" ebe "#ese e '"&e" s$s,e';,$#" y es,"&"$<"".
E')e<" +" +e#,-" e+ 5(,$s e& e+ #e&,( e+ e/,e'( $<=-$e( e
+" +;'$&"4 "0-s,"&( +e!e'e&,e #(& e+ ,(&$++( '$# (',$#(.
3. Des)-s e "be e/"'$&"( -& #"')( '$#(s#%)$#(4 '(!e +"
+;'$&" e& 5('" +(&8$,-$&"+4 )"" e/"'$&" e+ s$8-$e&,e #"')(
"#$" +" ee#" . De es," '"&e"4 e/"'$&" ,((s +(s #"')(s
'$# (s#%)$#(s4 ese e+ )$&#$)$( "s," e+ 5 $& e +" +(&8$,-
#e&,"+ e+ 5(,$s. E+ &6'e( e #"')(s '$#(s#%)$#(s =-e
#( es)(&e " +" +(&8$,- e+ 5(,$s es e 199 ")(/$'""'e&,e .
. Se #(&s$e " #"')( '$#(s#%)$#( 6,$+4 "=-e+ e& e+ #-"+ se
(bse!"& e+e'e&,(s #e+-+" es e ($8e& b(&=-$"+ >+e-#(#$,(s.
5$b "s '-#(s"s * #+-+"s?. L(s #"')(s e& +(s =-e &( ")"e<#"&
$#(s e+e'e&,(s4&( ebe& #(&,"b$+$<"se e& +" +e#,-" .
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 6/66
. C-"&( &( se e&#-e&,e& b"#$+(s ;#$("+#((+ es$s,e&,e
>BAAR?4 e& 199 #"')(s se ebe "#e -&" &-e!" b6s=-e"
';s #-$"(s" e& (,(s 199
35
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 7/66
#"')(s. M(!e +" +;'$&" -&(s '$+7'e,(s "#$" ",;s * +ee -&" se8-&"
+(&8$,- e+ '$s'( >e ee#" " $<=-$e"? .
. L(s b"#$+(s ,-be #-+(s(s se (bse!"& #('( b"s,(&#$,(s e+8"(s *
(0(s4 +$8e"'e&,e #-!(s4 ';s ( 'e&(s 8"&-+(s(s 4"$s+"(s4
)"e"(s ( e& 8-)(s4 es,"#;&(se #+""'e&,e #(&," e+ (&( "<-+.
C"+#-+" e+ &-'e( e b"#$+(s !$s,(s )( #"')(.
. A+ 5$&"+$<" e+ e/"'e& 4 se)"" e+ (b0e,$!( e +" +;'$&"4 e,$"+" *
!e$5$#" +" $e&,$5$#"#$%& #(& e+ &-'e( 8"b"( e& +" +;'$&" *
"&(," e+ es-+,"( e& e+ +$b( e e8$s,( PCT 4 )(s,e$('e&,e
)"s" +(s es-+,"(s " +" PCT 3.
. A&,es e e/"'$&" -& &-e!( (,7s4+$')$" e+ +e&,e e $&'es$%& #(&)")e+ )""
+$')$" +e&,es ( "+8(%&.
. L$')$" e+ "#e$,e e +" +;'$&" * 8-""+" )"" s- e&!$( "+ #(&,(+ e#"+$".
1J+ G......K - .....
12.2 INFORME DE RESULTADOS.
E+ &-'e( e b"#$+(s e&#(&,"(s es '-* $')(,"&,e #('( e+e'e&,( e
$&5('"#$%&4"" s- e+"#$%& #(& e+ 8"( e #(&,"8$(s$" e+ )"#$e&,e4"s$
#('( #(& +" se!e$" e +" e&5e'e" * +" e!(+-#$%& e+ )"#$e&,e b"0( ,","'$e&,(
. P( es," "<%& e+ $&5('e ebe se &( s(+( #-"+$,",$!( s$&( #-"&,$,",$!(.
Se e#('$e&" se8-$ +"s s$8-$e&,es )"-,"s )"" +" )ese&,"#$%& e+ $&5('e e
+(s es-+,"(s
3.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 8/66
36
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 9/66
NUMERO DE BACILOS
ENCONTRADOS
CAMPOS DE
INMERSIÓN
OBSERVADOS
REPORTE
Ne8",$!(N( se (bse!"& BAAR e& 199 #"')(s
De 1 " BAAR e& 199 C"')(s N6'e ( e/"#,( eb"#$+(s (bse!"(s e&
.+(..s 199 #"')(s
DE O 1 BAAR )( #"')( e& 199 #"')(s +
DE 1 19 BAAR )( #"')( e& 9 #"')(s ++
M;s e1O BAAR )( #"')( e& 29 #"')(s +++
C(+(#" es,e e)(,e e& (bse!"#,(&es e& +" PCT34 #(& ,, &," e #(+( (:( )(
e7e')+( KSe (bse!"& b"#$+(s e& 199 #"')(s (bse!"(s
P"" e)(," -&" b"#$+(s#()$" #('( )(s$,$!" -&" #-< >?4ebe; e "be !$s,(
#('( '7&$'(4 ';s e 19 b"#$+(s e& ,((s +(s #"')(s (bse!"(s.
E&!$" e+ es-+,"( +( '"s )(&,( )(s$b+e "+ es,"b+e#$'$e&,( e s"+- ( "+ '$#( =-e
s(+7#$,( e+ e/"'e&. E+ ,$e')( =-e ,"" e& e&!$" +(s es-+,"(s es $&$#"( e +"
e5$#$e&#$" e s- +"b(",($(.
T(" e'(" e& +" e&,e8" e -& es-+,"( )(s$,$!( )-ee e,"s" e+ $&$#$( e+
,","'$e&,( 4 )(+(&8" e+ )e$(( -"&,e e+ #-"+ e+ )"#$e&,e )e'"&e#e $&5e##$(s(
( e,e'$&" =-e se )$e " -& e&5e'(4 es &e#es"$( e+ '"*( es5-e<( )(s$b+e
)"" =-e +(s es-+,"(s e +" b"#$+(s#()7" se"& e#$b$(s +( ';s )(&,( )(s$b+e.
T(( es-+,"( )(s$,$!(4 ebe $&5 ('"se $&'e$","'e&,e "+ e&#"8"(e+
)(8"'" e #(&,(+ e +" ,-be#-+(s$s e+ es,"b+e#$'$e&,( es"+-.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 10/66
37
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 11/66
13. BIOSEGURIDAD.
S$e')e =-e e+ )es(&"+ e +"b(",($( #-')+" +"s 'e$"s b;s$#"s e b$(se8-$" e&
e+ '('e&,( e e"+$<" +(s e/,e&$(s e b"#$+(s#()$"s se $s'$&-$;
#(&s$e"b+e'e&,e e+ $es8( e $&5e##$%&.
P( +( "&,e$( es &e#es" $( s$e')e ")+$#" +(s ) (#e$'$e&,(s es,"&"$<"(s e
b$(se8-$" 4)"" e+ #-')+$'$e&,( e #(&, (+ e $&5e##$(&es 4 +( =-e se +(8" e& )",e4
'e$"&,e +" (8"&$<"#$%& e& e+ ,"b"0(4 +" #(&#e&,"#$%& 4 e+ es,"( e "+e," * +"
$')+e'e&,"#$%& e 'e$"s e )e#"-#$%& '-* s$')+es * e )(#( #(s,(.
Es $')(,"&,e e#(" =-e e& e+ '('e&,( =-e se es,; 5e&,e "+ )"#$e&,e,(se(
es e+ '"*( $es8( e $&5e#,"se )( "s)$ "#$%& e &6#+e(s e 8(,"s #(&,e&$e&(BAAR.
13.1 Inform!"#n y !on$ro% m&'"!o '(% )(r*on% '(%+or$or"o.
L(s ,"b"0"(es e s"+- $&5e#,"(s #(& VIH - (," e&5e'e"
$&'-&(s-)es( "4 #(& , ","'$e&,(s ) (+(&8"(s #(&
'e$#"'e&,(s
$&'-&(s-)es( es >#('( #(,$#($es? ( $"b,$#(s &( ebe& , "b"0"
e& ;e"s e $es8(4e& )",$#-+" e& e+ +"b(",($( e ,-be#-+(s$s.
L(s =-e )"e#e& e&5e 'e"es )-+'(&"es #%&$#"s ebe& #(&," #(&
"-,($<"#$%& e s- '$#( )"" se $&#()("(s " +"s ,"e"s e+ +"b(",($(
e ,-be#-+(s$s.
S(& &e#es" $"s +"s e-&$(&es )e $%$#"s #(& ,(( e+ )es(&"+ e
+"b(",($(4 es,$&""s " e#(" +"s 'e$"s e b$(se8-$"4 "&"+$<"
s$ se es,;& #-')+$e&( #(& e8-+" $"4 $+-#$" +"s #"-s"s e +(s"##$e&,es =-e )-$e "& "be se )(-#$( * e"+$<" +"s #(e##$(&es
=-e 5-e"& &e#es"$"s e& +" -,$&" e ,"b"0( .
C-"&( e+ )es(&"+ )ese&,e s7&,('"s es)$",($(s )( ';s e 1 $"s4 se
ebe; $s)(&e s- e/"'e& '$#(4 b"#$+(s#()7" 4 "$(+(87" e ,%"/ *
#-+,$!( e '-es, "s e es)-,(.
E& #"" se##$%& ebe& es," e/)-es,"s +"s &('"s b;s$#"s e
b$(se8-$" es)e#75$#"s )" " #"" ,$)( e ,"e" .
E+ )es(&"+ ebe $&5('" " s- 0e5e $&'e$",( #-"+=-$e "##$e&,e e ,"b"0( .
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 12/66
38
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 13/66
13.2 ,r (!-!"on(* (n(r%(* (n (% Tr+ / o '( m"!r o*!o)0 )r
(% '"n#*$"!o '( $-+ (r !-%o*"*.
A)+$#" ,("s +"s 'e$"s +%8$#"s )"" e!$," +" 8e&e"#$%& y '(!$'$e&,( e
"e(s(+es =-e s(& e+ !e7#-+( )$&#$)"+e ,"&s'$s$%& e b"#$+(s.
