Bases racionais para a solicitação e interpretação de testes diagnósticos em doenças infecciosas
Palavras-chave:
infecção, diagnóstico, laboratório, amostra, cultura, antibiogramaResumo
Em Medicina, a formulação de hipóteses diagnósticas é feita através de informações obtidas através da anamnese e do exame físico. A solicitação adequada de exames complementares (laboratoriais, de imagem), quando necessários para confirmar ou afastar hipóteses diagnósticas, deve ser feita a partir de informações clínicas e epidemiológicas cuidadosamente obtidas. Adicionalmente, a solicitação racional de qualquer exame complementar deve ter um objetivo predeterminado e ser capaz de resultar em uma consequência. Em outras palavras, o médico deve saber por que está solicitando um exame e qual a utilidade do resultado para o paciente ou para a população. Os exames solicitados sem que estes dois princípios básicos sejam observados são frequentemente desnecessários e podem trazer prejuízos para o paciente ao retardar o correto diagnóstico ou resultar em uso inadequado de antimicrobianos. Ademais, repercutem negativamente na instituição, elevando desnecessariamente o custo do atendimento. A despeito de todo avanço tecnológico que marcou as últimas décadas, da disponibilização de técnicas automatizadas e da integração da genômica e proteômica na microbiologia, a correta interpretação do resultado que repercutirá na estratégia de intervenção mais eficiente para o paciente ainda depende da racionalidade da escolha do teste a ser realizado e da qualidade da amostra que for coletada, transportada e recebida para processamento e análise.
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