Drug-resistant tuberculosis (TB) is a growing global threat. Approximately 450,000
people developed multidrug-resistant TB worldwide in 2012 and an estimated 170,000
people died from the disease. This paper describes the sociodemographic,
clinical-epidemiological and bacteriological aspects of TB and correlates these
features with the distribution of anti-TB drug resistance. Mycobacterium tuberculosis
(MT) cultures and drug susceptibility testing were performed according to the BACTEC
MGIT 960 method. The results demonstrated that MT strains from individuals who
received treatment for TB and people who were infected with human immunodeficiency
virus were more resistant to TB drugs compared to other individuals (p < 0.05).
Approximately half of the individuals received supervised treatment, but most
drug-resistant cases were positive for pulmonary TB and exhibited positive acid-fast
bacilli smears, which are complicating factors for TB control programs. Primary
healthcare is the ideal level for early disease detection, but tertiary healthcare is
the most common entry point for patients into the system. These factors require
special attention from healthcare managers and professionals to effectively control
and monitor the spread of TB drug-resistant cases.
In the study region, mycobacteriosis most affected adult males with low schooling. Most patients presented comorbidities in particular co-infection with the HIV virus. M. avium is the most prevalent species in the region with the M. abscessus/M. massiliense/M. bolletii species being the main cause of nosocomial infections.
Summary
Objective To evaluate retrospectively the microbiological profile of Mycobacterium species isolated from HIV‐infected patients attending the HIV/TB reference health care units in São José do Rio Preto, Brazil.
Method Retrospective evaluation of all HIV‐1 positive patients whose IAL‐SJRP laboratorial analysis was positive for Mycobacterium sp. after diagnosis of HIV Infection, from January 2000 to December 2006.
Results Of 198 patients, acid‐fast staining detected mycobacteria early in 41%. Culture revealed 52.5% to be infected with Mycobacterium tuberculosis (MT). 42.4% had non‐tuberculous mycobacteria (NTM) and 5.1% had MT/NTM positive cultures. Eleven per cent of MT strains were resistant to at least one of the antimycobacterial drugs and 3.1% were multidrug resistant. 39.4% of isolated mycobacteria were NTM species.
Conclusion Our data may serve as a starting point for further comparisons with other Brazilian regions and other developing countries. The data may provide important clues to the future understanding, prevention and control of such co‐infections around the world.
We report on M. tuberculosis detection among inmates in detention facilities in the region of São José do Rio Preto, São Paulo State, Brazil. From 2003 to 2006, 1,070 inmates from three prisons with suspicion of tuberculosis were evaluated. Mycobacterium sp. infection was tested using acid-fast bacilli and/or culture. Statistical analysis was performed using EPI INFO and BioEstat. There were no significant differences in the frequencies of positive results between the three correctional facilities. Tuberculosis infection was identified in 6.9% of all prisoners and the drug susceptibility profile showed that 4.2% of the prisoners had isoniazid-resistant isolates while 6.2% had rifampicin-resistant bacteria. Isoniazid and rifampicin resistant isolates were obtained from inmates with positive results by acid-fast bacilli, pointing to the possibility of intra-institutional transmission. These data will be useful for future studies to establish the level of tuberculosis in the São Paulo state penitentiary system and the drug resistance profile.
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