M"&$)-+" e+ '",e $"+ )(,e&#$"+'e&,e $&5e##$(s( e& ;e"s "+e0""s e +"
#$#-+"#$%& 8e&e"+. Res,$&8$ e+ "##es( "+ +"b(",($( e )es(&"+ "0e&(
"+ ;e" e ,"b"0( )"" e!$," '(!$'$e&,(s. #($e&,es e "$e4
$s,"##$(&es y e/)(s$#$%& e )es(&"s &( $&!(+-#""s .
N( -,$+$<" !e&,$+"(es &$"#(&$#$(&"(es =-e 8e&ee& '(!$'$e&,(s e
"$e e& e+ ;e" (&e se '"&$)-+" '",e$"+ )(,e&#$"+'e&,e $&5 e##$(s( 4
'$e&,"s se es,; ,"b"0"&( .
A+ 5$&"+$<" +" ,"e" y "&,es e )(&e e& 5-&#$(&"'$e&,( !e&,$+"(es y "$es
"#(&$#$(&"(s 4 es$&5e#," +"s s-)e5$#$es e 'es"s (&e se e"+$<"(&
+(s e/,e&$(s y (&e se #(+(#"(& e#$)$e&,es #(& '",e $"+
)(,e&#$"+'e&,e $&5e##$(s(4 se
)es(&"s "0e&"s " es,"
"#,$!$"
e#('$e&" &( )e'$,$ e+ $&8es(
e -"&,e 'e$"
(" #('( '7&$'( *
+-e8( !e&,$+" )"" e+$'$&" !")(es e #+(( ( 5e&"+. N( b"e &$ +$')$" s-)e5$#$es e& se#(4 -,$+$<" s$e')e -&
,")e"( 6'e(. N( e&#e" .N( +e!"&," )(+!( "+ +$')$" .
N( -b$#" e& e+ ;e" e ,"b"0( (b0e,(s $&&e#es"$(s >"(&(s4
)+"&,"s4 5+( e(s * (,(s? &$ s"#" e8$s,(s ( e+e'e&,(s "++7 -,$+$<"(s.
U,$+$<" s$e')e 8"b"#"s e '"&8"s +"8"s * #e"" +" 8"b"#"
es 6,$+ )"" )(,e8e e +"s
s-s,"&# $"s =-7'$#"s4#(+("&,es * s"+)$#"-"s
"##$e&,"+es #(& '-es,"s. )e( &( #(&," +" $&5e##$%& )( !7"
"e%8e&" .
U,$+$<" '"s#"$++"s N 19 BFE4 +" '"s#"$++" ebe #-')+$ +"s &('"s
e +" NIOSH. ebe& se e -s( )es(&"+. )-ee& se e-,$+$<""s "s,"
-& 'es s$e')e y #-"&( se #(&se!e& e& -& +-8" se#( y &(
"=-$e"& -'e". &$ se e5('e& )"" =-e &( se -'ee<#"& &(
8-""+"s e&,( e e&!(+,-"s )+;s,$#"s.
E+ -s( e 8-"&,es )" " e+ ,"b"0( #(& '-es,"s e es)-,( es &e#es"$(.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 14/66
+( '$s'( )"" +$')$" e"'es4'"&$)-+" es$&5e#,"&,es.
L"!"se +"s '"&(s "&,es * es)-s e+ -s( e 8-"&,es s$e')e =-e 5-e"
39
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 15/66
&e#es" $(4 &( ,(#" $&s,"+"#$(&es4 '",e$"+ e es#$,($( ( e=-$)(
e+ +"b(",($( #(& +(s 8-"&,es )-es,(s.
N( bebe 4 #('e &$ 5-'" e& e+ ; e" e ,"b"0( (&e se )(#es"
'",e$"+ )(,e&#$"+'e&,e $&5e##$(s(.
N( $&, (-#$ e& +" b(#"4 )( &$&86& '(,$!(4 e+e'e&,(s
-,$+$<"(s ( e/$s,e&,es e& e+ +"b(",($(.
13.3 R(!om(n'!"on(* (n(r%(* (n (% r( '( $r+/o.
E+ ;e" e ,"b"0( ebe '"&,e&e se +$')$" * (e&"" #(& s-5$#$e&,e +-<
>&",-"+ ( ",$5$#$"+? * b-e&" !e&,$+"#$%&.
E& #"s( e "##$e&,e4 =-e se e "'e -&" '-es, " e& e+ )$s( ( e& +"
'es" e ,"b" 0(4 #(+(#" $)(#+( $,( e s($( "+ 9. ( 5e&(+ "+ 4
#-b$ #(& )")e+ )e$%$#( * e')")" #-$"(s"'e&,e e+ )")e+. De0"+(
-"&,e 39 '$&-,(s "&,es e +$')$" e+ ;e". L-e8( es#","+( #('(
'",e$"+ b$($&5e##$(s(.
T(( '",e$"+ #(&,"'$&"( +;'$&"s )(,"(b0e,(s 4 5"s#(se#(+e#,(es e
es)-,(4 * (,(s "&,es e s"+$ e+ +"b( ",( $( ebe& e#$b$ "+86& ,","'$e&,(e
e#(&,"'$&"#$%& es#","&( e+ '",e$"+ "e#-""'e&,e.
N$&86& e=-$)( e )(,e##$%& s-s,$,-*e e+ #-$"(4 (e& * )e#"-#$%&
=-e ebe ,e&e #"" ,#&$#( "+ e"+$<" s- ,"b"0(.
S$ se )(-#e e$" #(,"&,e ( )-&<"&,e e& e+ '('e&,( e& =-e
se es,; '"&$)-+"&( '-es,"s 4 e/,e&$(s4 ( '",e $"+ es#","( 4
+"!" se +"s '"&(s ( <(&""5e#,"" e $&'e$",( #(& "b-&"&,e "8-"
* 0"b%&4 ")+$#"&( $&'e$","'e&,e "+#((+ e,7+$#( "+ 9.
S$ se )(-#e -&" s"+)$#"-" =-e "5e#,e e+ (0( #(& '",e $"+
)(,e&#$"+'e&,e $&5e##$(s( ( -& e"#,$!(4 +"!"+( #(& "8-" es,$+"" (
s(+-#$%& 5$s$(+%8$#" es,$+ -,$+$<"&( -& e#$)$e&,e es,$+.
S$ se )(-#e #(&,"#,( #(& -& ;#$( #(&#e&,"(4 +"!" +" <(&" * ()"
"5e#,"" #(& "b-&"&,e "8-".
C('-&$#" "+ 0e5e e +"b(",($( +-e8( e ,('" +"s 'e$"s es# $,"s.
T(" !e< =-e se -b$e " )(-#$( #(&,"#,( e -&" '-es," e& +" =-e se"&
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 16/66
e,e#,"( b"#$+(s #(& -&" e $"4 ( )e&e,"#$%& #-,;&e" ( )('-#(s"s4
40
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 17/66
es)-s e+ -8e&,e +"!"( y +$')$e<" +(#"+4 ebe se #(&s-+,"( -& '$#(
)"" =-e #(&,(+e "+ ,"b"0"( * $s)(&8" +" "'$&$s,"#$%& e =-$'$()(5$+"/ $s
s$ es )e,$&e&,e.
13. MTODO DE LIMPIEZA DE LQMINAS PORTAOBJETOS POSTERIOR AL
CONTROL DE CALIDAD.
13..1 Des#(&,"'$&"#$%&
C(&s$s,e e& +" -,$+$<"#$%& e )(#es(s =-e e+$'$&"& ,(,"+ ( )"#$"+'e&,e +(s'$#((8"&$s'(s . T"'b$& se -,$+$<" es,e ,'$&( )"" e5e$se " +" e+$'$&"#$%&
( &e-,"+$<"#$%& e s-s,"&#$"s =-7'$#"s )e+$8(s"s y '",e$"+es "$("#,$!(s. E+
(b0e,$!( es !(+!e #-"+=-$e '",e $"+ se8- ( )"" e+ es#",e 5$&"+ ( )" " s-
e-,$+$<"#$%&.
L(s es$&5e#,"&,es =-7'$#(s se !e& "5e#,"(s e& s- "##$%& 8e'$#$" )( "+8-&(s
5"#,(es ,"+es #(&( #(&#e&,"#$%& e+ es$&5e#,"&,e * '$# ((8"&$s'(s )ese&,es4 "+
$8-"+ =-e e& +(s ',((s 57s$#(s4e+ ,$e')( * )ese&#$" e '",e$" (8;&$#" es -& 5"#,(
)$'($"+. L(s ,$e')(s e #(&,"#,( #(& +(s es$&5e#,"&,es s(& $s,$&,(s )"" #""
'",e$"+ * #"" 5"b$#"&,e. As7 )-es4 ,("s +"s e#('e&"#$(&es )"" e+ -s( e
es$&5e#,"&,es ebe& se8-$ +"s es)e#$5$#"#$(&es e+ 5"b$#"&,e .
13..2 L$')$e<" e +;'$&"s -,$+$<""s e& e+ $"8&%s,$#( e ,-be #-+(s$s "
,"!s e '$#(s#()7"
1. C(+(#" +"s +;'$&"s &e8",$!"s -s""s e& -& e#$)$e&,e #(& +e0$" #('e#$"+ "+
9. %, -"&,e ("s.
2. L"!" #(& "8-" #($e&,e y e,e8e&,e.
3. E&0-"8" #(& "8-" es,$+"" >)e5e$b+e'e&,e?.
. Se#" " ,e')e",-" "'b$e&,e ( #"+( se#(.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 18/66
1
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 19/66
13..3 LIM,IEZA DE MESAS DETRABAO4
L"s 'es"s e +"b(",($( se ebe& es$&5e#," #(& $)(#+($,( e s($( "+ 9.1 >+e07"
7+-7" 19? "+ 9. >+e07" $+-$" 119? "&,es * es)-s e +" -,$&" e
,"b"0(. L" es$&5e##$%& e +"s 'es"s ebe se e#" )( e+ )es(&"+ ,#&$#(4 &(
ebe& e0"se "+ )es(&"+ e +$')$e<".
Es e e#(" =-e +"s $+-#$(&es e +e07" ebe& e )e)"se #"" 7"4 s,"s +$be"&
#+(( e& 5('" 8"se(s" #(& +( =-e se eb$+$," s- )(,e&#$"+ 8e'$#$" ,"&s#-$( e+
,$e')(4 "e';s +"s s(+-#$(&es e $)(#+($,( e s($( s(& $&"#,$!""s e& )ese&#$"
e 8"&es #"&,$"es e '",e$" ( 8;&$#" .
