Streptomycin Resistance in Pulmonary Tuberculosis

The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis

“…Using molecular epidemiological tools, various mechanisms for the development of drug-resistant tuberculosis have been described: 1) primary infection with a drugresistant strain; 57 2) re-infection with a drug-resistant strain during treatment for drug-susceptible tuberculosis; 54 3) re-infection with a drug-resistant strain after successful treatment for drug-susceptible tuberculosis; [54][55][56]97 4) mixed infection with a susceptible and resistant strain with unmasking of the resistant strain during treatment for drug-susceptible tubercu losis; 54 and 5) acquisition of resistance during therapy. 98 A major outcome of largescale genotyping studies was that, in several highincidence settings, the contribution of transmission for fuelling the drug resistance epidemic was underestimated. 49,82,[99][100][101] In most regions of the world, drug-resistant tuberculosis is now predominantly caused by transmission rather than acquisition of resistance, with an estimated 95·9% of MDR tuberculosis in new tuberculosis cases and 61·3% in previously treated cases being due to transmission.…”

Risk factors for acquired multidrug-resistant tuberculosis

“…Soon after antituberculosis chemotherapy started, the first studies about resistance to the used drugs were published (1,2) . During the 1980's, it was believed in the industrialized countries that the eradication of tuberculosis (TB) was imminent, and research in this field became scarce.…”

Fatores associados aos tratamentos inadequados em grupo de portadores de tuberculose multirresistente

“…(1,2) Em 1947, Pyle publicou o primeiro estudo sobre bacilos resistentes à estreptomicina (SM), (1) tendo sido seguido por vários outros autores. Crofton e Mitchenson, (3) em 1948, mostraram que 12 de 13 casos de tuberculose (TB) pulmonar grave bilateral desenvolveram resistência à SM, usando-se 2g/ dia por quatro meses ou mais. No Brasil, o primeiro estudo foi publicado por Rosemberg et al, (4) em 1953.…”