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 20/66
42
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 21/66
1. SU,ER5ISIÓN 6 CONTROL DE CALIDAD.
L" s-)e!$s$%& es -& )(#es( e-#",$!( e#7) (#(4 )e'"&e&,e4 e8-+" * )+"&$5$#"(4
=-e )e'$,e es"(++" +(s #(&(#$'$e&,(s * +" #")"#$" e+ )es(&"+4 #e" "#,$,-es
es)e#,( "+ ,"b"0( * #(&,$b-$ " '"&,e&e +" e5$#"#$" e -&" e e se!$#$(s(8"&$<"(s4 e& es,e #"s(4 +(s +"b(",($(s =-e e5e#,6"& ,#&$#"s b"#,e$(+%8$#"s e
,-be#-+(s$s.
L" s-)e!$s$%& $')+$#" (bse!"#$%&4 #(($&"#$%&4 #(e##$%&4 e&se@"&<"4 es,7'-+( *
e!"+-"#$%& e +"s "#,$!$"es e+ )es(&"+ =-e se ese')e@" e& +(s +"b(",($(s4
#(& e+ )()%s$,( e =-e e+ ,"b"0( se" e"+$<"( e& 5('" e5$#$e&,e.
P"" s-)e!$s" es ) e#$s( #(&," #(& ,#&$#"s ()e",$!"s es,;&"es )"" "$es,"
"+ )es(&"+.
1.1 MÉTODOS DESU,ER5ISIÓN.
"? P(#e$'$e&,(s$&$e#,(s.
S(& "=-e++(s =-e se e5e#,6"& " $s,"&#$"4 b"s"(s e& "+8-&"s e +"s
s$8-$e&,es '("+$"es
E&!7( e '-es,"s ( +;'$&"s e es-+,"( #(&(#$( )( e+ &$!e+ s-)e!$s( "+
s-)e!$s"( 4)"" #(')"" +(s es-+,"(s.
E&!7( e +;'$&"s e+ ,"b"0( "b$,-"+ ese e+ &$!e+ +(#"+ "+ &$!e+ $&,e'e$( (
"+ &$!e+ s-)e$( )"" #(')"" +(s es-+,"(s * e!"+-" +" ")+$#"#$%& e +"
,#&$#" b"#$+(s#%)$#". Es," '("+$" es +" ';s "#e),"b+e ese e+ )-&,(
e !$s," ()e"#$(&"+ * #(&s,$,-*e +" s-)e!$s$%& ,#&$#" $&$e#,".
E+ "&;+$s$s #$,$#(4 #-"&,$,",$!( * #-"+$,",$!( e +" $&5('"#$%& es,"7s,$#".
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 22/66
43
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 23/66
b? P(#e$'$e&,(s $e#,(s.
Es,(s )(#e$'$e&,(s se b"s"& e& +" !$s$," )es(&"+ e 5-&#$(&"$(s e+ &$!e+ s-)e$( "
+(s se!$#$(s +(#"+es * #(&s,$,-*e +" s-)e!$s$%& ,#&$#" * "'$&$s,",$!" $e#," .
L" s-)e!$s$%& $e#," 4 )( s- #(&,"#,( )es(&"+4es ';s ;)$"4 e5 e#,$!" * )e'$,e"()," e#$s$(&es e& e+ ,ee&(. S$& e'b"8(4ese e+ )-&,( e !$s," ()e"#$(&"+
es-+," ';s $5$#$+ e ++e!" " #"b( e& 5('" e8-+" * ()(,-&" )( +"s +$'$,"#$(&es
e ,$e')(4 '(!$+$<"#$%& * 5"#,$b$+$" e #(be,-" e+ s-)e!$s( .
1.2 Con$r o% '( !%"'' "n'"r(!$o '( %* +!"%o*!o)"*.
E+ #(&,(+ e #"+$" )e'$,e e!"+-" s$ +" $&5('"#$%& )(-#$" )( e+ +"b(",($(
es )e#$s" 4e)(-#$b+e * ()(,-&" .
I&s,"-" -& s$s,e'" e "+"'"s =-e )e'$,e )e!e&$4 es#-b$ * #(e8$ e(es .
Res-+," ';s e5$#"< )"" e,e#," * "s$s,$ " +(s #"s(s e ,-be#-+(s$s * )""
#(&, (+" +" e&5e'e".
E+ #(&, (+ e #"+$" es -& )(#e$'$e&,( =-e e')e&e& e& #(&0-&,( +(s $s,$&,(s
&$!e+es e +" e e +"b(",($(s * ,$e&e #('( (b0e,$!( e+e!" * '"&,e&e +" #"+$" e
,"b"0(.N( ,$e&e #";#,e )-&$,$!( >")+$#"#$%& e s"&#$(&es?.
1.3 Con$ro% '( !%"'' "n$(rno.
Es -&" es)(&s"b$+$" =-e se ebe "s-'$ e& #"" +"b(",($( =-e e"+$<"
b"#$+(s#()$"s. E& )",$#-+" 4 e+ es)(&s"b+e e+ +"b(",($( ebe es,"b+e#e e& +"
-,$&" e ,"b"0( -& s$s,e'" e #(&, (+es e8-+"es * #(&,$&-(s e +(s )-&,(s # 7,$#(s.
E+#(&, (+ e #"+$" $&,e&( #(') e&e
E!"+-"#$%& e '",e$"+es4e=-$)(s * e"#,$!(s.
Dese')e@( e+ )es(&"+.
P(#e$'$e&,(s es,"&"$<"(s .
Pe#$s$%& * ()(,-&$" e +(s $&5('es.
O5e," * ")+$#"#$%& "e#-"" e +" b"#$+(s#()$" .
Re&$'$e&,( e +" b"#$+(s#()7" )"" e,e#," #"s(s.
Se8-$'$e&,( e +(s es-+,"(s (b,e&$(s .
44
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 24/66
Me$"s #(e#,$!"s " ")+$#" #-"&( +" $')e#$s$%& e+ es-+,"(
e/#ee +(s +$'$,es #(&s$e"(s "#e),"b+es ( se )(-#e& e'("s
e!$,"b+es.
1. ,r()r!"#n '( %m"n* )r (% !on$ro% "n$(rno '( % !o%or!"#n4
Pe)"" e/,e&$(s e '-es,"s )(s$,$!"s y &e8",$!"s , ",""s
)e!$"'e&,e #(& 19 8(,"s e 7)(#+($,( e s($( "+ 9. -"&,e )( +(
'e&(s 'e$" (". Pe)"" #(& e++"s ,"&,(s e/,e&$(s #('( se"&
&e#es"$(s4 )"" =-e )-e"& se -,$+$<"(s -"&,e (s 'eses.
G-""+"s e& #"0"s #(& se)""#$(&es4 $se@""s )"" 8-""
e/,e&$(s4 ( e&,( e -&" #"0" e&!-e+,"s e& )")e+ s-"!e4b$e&
"#(&$#$(&""s 4e& +-8" se#(.
C(&,(+" +" #"+$" e +" #(+("#$%& e& #"" se$e e e/,e& $(s "
#(+(e" 4 ,$@e&( -&" +;'$&" &e8",$!" y (," )(s$,$!". Re8$s," e+ es-+,"(
e es,e #(&,(+ e #"+$" e& +" PCT. >!e "&e/( ?.
C(')(b" =-e +(s BAAR se !e"& #(')+e," e $&,e&s"'e&,e
#(+(e"(s #(& 5-#s$&" y =-e +" #(+("#$%& e 5 (&( se" -&$5 ('e4 e+
#(+( es)e"( y =-e (5e<#" b-e& #(&,"s,e.
S$ se e,e#,"& e5e#,(s 4 e)e,$ e+ #(&,(+ #(& (,(s e/,e&$(s )""es#"," -&
)(s$b+e e( e& +" ,#&$#" e ,$&#$%& . S7 )es$s,e e+ e5e#,(4 $&!es,$8" +"
#"-s" e e( . S$ se e"+$<"& ';s e 1O b"#$+(s#()7"s )( 7"4 se ebe
e)e,$ e+ #(&,(+ "$b" es#$,( >#(+("#$%& e -& e/,e&$( )(s$,$!( y -&(
&e8",$!(? -&" !e< )( se'"&".
S$ se e"+$<"& 'e&(s e 19 b"#$+(s#()7"s )( 7" se ebe& $&#+-$ +(s 5(+$s )(s$,$!( y
&e8",$!( #('( #(&,(+ $"$"'e&,e.
1. Con$r o% '( r("*$ro* ( "n'"!'or(* '( % !%"'' '( $r+/o4
D$s)(&e =-e -&" )es(&" &( $&!(+-#"" e& +" e"+$<"#$%& e $&5('e
e +" b"#$+(s#()$" !e$5$=-e -& 7" )( se'"&" "+ "<" 4 =-e +(s ",(s y
es-+,"(s #(&s$8&"(s e& +(s $&5('es e+"b("(s ese 7" #($&#$"&
e/"#,"'e&,e #(& +(s e8$s,"(s e& +" PCT. Es,( ebe se e"+$<"(
)( e+ es)(&s"b+e e+ +"b(",($(4 e& #"s( =-e + '$s'( &( )(#ese e
$&5('e '-es,"s.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 25/66
45
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 26/66
Ve$5$#" =-e +"s '-es,"s es,& s$e&( ) (#es""s e& e+ 7" e& =-e
5-e(& e#$b$"s ( "+ 7" s$8-$e&,e. S$ e+ +"b(",($( &( )-ee "#e
b"#$+(s#()$"s ,((s +(s 7"s ( s$ e#$be '-es,"s e #e&,(s )e$5$#(s4
!e$5$#" =-e &( ,"&s#-"& ';s e 7"s ese =-e +"s '-es,"s
5-e(& ,('""s "s," =-e s(& )(#es""s e $&5( '""s.
C(&,(+" =-e +(s es-+,"(s e +"s b"#$+(s#()$"s se es,&
e&,e8"&( e8-+"'e&,e #('( ';/$'( 3 $"s ;b$+es es)-s e+
e#$b( e +" '-es,"
Ve$5$#" =-e +(s es-+,"(s se"& e#$b$(s4 e& e+ se!$#$( e& e+ =-e e+
)"#$e&,e e&,e8% s- '-es," ( e& e+ #(&s-+,($( e+ '$#( =-e s(+$#$,%
e+ es,-$( e& e+ 'e&( ,$e')( )(s$b+e )( ';s "+e0"(s =-e es,&.
Ve$5$#" =-e "*"& s$( e$!""s )"" #-+,7!( +"s '-es,"s =-e +(e=-$ee&4 se86& +( &('"(.
A&"+$<" 'e&s-"+'e&,e * '"&,e&e -& e8$s,( e +(s s$8-$e&,es $&$#"( es
C(&#e&,"#$%& e b"#$+(s#()7" )( S$&,(';,$#( Res)$",($(.
Re&$'$e&,( T#&$#(.
N6'e( e b"#$+(s#()7"s e"+$<""s )( #"s(.
S$ es,(s !"+(es se "+e0"& s$8&$5$#",$!"'e&,e e +(s "b$,-"+es 4 se ebe& $&!es,$8"
+"s #"-s"s.
S-#es$%& e es-+,"(s )(s$,$!(s e& -&( ( -&(s )(#(s 7"s e ,"b"0(. S$ se
e,e#,"&. $&!es,$8" s7 se " )(-#$( #(&,"'$&"#$%& #-<"" >,"&s5ee&#$" e
b"#$+(s ese -&" '-es," "+,"'e&,e )(s$,$!" " +"s s$8-$e&,es?
E& e+ #"s( e& =-e e,e#,e& "&('"+$"es * &( se )-e"& se$e&,$5$#""s +"s
#"-s"s4#(&s-+," "+ +"b(",($( e e5e e&#$" .
1. S-)(r7"*"#n $&!n"! "n'"r(!$ '( %+!"%o*!o)".
C(&s$s,e e& e+ e&!7( e +;'$&"s ese e+ +"b(",($( +(#"+ >s-)e!$s"(? "+ +"b(",($(
s-)e!$s( >#e&,( e e5ee&#$" e #(&,(+ e #"+$" e b"#$+(s#()7"? * se b"s" e& +"
#(')""#$%& e es-+,"(s * +" e!"+-"#$%& e +" ")+$#"#$%& e +" ,#&$#" b"#$+(s#%)$#"
e& +"s +;'$&"s )e)"""s )( +(s +"b(",($(s e& s- ,"b" 0( e -,$&". L(s +"b(",($(s
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 27/66
e +(s #e&,(s e e5ee&#$" e #(&,(+ e #"+$" ,e&;& b"0( s- s-)e!$s$%& " s- e
+(#"+ * e+ +"b(",($( #e&,"+ " +(s #e&,(s e e5ee&#$" e #(&,(+ e #"+$".
46
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 28/66
1. !on*(r7!"#n y (n70o '( %* %m"n*.
T((s +(s +"b(",($(s =-e e5e#,6"& b"#$+(s#()$"s ebe& #(&se!"
-"&,e -& 'es +" ,(,"+$" e +"s +;'$&"s )(s$,$!"s * &e8",$!"s.
P"" #(&se!" +"s +;'$&"s se ebe =-$," e+ "#e$,e e $&'es$%& #(&
)")e+ "bs(be&,e . U&" !e< +$')$"s e!$s" +" &-'e "#$%& %
$e&,$5$#"#$%& y 8-""+"s.
L"s +;'$&"s ebe& se e&!$""s e& +(s )$'e(s 7"s e+ 'es
s$8-$e&,e #-')+$e&( +"s $&$#"#$(&es e+ $&s,-#,$!( )"" e+ ++e&"( e+
e&!$( e #(&,(+ e #"+$" $&$e#,( e b"#$+(s#()7" .
1.8 E7%-!"#n '( r(*-%$'o* '( *-)(r7"*"#n '( !' %m"n.
A+ "#e +" s-)e!$s$%& e #"" +;'$&" se e!"+-";
C(&#("&#$" e +(s es-+,"(s.
G(s( y e8-+"$" e+ e/,e&$(.
T$&#$%& )ese&#$" e )e#$)$,"(s ( #$s,"+es e 5-#s$&"4 e5e#,(s e
#(+("#$%& y #""#,e7s,$#"s e +" ,$&#$%& e 5(&(.
T(" +" $&5('"#$%& 8e&e"" e& +" s-)e!$s$%& ,#&$#" $&$e#," ebe se
#('-&$#"" " +(s se!$#$(s.
1. S-)(r7"*"#n 'm"n"*$r$"7 "n'"r(!$.
C(&s$s,e e& e+ "&;+$s$s y +" e!"+-"#$%& #7,$#" #-"&,$,",$!" y #-"+$,",$!" e +" $&5('"#$%&
es,"7s,$#" 'e&s-"+ )"" )(e e!"+-"
C(e+"#$%& #-"&,$,",$!" y #-"+$,",$!" #(& +" $&5('"#$%& e 'eses
"&,e$(es.
P()(#$%& e b"#$+(s#()$"s )"" $"8&%s,$#( y )"" e+ #(&,(+ e+
,","'$e&,( .
V" $"#$(&es e& +" )()(#$%& e es-+,"(s )(s$,$!(s e& +"s b"#$+(s#()7"s
)"" $"8&%s, $#(.
Re+"#$%& e&,e b"#$+(s#()$"s e $"8&%s,$#( )(s$,$!( * #"s(s
$"8&(s,$#"(s.
47
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 29/66
C(e+"#$%& e&,e b"#$+(s#()$"s e #(&, (+ e , ","'$e&,( * #"s(s e&
,","'$e&,(.
Es #(&!e&$e&,e4=-e e+ e=-$)( e+ PNTYER e+ &$!e+ +(#"+4e5e#,6e -& "&;+$s$s 8+(b"+e +" $&5('"#$%& 'e&s-"+ )"" es,"b+e#e +"s e+"#$(&es )e,$&e&,es e&,e +"s
$!es"s "#,$!$"es +(#"+$<"#$%& e #"s(s4e/;'e&es b"#,e$(+%8$#(s 4
&(,$5$#"#$%&4e&5 e'(s e& , ","'$e&,(4 e,#.
L" s-)e!$s$%& es -&" "#,$!$" )$($,"$" e& e+ PNTYER4" 5$& e '"&,e&e +"#"+$" y
e5 $#$e&#$" e +" e e +"b( ",($(s =-e e5e#,6"& ,#&$#"s b"#,e$(+%8$#"s e
,-be#-+(s$s * es -&" es)(&s"b$+$" ese&#$"+ e+ &$!e+ s-)e$( e $&,e'e$(.
N('"+'e&,e s(& e=-e $(s +(s e8$s,(s * +(s es-+,"(s e #(&, (+ e #"+$"
$&,e&( * e/,e&( -"&,e +" !$s$," e s-)e!$s$%&4 )( +( =-e ebe& es,"
$s)(&$b+es.
48
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 30/66
1. SISTEMA DE REGISTRO.
E+ e8$s,( e+ +"b(",($( &( s%+( s$!e )"" (#-'e&," +(s es-+,"(s e+ e/"'e&
'$#(s#%)$#( e +"s '-es,"s ,"'b$& ")(," $&5('"#$%& =-e $&,e8"" " +" )(-#$"
)( (,(s +"b(",( $(s4 es 6,$+ )"" e!"+-" +" s$,-"#$%& e)$e'$(+%8$#" * +" #"+$" e +"s"#,$!$"es es,$&""s "+ #(&,(+ e +" ,-be#-+(s$s y )"" )+"&$5$#" 5-,-"s "#,$!$"es
. Ae';s )e'$,e #(&(#e4 se8-$ e+ es"(++( 4 -,$+$<"#$%& y e5$#$e&#$" e +(s se!$#$(s
e +" Re e L"b(",($(s .
E+ +"b(",($( ebe )(e "s,e" e& s-s e8$s,(s +"s '-es,"s e#$b$"s4 )(#es""s *
e$!""s )"" #-+,$!( * )-eb" e se&s$b$+$" 4 SR $&!es,$8"(s4 #"s(s $"8&(s,$#"(s
y #(&,(+"(s 4 e+ es-+,"( e +"s b"#$+(s#()$"s e #"" )"#$e&,e4 e"#,$!(s e
$&s-'"s e#$b$(s y #(&s-'$(s.
L(s +"b(",($(s e +" Re ebe& #(&," #(& +(s s$8-$e&,es $&s,-'e&,(s es,"&"$<"(s
)( e+ PNTYER
N('" N"#$(&"+ e Pe!e&#$%& * C(&,(+ e +" T-be#-+(s$s.
M"&-"+ e P(#e$'$e&,(s )"" e+ D$"8&%s,$#( B"#,e$(+%8$#( e +"
T-be#-+(s$s )( M$#(s#()$" D$e#,"
M"&-"+ e C(&,(+ e C"+$" e +" Re e L"b(",($(s e T-be#-+(s$s.
L$b( )"" e+ ++e&"( e+ e&!$% e+ C(&,(+ e C"+$" I&$e#,( e
B"#$+(s#()$".
S(+$#$,- e e/"'e& b"#,e$(+%8$#( e ,-be#-+(s $s PCT3.
Re8$s,( e "#,$!$"es e +"b( ",($( PCT.
L$b ( e Re8$s,( e e&!7( e #-+,$!(s BAAR PCT11.
L(s e8$s,(s ebe& se #(&se!"(s POR LO MENOS DURANTE AOS
L" ) e#$s$%& e& +" (#-'e&,"#$%& es #7,$#" )"" "s,e" es-+,"(s4e!"+-" *
)+"&$5$#" ")()$""'e&,e +"s "#,$!$"es.
L(s $&s,-'e&,(s e e8$s,( ebe& se8-$ +"s &('"s e+ P (8"'" e C(&, (+
e
T-be#-+(s$s.
L(s e8$s,(s ebe& es," #(')+e,(s * #(&,e&e $&5('"#$%& #(&5$"b+e * #(&s$s,e&,e
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 31/66
49
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 32/66
1. ANEXOS .
A&e/(1.
A&e/(2.
A&e/(3.
A&e/( .
A&e/( .
A&e/(.
A&e/(.
A&e/( .
A&e/( .
EL MICROSCOPIO Y SUS PARTES.
TABLA DE CQLCULO PARA ELABORAR EL PEDIDO DEMATERIALES.
PREPARACIÓN DE REACTIVOS.
CAUSAS DE ERROR EN LA
BACILOSCOPIA. INDICADORES
OPERACIONALES .
INDICACIONES PARA EL LLENADO DEL LIBRO DEREGISTRO DE ACTIVIDADES DE L ABORATORIO . >PCT ?.
SOLICITUD DE EAMEN BACTERIOLÓGICO DETUBERCULOSIS >PCT 3?. E INDICACIONES DE CULTIVO Y SENSIBILIDAD .
INSTRUCTIVO PARA EL LLEN ADO DEL ENVIO DEL CONTROLDE CALIDAD INDIRCTO DE BACILOSCOPA Y HOJA DE ENVIODEL CONTROL OC CALIDAD INDIRECTO DE BACILOSCOPIAS.
LIBRO DE REGISTRO DE ENVIO DE CULTIVO BAAR >PCT 11?.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 33/66
50
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 34/66
ANEXO 1
EL MICROSCO,IO 6 SUS ,ARTES.
E+ '$#(s#()$( =-e se -,$+$<" e& e+ +"b( ",( $( )" " e+ e/"'e& '$#(s#%)$#(e +"s b"#$+(s#()$"s. es e+ '$#(s#()$( #(')-es,( e #"')( #+" (.
E+ '$# (s#()$( e #"')( #+" (4 #(&s," e )",e Me#;&$#" * Ó),$#".
1 P",e 'e#;&$#"
B"se ( s()(,e e+ '$#(s#()$(4 )+",$&"4 #"( 'e#;&$#(4,(&$++( '"#(',$#( 4
,(&$++( '$#(',$#( 4 b"<(.
2 P",e %),$#" O#-+"es4 (b0e,$!(s4 #(&e&s"( 4 5-e&,e e +-<4 )$s'"s >e&,( e+
,-b( b$&(#-+".?
Rno1&
OJ I9
Ca ho .·. /al
Br ato
Pl!llll
a
U ,.1'('91 $,(
$J1!l.ro!n0tr!"o
Con# n a#or
1
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 35/66
ANEXO 2
TABLA DE C9LCULO ,ARA ELABORAR EL ,EDIDO DEMATERIALES.
E+ #;+#-+( e +(s '",e$"+es " &e#es$,"4 se "#e e& b"se "+ ,"b"0( e"+$<"( e& e+ "@(
"&,e$( 4 '$e&,"s &( se "8"& #"'b$(s e& +"s "#,$!$"es y 'e,"s b;s$#"s e+
PNTYER. E+ )e$( se e5e#,6" #"" 3 'eses )e5e$b+e'e&,e .
F"s#(s e#(+e#,(es
L;'$&"s )(,"(b0e,(
A)+$#"( e '"e"
P")e+ )"" +$')$" +e&,es
S(+-#$%& e 5e&(+ "+ $ +e07"
C('e#$"+
A#e$,e e $&'es$%&
A+#((+ 9 )"" 'e#e(
L;)$< 8"5$,( .
F-#s$&" 5e&$#""
A+#((+;#$(
A<-+ e 'e,$+e&(.
M"s#"$++"s N
G-"&,es
P")e+ ,("++"
E'b-(s
P+$e8(s e )")e+ 5$+,(
L;')"" )"" '$#(s#()$(
1 )( b"#$+(s#()7"
1 )( b"#$+(s#()$"
2 )( b"#$+(s#()7"
1 )( #"" 19b"#$+(s#()7"s.
1 8" "5" )( 'es.
1 8(," 9.9 '$ )(
b"#$+(s#()7".
1 +$, ( )( 'es. 1 #"" 3
'eses.
'$. )( b"#$+(s#()7".
'$. )( b"#$+(s#()7".
'$. )(
b"#$+(s#()7" . 1
'e&s-" + )( e#-s( .
1 )" $"$(.
1 (++( 'e&s-"+.
2 "+ "@(.
1 )+$e8( )( 'es.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 36/66
1)( "@(.
No$4 P"" +(s #(+("&,es 4 es e#('e&"b+e ,e&e -& s,(#W e ese!" e 99 '$.
5
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 37/66
ANEXO 3
,RE,ARACIÓN DE REACTI5OS.
FUCSINA FENICADA.
3 8 e 5-#s$&"b;s$#". 199 '$.4e
"+#((+ e X
'$ e 5e&"+
"#-(s(.
Se "8$," * se "8e8" "8-" es,$+"" "s," #(')+e," -& +$,(4
se e0" e)(s" 2 .4 * se 5$+,".
>?Fe&"+ "#-(s( 199 8 e 5e&"+ #$s,"+$<"( * 19 '$ e "8-"
es,$+""4 se #"+$e&," e& b"@( e '"7" "s," #(')+e,"
$s(+-#$%&4 +-e8( se e&55".
AZUL DEMETILENO. 18 e "<-+ e 'e,$+e&(.
199 '$ e "+#((+ e X.
Se $s-e+!e )( "8$,"#$%& * se "8e8" "8-" es,$+"" "s,"
#(')+e," -& +$,(. Se e0" e)(s" 2 * se 5$+,".
SOLUCIÓN DECOLORANTE .
39 '$ e ;#$( #+(7$#( )"" "&;+$s$s.
9 '$ e "+#((+ e X.
C(& -&" )$)e," Se e0" es#- $ )( +"s )"ees e+ ;#$(
#+(7 $#( e& e+ '","< =-e #(&,$e&e e+ "+#((+4 +-e8( se
"8$," &-e!"'e&,e.
C"" !e< =-e +(s #(+("&,es se -,$+$<"& ebe& 5$+,"se )e!$"'e&,e.
CONSER5ACIÓN.
L(s #(+("&,es ebe& #(&se!"se e& 5"s#(s e #(+( ;'b" )( -& ,$e')( &( '"*(
e -& 'es.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 38/66
53
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 39/66
ANEO .
CAUSAS DE ERROR EN LABACILOSCOPIA .
FALSOSPOSITIVOS FALSOSNEGATIVOS
INHERENTESM-es," &( e)ese&,",$!" e +" +es$%&.
M-es, " e#(8$" e& '('e&,(s
A LA $&"e#-"(s. MUESTRA M-es," e& #"&,$" $&s-5$#$e&,e .
M-es," e& e&!"se e-,$+$<"b+e.M-es," '"+ #(&se!"" >b"#,e$(+$s$s?
INHERENTES
M"+" se+e##$%& e +" )",7#-+" 6,$+.
De5e#,(s e& +" e"+$<"#$%& e+ es,-$(E/,e&$(s 5$&(s4 8-es(s ( )(#(('(8&e(s. Us( e )(,"(b0e,(s "*"(s ( s-#$(s.
AL F$0"#$%& e e/,e&$( 6'e( ( "OPERADOR ,e')e ",-" s-)e$( " 9X &
De5e#,(s e& +" e"+$<"#$%& e +"#(+("#$%&. C"+e&,"'$e&,( e5$#$e&,e ( e/#es$!(. M"+" e#(+("#$%& e 5(&(.Pe#$)$,"#$%& e #$s,"+es )( -s( e
e"#,$!(s &( 5$+,"(s ( #"+e&,"'$e&,( e/#es$!(. De#(+("#$%& e/#es$!" .De5e#,(s e& +" +e#,-" . & Us( e '$#(s#()$(s e5e#,-(s(s.Le#,-" e -& &6'e( $&s-5$#$e&,e e #"')(s.P(#" #")"#$" )"" $5ee&#$" b"#$+(s e ",$5$#$(s e #(+("#$%&. Obse!"#$%& e -& s(+( &$!e+ e+e/,e&$(
T"&s5 ee&#$" e b"#$+(s e -& e/,e&$( &
" (,( >!"$++" e "#e$,e e $&'es$%&? &
C(&5-s$%& e '-es,"s *( e/,e&$(s .E(es e& ,"s#$)#$%& e es-+,"(s.
INHERENTES ALA
TCNICA
L$'$,e e se&s$b$+$" 999 D 19999b"#$+(s )( '$.Es)e#$5$#$" se e,e#,"& BAAR =-e)-ee& se &( )",%8e&(s * N(#"$".
54
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 40/66
ANEO
INDICADORES OPERACIONALES DE LABORATORIO
CONCENTRACIÓN DE BACILOSCOPI AS POR SR.
T(,"+ e B[ e $"8&%s,$#( >M 9 M
2?V.E. 3
SR $&!es,$8"(s )( e++"b( ",( $(
RENDIMIENTO TECNICO
M 9
T(,"+ e BW e $"8&%s,$#( )(s$,$!"s "+ SR 199 M9>B[+ M2>B[+ 199 V.E T(,"+ e BW e $"8&(s,$#( e"+$<""s "+ SR M 9 M 2
NX DE B[ RE ALIZADAS POR C ASO
T(,"+ e B[ e $ "8 &%s,$#( e"+$<""s "+ SRT(,"+ e #"s(s B[ >?>&-e!(s * e e,","'$e&,($"8&(s,$#"(s e& e+ +"b( ",($(?
I&,e)e,"#$%& e $&$#"(es e +"b(",($(
C(&#e&,"#$%& '$e e+ &6'e( e B"#$+(s#()$" e"+$<"" e& )('e$(4)( #"" S$&,(';,$#( Res)$",($(.
Re&$'$e&,( ,#&$#( e +"b(",($( '$e e+ )(#e&,"0e e BW >? e+ ,(,"+e BW e $"8&%s,$#( e"+$<""s.
NX. e BW e"+$<""s )( #"s(se (b,$e&e e+ &6'e( e BW e"+$<""s
)" " e&#(&," -& #"s( BW )(s$,$!(4 se" &-e!( ( e e,","'$e&,(.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 41/66
55
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 42/66
ANEXO :
INDICACIONES ,ARA EL LLENADO DEL LIBRO DE ACTI5IDADES
DE LABORATORIO . ;,CT <.
"? E+ )ese&,e +$b ( e Re8$s,( e A#,$!$"es e L"b(",($( >PCT?4 es -&
$&s,-'e&,( e $&5('"#$%& (5$#$"+ e+ P(8"'" N"#$(&"+ e T-be#-+(s$s *
E&5e'e"es Res)$",($"s e E+ S"+!"(. e+ #-"+ ebe se "e#-""'e&,e
++e&"( * #(&se!"(.
b? Se #(&s$e" S$&,(';,$#( Res)$",($( $&!es,$8"( "+ -s-"$( '"*( e 19 "@(s
=-e )ese&," ,(s #(& e/)e#,("#$%& )( ';s e 1 7"s e e!(+-#$%& 4 =-e es
#"),"( e& +" #(&s-+," e/,e&"4 e'e8e&#$" 4 (s)$,"+$<"#$%&4 #e&,(s )e&"+es (
e& +" #('-&$" * =-e )()(#$(&" '-es," e es)-,( )"" se e/"'$&"".
#? E& es,e +$b( ebe& e8$s,"se ,((s +(s s$&,(';,$#(s es)$",( $(s I&!es,$8"(s)(
e++"b(",($(.
? Se)"" +" $&5('"#$%& #"" 'es y ,(,"+$<"+( )"" "#e +(s #(&s(+$"(s
'e&s-"+es * ,$'es,"+es .
SIBASI
A&(," e+ &('be#(es)(&$e&,e
ESTABLECIMIENTO DESALUD
A&(," e+ &('be e+ es,"b+e#$'$e&,( e s"+-
#( es)(&$e&,e.
LABORATORISTA ENCARGADOA DEL PCT
A&(," e+ &('be e++"b(",($s," es)(&s"b+e e+ ++e&"( e+ +$b( #""'es
1.FECHA
A&(," #(& &6'e(s e+ $" =-e )(#es" +"'-es,".
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 43/66
56
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 44/66
2.PROCEDENCI A
A&(," +" $e##$%& e/"#," e+ +-8" e )(#ee&#$" e+ )"#$e&,e4 e& 5( '" #(')+e,"
)"" 5"#$+$," e+ se8-$'$e&,( s$ s,e es-+," se #"s( )(s$,$!( e
TB.E& #"s( e =-e +"s '-es,"s se"& e5e$"s e -& es,"b+e#$'$e&,( =-e &( ,e&8"
+"b(",( $( se es#$b$; e+ &('be e+ es,"b+e#$'$e&,( e (&e)(#ee.
3 NOMBRES Y APELLIDOS
Es#$b" #(& +e," +e8$b+e * (e&"" * e '"&e" #(')+e," +(s &('bes * ")e++$(s
e+ )"#$e&,e 4 )"" 5"#$+$," s- se8-$'$e&,( .
.EDAD
A&(," +" e" e+ )"#$e&,e e&"@(s.
4SEO
Se '"#" #(& -&" e+ se/(#( es)(&$e&,e.
.NUMERO CORRELATIVO
A&(," +(s &6'e(s e& 5 ('" #(e+",$!"4e "#-e ( "+ (e& e e&, e8" e +"
'-es," e+ )"#$e&,e . N( se ebe& e)e,$ +(s &6'e(s &$ -,$+$<" +e,"s.
Re#(" =-e )"" $"8&%s,$#( s(& , es b"#$+(s#()7"s4 * )"" #(&,(+ s(&(s
b"#$+(s#()7"s )( )"#$e&,e * #"" -&" ,$e&e =-e ++e!" -& &6'e($5 e e&,e.
I&$#$" #(& e+ &6'e( 1 e+ e8$s,( e b"#$+(s#()$"s e #"" 'es4 s$8-$&(+(
e& #(e+",$!( "s," e+ 5$&"+ e+ 'es. L(s &6'e(s #( e+",$!(s e -& '$s'(
)"#$e&,e &( ebe& se &e#es"$"'e&,e #(&se#-,$!(s. E0e')+(
J(s A&,(&$( Pe< G%'e< 1 5 8
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 45/66
J-"&" L-$s" Be+, ;& G"#7" 3
4 * 19 BACILOSCOP I AS DIAGNÓSTICAS S.R
57
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 46/66
A&(," +(s es-+,"(s e +"s '-es,"s #(& #(+( (0(4 s$ es )(s$,$!( y e+ &6'e( e
#-#es >\ >\ >? s$ es &e8",$!( es#$b$ #(& -&" N #(& #-"+=-$e (,( #(+( e& +"
#"s$++" se86& #(es)(&" >1".4 2".4 3".\ '-es,".
114124 13 BACILOSCOPIAS DE CONTROL DE TRATAM +ENTO
A&(," +(s es-+,"(s e b"#$+(s#()7"s e #(&,(+ e ,","'$e&,( e #"s(s >"+ 2(.4 ,(.
y ,(. Mes e ,","'$e&,(\4 #(& #(+( (0( s$ es )(s$,$!( y e+ &6'e( e #-#es s$ es
&e8",$!( es#$b$ -&" N #(& #-"+=-$e (,( #(+( e& +" #"s$++" #(es)(&$e&,e . S$ es
e,","'$e&,( #(+(#" es-+,"(s e+ #(&,(+ e+ 3(.4 ,(. Y !(. 'es e& #(+-'&"s 114
12 * 13 es)e#,$!"'e&,e * "&(," e& (bse!"#$%& e,","'$e&,(.
1. TIPO DEMUESTRA
A&(," e+ ,$)( e '-es," e#$b$"4 E0. Es)-,(4 "s)$"( 8;s,$#( ( #-"+=-$e (,"
'-es," " +" =-e se +e s(+$#$," "#e B[.
1. OBSERVACIONES
A&(," #-"+=-$e $&5('"#$%& =-e se #(&s$ee $')(,"&,e es-+,"(s e VIH -(,".
ES FUNCIÓN DEL ENCARGADO DEL ,ROGRAMA DE LABORATORIO4
C(')"" s- $&5('"#$%& #(& e+ e&#"8"( e P(8"'" e TB e+
es,"b+e#$'$e&,( )"" e!"+-" e+ ' e SR =-e #(&s-+,"(& * e+ ' e BW =-e se
e"+$<"(&.
Se)"" +" $&5('"#$%& #"" 'es4 ,"<"&( -&" +7&e" (0" y ,(,"+$<"+( )""
"#e +(s #(&s(+$"(s 'e&s-"+ y ,$'es,"+.
E&!$" "+ #e&,( e #(&,(+ e #"+$" #(es)(&$e&,e ,("s +"s
b"#$+(s#()7"s e"+$<""s e& e+ 'es )"" s- es)e#,$!( #(&,(+ e #"+$"4
-"&,e +" )$'e" se'"&" e+ 'es s$8-$e&,e. >E0.L"s b"#$+(s#()7"s
e"+$<""s e& E&e( se e&!$";& +" 1K se'"&" e+ 'es e Febe(\ .
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 47/66
58
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 48/66
MINISTERIO DE SALUD P]BLICA Y ASISTENCIA SOCIALPROGRAMA NACIONAL DE TUBERCULOSIS Y ENFERMEDADES RESPIRATORIAS
REGISTRO DE ACTIV IDADES DE LABORATORIO PCT
SIBASI MES1 U AO 1
ESTABLECIMIENTO DE SALUD U
LABORATORISTA ENCARGADO DEL PROGRAMA
Fe#" P (#ee&#$" N('bes * ")e++$(s E"
Se/( N6'e (B"#$+(s#()7"s$"8&(s,$#"s
S.R
B[ #(&, (+ e, ","'$e&,(
T$)( e'-es,"
Obse!"#$(&es
#(e+"b!(N( >1? >2? (3) (4) (5) (6) (7) >? >? (10) (11) >12? (13) >1? (15)
M F 1*. 2K 3+. 1*. 2K. 3+. 2K%3+.
XF
5*.
,* -a*.
59
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 49/66
ANEXO =
MINISTEIUO DESALUD P>M-CA Y ASISTEHCIA SOC^.,ro>.m N!"on% '( T-+(r!-%o$. y Enf(%?f$M'('(
ReepiNtortu
SOUCITUD DE EAMEN BACTERIOLOGICO DE TUBERCULOSIS >PCT..1)
tal/o!/nto /"ha y hora #/ r/"/2"!$n /n /l la or.ltor!o4 o0r/ DDDDDDDDDDDDDDDDDND #/ 2. VIH>?9VIH >?9 Pe&$e&,e 9
E"#+ U U
U
S.... 657 F 57 -n/4aCon+8lta 9t/n* O /,:+++O ;o2<#$nO
·Ead ---------------------------------- --Nombredelsoial lnte: --------------------
F(!@ '( %n'+'#n4. A
=o2o #/ -tra ESPUTO 57 OTRA 57 ,oo";!/ar8--------------------------
EAMEN SOLICITADOB[ ENS.R. B 2'o.SERIADO CUL&VO PARA DIAGNÓS&CO CULTIVO DECONTRO+. > TESOE
7 TIIATAMIENTO A CATEGORIA SENSLBIUDAD
CJGJGJGJ57
BACILOSCOPIA PARA CONTROL DE TRATAMIENTO ACTUAL 1(. #a .
DROGAS H 57 R 57 Z 57 E 57 S 57 B? 0@ CCNTROL 0@6-A %+. 57 4•. 57 6. 57 OOK( _?
Ob..4!(#$(&22
RESULTADO
1. BacUoKopla:Pos.itivo; 2. ultivo: Positivo:
3/9at!Bo
* 57 ,* 57 a* 57
Nom+r( C S(%+4DDDDDDDDDDDDDDDDDDDD?F.!$% '$ RM-%$'O4 A
!t.ervadones:
?5(r %n'%!!%onH '( !-$$$7o % 'oro
60
1r a. 57 1r. 57#a. 57 %#a. 573ra. 57 3ra. 57
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 50/66
U IM CILOSCOI'IA
YELCULnJIOSOf!/GRATVITOS.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 51/66
INDICACIONES DE CULTI5O ;6 SENSIBILIDAD< .
E+ #-+,$!( e+ M. ,-be#-+(s$s es -& e/"'e& e 8"& se&s$b$+$"4 )e( e "+,(
#(s,( * #(')+$#"" ,#&$#" )( +( ,"&,(4"se86ese =-e s- $&$#"#$%& se
e&#-e&,e e&, ( e "+8-&" e +"s s$8-$e&,es >e&#$e e e& -& #$ #-+( e+ &6'e(=-e #(es)(&e " +" $&$#"#$%&?
1. P"#$e&,e #(& "+," s(s)e#" e ,-be#-+(s$s )-+'(&" #-*"s
b"#$+(s#()7"s se$""s s(& )es$s,e&,e'e&,e &e8",$!"s .
2. P"" $"8&%s,$#( e ,-be #-+(s$s I&5"&,$+ >"s)$ "( 8;s,$#( - (," '-es,"?
3. P"" #(&5$'"#$%& e $"8&%s,$#( e ,-be#-+(s$s e/,")-+'(&"
. C"s( VIH )(s$,$!( * s(s)e#" e ,-be#-+(s$s4 )e ( =-e )ese&," s$8&(s
* s7&,('"s #( es)(&$e&,es " ,-be #-+(s$s
. S(s)e#" e F "#"s( ,e")-, $#( ( Ab"&(&( e#-)e "( *( Re#"7"
>)e!$"'e&,e ,","(s?
. C(&,"#,( e ,-be#-+(s$s '-+,$es$s,e&,e #(&5$'"(
. A&,e#ee&,es e es,"&#$"s )e!$"s e& #e&, (s )e&$,e&#$"$(s
. P"#$e&,es #($&5e#,"(s TBNIH
. P"#$e&,e =-e &( &e8",$!$<" "+ 2X. % 3X.'es e ,","'$e&,(
N(,"
N( (+!$e =-e e+ $&5('e e +(s es-+,"(s se "; " +(s 39 % % 9 7"s
* &-&#" "&,es
N( se e=-$ee #-+,$!( )"" "+," e )"#$e&,es
N('be e +" )es(&" =-e $&$#" e+ #-+,$!(
F$'" e+ s(+$#$,"&,e
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 52/66
F1
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 53/66
ANEXO 8INSTRUCTI5O ,ARA EL LLENADO DEL EN5IO DEL CONTROL
DE
CALIDAD INDIRECTO DE BACILOSCO,A .
Z(&" "&(," e+ &('be e +" <(&" "+ =-e #( es)(&e e+ es,"b+e#$'$e&,( es"+-
SIBASI e8$s," e+ &('be e+ SIBASI#(es)(&$e&,e.
Es,"b+e#$'$e&,(es#$b$ e+ &('be e+es,"b+e#$'$e&,( e (&e se es,"e&!$"( e+
#(&,(+ e#"+$".
Mes e e&!7(#(+(#" e+ &('b e e+ 'es e& =-e 5-e (& !$s,"s +"s +;'$&"s e&e+ &$!e+
+(#"+.
Fe#" e e&!7(")-&," +" 5e#" e& =-e se es," e&!$"&( e+ #(&,(+ e #"+$"e0e')+(
s$ se es,;& e&!$"&( +"s +;'$&"s !$s,"s e& e+ 'es e e&e ( e& e+ es,"b+e#$'$e&,(
e s"+-4 +" 5e#" e+ 'es e e&!7( es," 7" e&,e +(s )$'e(s #$&#( 7"s e+ 'es
e 5 ebe(.
T(,"+ e +;'$&"s e&!$""s "&(," e& &6'e (s "bs(+-,(s e+ ,(," + d e +;'$&"s =-e
es," e&!$"&( " #(&,(+ e #"+$" e0e')+( s$ e+ es,"b+e#$'$e&,( e s"+- e#$b$%
399 b"#$+(s#()7"s e& -& 'es e,e'$&"(4 e+ ,(,"+ e +;'$&"s e&!$""s se$" 399.
T(,"+ e +;'$&"s &e8",$!"s e&!$""s e& &6'e( "bs(+-,( e8$s,"; e+ ,(,"+ e
+;'$&"s =-e e+ es,"b+e#$'$e&,( e s"+- " e)(,"( #('( &e8",$!"s e& s- PCT-4
e0e')+( s$ e 399 b"#$+(s#()$"s e#$b$"s4 e+ es,"b+e#$'$e&,( e s"+- e)(,( 29
&e8",$!"s4 es,e se ; e+ &6'e( "bs(+-,( e8$s,"( e& ,(,"+ e +;'$&"s &e8",$!"s
e&!$""s >29?.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 54/66
T(,"+ e +;'$&"s )(s$,$!"s e&!$""s e& &6'e( "bs(+-,( e8$s," ; e+ ,(,"+ de
+;'$&"s
=-e e+ es,"b+e#$'$e&,( e s"+- " e)(,"( #('( )(s$,$!"s e& s- PCT-4 e0e')+( s$e+
62
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 55/66
es,"b+e#$'$e&,( e s"+- e 399 b"#$+(s#()$"s e#$b$"s4e)(,( 9 )(s$,$!"s.es,e se;
e+ &6'e( "bs(+-,( e8$s,"( e& ,(,"+ e +;'$&"s )(s$,$!"s e&!$""s>9?.
N e +;'$&"s )(s$,$!"s e&!$""s e8$s," +(s &6'e(s #(e+",$!(s e +;'$&"s !$s,"
#('( )(s$,$!"s * e)(,""s e& +" PCT #('( ,"+e0e')+( +" b"#$+(s#()7" 34 14 34
4 4 194 5-e(& e)(,""s #('( )(s$,$!"s4 es,"s s(& +"s =-e se e)(,";& e&
es," #(+-'&" .
Res-+,"( )( #-#es e8$s," e+ &6'e( e #-#es #(es)(&$e&,es " #"" +;'$&"
)(s$,$!"4 4 .>e& #(+( (0(?
B"#$+(s#()$" $"8&%s,$#" SR #(& -&" K/K '"#" s$ +" +;'$&" )(s$,$!" #(es)(&e "
+" )$'e" >1?. se8-&" >2? ( ,e#e" '-es," >3? e+ SR.
B"#$+(s#()7" #(&, (+ e ,","'$e&,( #(& -&" " )(' '"#" s$ +" +;'$&")(s$,$!"
#(es)(&e "+4 2. .K $ 3X.X * " 'es e
,","'$e&,( .
Obse!"#$(&es A&(," #-"+=-$e #(s" e+e!"&,e4 )( e0e')+( )"#$e&,e VIH
>?4&('be e+ )"#$e&,e4( #-"+=-$e (,( "s)e#,( =-e +e se" e -,$+$" "+
es)(&s"b+e e+ #e&,( e e5ee&#$" e #(&,(+ e #"+$".
N('be e+ 0e5e e +"b(",($( "&(," e+ &('be e+ 0e5e e +"b(",($(4 e+ #-"+
ebe; !e$5$#" s$e')e #('( se es," e&!$"&( e+ #(&,(+ e #"+$".
Res)(&s"b+e &('be e +" )es(&" =-e e+ 0e5e " "s$8&"( )"" -& 'ese,e'$&"(
y =-e es,"; )e&$e&,e e )e)"" es,e #(&,(+ e #"+$" )"" s- e&!7(.
Se++( se++( e+ +"b(",($( =-e es," e&!$"&( e+ #(&,(+ e #"+$" e b"#$+(s#()$".
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 56/66
63
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 57/66
MINISTERIO DE SALUD P]BLICA Y ASISTENCIA SOCIAL
PROGRAMA NACIONAL DE TUBERCULOSIS YENFERMEDADES RESPIRATORIAS
CONTROL DE CALIDAD INDIRECTO DE BACILOSCOPAS
ZONA
SIB ASI
ESTABLECIMIENTO 1.
MES DE
U U U U
ENVIODDDDDDDDDDDDDDDDDDDDDDDDDDDD
FECHA DEENVIO U
TOTAL DE LAMINASENVIADAS 1 U
TOTAL DE LAMIN AS NEGATIVASENVIADAS
TOTAL DE LAMINAS POSITIVAS
NM1 DE FED C REKK.TADO BACILOSC.!(K BDCFGOACOPHD
ENVIADAS U
CONTROL DEPOSITIVAS POR CRUCES 1 DIAGNÓSTICA SR TRATAMIENTO
f" 2K 3K %* 4* ,·
++$$+$$
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 58/66
64
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 59/66
ANEXO
MINISTERIO D, S ALUD P]BLICA Y ASISTENCI A SOCIALPROGRAM A N: CIONAL DE TUBERCULOSIS Y ENFERMEDADES RESPIRATORIA S
INSTRUCTIVO I A R A EL LLENADO DEL LIBRO DE REGISTRO DE ENVIO DE CUITIVOS BAAR (PC=- 11)
E+ )ese&,e +$b ( e Re8$s,( e e&!$( e #-+,$!(s BAAR >PCT11?. es -&$&s+,J'e&,( e I&5('"#$%& (5$#$"+ e+ P(8 "'" N"#$(&"+ e T-be #-+(s$s *E&5e'e"es Res)$",($"s e E+ S"+!"( .e+ #-"+ebe se "e#-""'e&,e++e&"( y #(&se_V"(.
E& es,e +$b ( ebe& e8$s," se e+ e&!$( y es-+,"(s e ,((s +(s #-+,$!(s BAAR=-ese e&!7"& " +(s +"b( ",($(s e
e5ee&#$".
Se)"" +" $&5('"#$%& #"" 'es * ,(+"+$<"+( )"" "#e e+#(&s(+$"(,$'es,"+.
REGIÓN A&(," e+ &('b e e +" e8$%& " +" =-e )e,e&e#e e+es,"b+e#$'$e&,( .
SIBASI A&(," e+&('b e e+ SIBASI#( es)(&$e&,e
ESTABLECIMIENTO DE SALUD A&(," e+ &('b e e+ es,"b+e#$'$e&,( e s"+- es)(&s"b+e e +"$&5('"#$%&
AO
A&(+" /l "&( -"&,e e+#-"+ se es,; e"+$<"&( e+ e8$s,(
PROFESIONAL RESPONSABLE
A&(," e+ &('be e+ )(5es$(&"+ es)(&s"b+e e+ ++e&"( e+ +$b(. >E&es,"b+e#$'$e&,(s #(& +"b(",($( se;& +(s )(5es$(&"+es e +"b( ",($( +(se&#" 8"(s e+ ++e&"( e +"s #(+-'&"s #( es)(&$e&,es "+ e&!$( #(& s-ses-+,"(s e& +Os es,"b+e#$'$e&,(s s$& +"b(",($( se; es)(&s"b$+$" e+'$#( ( e&5 e'e " e&#"8"(s e+) (8"'".
N(.Ub$#" e+&`'e( =-e +e #(es)(&e "+)"#$e&,e4 se8`& (e&#( e+",$!(
DIRECCIÓN COMPLETA DEL PACIENTE A&(," +" $e##$%& e )(#ee&#$" e+ )"#$e&,e. e& 5('" #(')+e," )" "5"#$+$," e+ se8-$'$e&,( e s,e.
MOTIVO DE INDICACIÓN DEL CULTIVOE& es," #(+-'&" "&(," e+ '(,$!( 2or e+ #-"+ " s$( $&$#"( e+ #-+,$!( >!e $&$#"#$(&es e& +" )",e e "b"0( e +" '",$<?
FECHA DE ENVO AL LABORATORIO DE REFERENCIA DE CUL&VO A&(," e+ 7"4 'es * "@( e& =-e 5-e e&!$"" +" '-es," "+ +"b( ",($( e#-+, !( BAAR #(es)(&$e&,e. se8`& e es,"b+e#$" * #(&(#$" )( ,((s.
NOMBRE DEL LABORATORIO AL CUAL SE ENVIA EL CULTIVO A&(," e+ &('b e e+ +"b(",($( e e5e e&#$" e #-+,$!( B AA R "+ #-"+ see&!7" +" '-es," )"" #-+,$!(.(I. L"b(",($( Ce&,"+4 +"b(",($( H(S)$,"+eS"& M$8-e+4e,#.?
NOMBRE DE aUIEN RECIBE LA MUESTRA EN EL LABORATORIO DECULTIVO BAAR
L" )e s(&" =-e e#$be +" '-es," e #-+,$!( ebe "&(," s-&('be #(')+e,(.
FECHA DE RECEPCIÓN DE RESULTADO DEL CULTIVO A&(," +" 5e#" e/"#," e& =-e e+ es,"b+e#$'$e&,( e#$be e+ es-+,"(e+ #-+,$!( BAAR
NOMBRE DE LA PERSONA aUE RECIBE LOS RESULTADOS DELCULTIVO
A&(," e+ &('b e #(')+e,( e ," )es(&" =-e e#$b$% +(s es-+,"(se+ #-+,$!( BAAR.
NOMBRE DEL PACIENTEEs#$b" #(& +e," +e8$b+e +(s &('bes * ")e++$(s #(')+e,(s e+)"#$e&,e. )""5"#$+$+"
s- se8-$'$e&,(. >P-ee& ,('"se ';s e-&" +$&e" )"" es#$b$ e+&('b e #(')+e,(?
RESULTADO DEL CULTIVO A&(," e+ es-+,"( e+#-+,$!( >)"s$,(.'$#(b"#,e$(s$s. (,(s?
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 60/66
&e8",$!(4 #(&,"'$&"(.
EDAD A&(," +" e" e+ )"#$e&,e e&"@(s.
RESULTADO DE SENSIBILIDAD A&(," e+ es-+,"( e se&s$b$+$".s$e/$s,$e" e& e+ e)(,e.
NOTA S$e')e =-e se e&!$ '-es," )"" #-+,$!( BAAR. ++e!" +" PCT D11 )"" =-e se e8$s,e e+ &('be e +" )es(&" =-e e#$be $#" '-es," >#(+-'&" ? y s$e')e=-e se e,$e& +(s es-+,"(s e+ #-+,$!(4,"'b$& ++e!" es,e +$b( )"" "&(," +" 5e#" >#(+-'&" ? y &('b e e =-$e& e#$be e+ es-+,"( e+ #-+,$!( >#(+-'&" 19?. Es,"s(s #(+-'&"s ebe;& se ++e&""s )( -&" )es(&" =-e ,"b"7e e& e++"b(",($( (&e se e"+$<" /l #-+, !(. L(s es-+,"(s e #-+,$!( se "& )( es#$,( * &-&#" !+",e+e5%&$#".
65
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 61/66
GN
MINISTERIO DE SALUD P]BLICA Y ASISTENCIASOCIALPROGRAMA NACIONAL DE TUBERCULOSIS Y ENFERMED ADES RESPIRATORIAS
UBRO DE REGISTRO DE ENVIO DE CULTIVOS BAAR >PCT 11?
SIBASI U U U
ESTABLECIMIENTO DES ALUD1 DJ!O :
PRO S NAL SPONSAB LE U U
Mo$"7o '(
Y 1P"#+e&+e #(& "11" s(s)e#." e TBP #-*"s B[ se&""s s(& n/Ka1!Ba, 2P"" D$"8&%s,$#( (e TBI&5"&,$+ 3P"" #(&5+,'"#(%& e TB e/&)-+'(&" 4- #"s(s !,H )(s $!(s *s(s)e#." e TB. )e( LM/ 2r/,/nta s8&(s * s+&+('"s ((es)(&$e&+e " TB 5- S(s)e#" (( F"#"s( +e")-$#( ( Ab"&%(&( C_Je"9 *Z( Re#"+" >)"#$e&+e )e!$"'((+e ,"+"(?&+"e+O eTB MOR #(&5$'""41· A&+e#ee&,e e es1"&#$" 2r/B!a e& #e&1(s )e&"+es a- P"#+e&+es #(&5e#+"( TBNIH 9- P"#+e&+e =-e &( &e8",$!" al %+ 3 'es e 1"1"'1e&19
66
N(.
(1)
Nom+r( '(% )'(n$
>2?
E"
(3)
D,,#O& C&702ltta e+)"e&,e
(4)
Y!nlNo"l$n e
aJ O15
Fe#" #/(n71o
%+Or$or"o
'( r(f(r(n!"
'( C-H$!(>?
N(',c_e.e+
lab!"atorio al(-% *( (n7%
(% !-$$4No
(7)
Nom+r( de H-MEIr('+( (n (%
+",c(",(&( e.r%$"7o BAAR
>?
F(!@ '(r/7 2#$n
r(*-%$'o
e+aJIIO>?
Nom+r( de tapersona #ue
r/"!/ lo,r (*-%$'o* '(1
#-1,+!(>19?
R(*-$%'o
de .3"$"7o
>11?
Res-$1".( #
*(n*"+"f"''
>12?
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 62/66
1=. ABRE5IATURA 6 SIGLAS.
1. ADA
2. BAAR3. BCG
. B[
. EDTA
. PNTYER
. TB
. TAES
9. SR1O.STOPTB
11. MOR
12.M9
13.M1
1.M2
1.9PS
1.V.E
Ae&(s$& e "'$&"s".
B"#$+( ;#$( "+#((+es$s,e&,e. B"#$+( C"+'e,,e
G-e$&. B"#$+(s#()$" .
Q#$( e,$+&$"'$&( ,e,""#,$#(.
P(8"'" N"#$(&"+ e ,-be#-+(s$s y e&5e'e"es es)$",%$"s.
T-be#-+(s$s
T","'$e&,( A#(,"( Es,$#,"'e&,e S-)e!$s"(.
S$&,(';,$#( Res)$",($(.
A+,( " +" ,-be#-+(s$s .
M-+,$(8(es$s,e&,e.
P$'e" '-es," e+ S$&,(';, $#(
Res)$",($( . B"#$+(s#()$" e #(&,(+ e
,","'$e&,(. B"#$+(s#()$"s s-bse#-e&,es .
O8"&$<"#$%& P"&"'e$#"&" e +" S"+-.
V"+( Es)e"(
67
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 63/66
18. BIBLIOGRAFA.
1.G-$" e B$(se8-$" )"" +(s L"b(",( $(s C+7&$#(s4 E+ S"+!"( 4 C.A. (#,-be4299.
2. M$&$s,e$( e S"+- P6b+$#" y As$s,e&#$" S(#$"+ e E% s"+!"( . P(8"'" N"#$(&"+ eT-be#-+(s$s. N('"s N"#$(&"+ e P e!e&#$%& * C(&,(+ e +" T-be #-+(s$s. Febe(299.
3.M$&$s,e$( e S"+- P6b+$#" * As$s,e&#$" S(#$"+ e E% s"+!"( . P(8"'" N"#$(&"+ e
T-be#-+(s$s . G-$" ,#&$#" )"" e+ D$"8&%s,$#( e T-be#-+(s $s )( M$#(s#()$" D$e#,".
E+
S"+!"( 4 299.
. M$&$s,e$( e S"+- P6b+$#" * As$s,e&#$" S(#$"+ e E+ S"+!"( . D$e##$%& e Re8-+"#$%&.
U&$" e L"b(",($( Ce&,"+ KD . M"/ B+(#K. M"&-"+ e C(&,(+ e C"+$" e +" Ree L"b(",($(s e T-be#-+(s$s4 E+ S"+!"( 299.
.N('"s I&,e&"#$(&"+es )"" +" As$s,e&#$" A&,$,-be#-+(s" >NIM?4 e&e( 299.
.O8"&$<"#$%& P"&"'e$#"&" e +" S"+-. N('"s y G-$" T#&$#"4 M"&-"+ )"" e+
D$"8&%s,$#( B"#,e $(+%8$#( e +" T-be#-+(s$s . P",e 1 B"#$+(s#()$"4 299 .
.O8"&$<"#$%& P"&"'e$#"&" e +" S"+-4 (#-'e&,(s b"se )" " +" "()#$%& e +(s
es,;&"es $&,e&"#$(&"+es )"" +" ",e&#$%& e +" ,-be #-+(s$s4 P(8"'" Re8$(&"+
e T-be#-+(s$s 4^"s$&8,(& OC4Se),$e'be e 299 .
.Se#e," $" e S"+-. M"&-"+ e T#&$#"s e L"b(",($( )"" e+ E/"'e& B"#$+(s#%)$#(4
M/$#(4 2993.
.U&$%& I&,e&"#$(&"+ C(&," +" T-be #-+(s$s * E&5e'e"es Res)$",($"s >UICTER? .
G-7" e +" ,-be#-+(s$s )"" M$#(s Es)e#$"+$s,"s42993 .
19. U&$%& I&,e&"#$(&"+ C(&," +" T-be#-+(s$s * E&5e'e"es Res)$",($"s >UICTER?.
B"ses E)$e'$(+%8$#"s e+ C(&,(+ e +" T-be#-+(s$s 4 P $'e" e$#$%& 1.
11. U&$%& I&,e&"#$(&"+ C(&," +" T-be#-+(s $s y E&5e'e"es Res)$",($"s >UICTER?.
M"&e0( e +" T-be#-+(s$s4 G-$" )"" +(s P"7ses #(& es#"s(s e#-s(s e#(&%'$#(s4
a-$&," e$#$%& 2999.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 64/66
68
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 65/66
Es,e M"&-"+ " s$( e+"b("( #(& e+ ")(*(
5$&"&#$e( e+ P(*e#,( F(&( G+(b"+4 F"se 11
C(')(&e&,e T-be#-+(s$sE+ S"+!"( 4O#,-be
299 Se8-&" E$#$%&
C(&s," e 2499e0e')+"es.
8/17/2019 Manual Tb Microscopia Directa P2
http://slidepdf.com/reader/full/manual-tb-microscopia-directa-p2 66/66