Palmero Domingo, Ritacco Viviana, Ambroggi Martha, Marcela Natiello, Barrera Lucía, Capone Lilian, Dambrosi Alicia, di Lonardo Martha, Isola Nélida, Poggi Susana, Vescovo Marisa, Abbate Eduardo
Hospital F. J. Muñiz, Buenos Aires, Argentina.
Emerg Infect Dis. 2003 Aug;9(8):965-9. doi: 10.3201/eid0908.020474.
Initial multidrug-resistant (MDR) tuberculosis (TB) in HIV-negative patients treated at a Buenos Aires referral hospital from 1991 to 2000 was examined by using molecular clustering of available isolates. Of 291 HIV-negative MDRTB patients, 79 were initially MDR. We observed an ascending trend of initial MDRTB during this decade (p=0.0033). The M strain, which was responsible for an institutional AIDS-associated outbreak that peaked in 1995 to 1997, caused 24 of the 49 initial MDRTB cases available for restriction fragment length polymorphism. Of those, 21 were diagnosed in 1997 or later. Hospital exposure increased the risk of acquiring M strain-associated MDRTB by approximately two and a half times. The emergence of initial MDRTB among HIV-negative patients after 1997 was apparently a sequel of the AIDS-related outbreak. Because the prevalence of M strain-associated disease in the study population did not level out by the end of the decade, further expansion of this disease is possible.
利用现有分离株的分子聚类方法，对1991年至2000年在布宜诺斯艾利斯一家转诊医院接受治疗的HIV阴性患者的初始耐多药（MDR）结核病（TB）情况进行了研究。在291例HIV阴性的耐多药结核病患者中，79例为初始耐多药。我们观察到在这十年间初始耐多药结核病呈上升趋势（p=0.0033）。M菌株曾导致1995年至1997年达到高峰的一次机构内艾滋病相关疫情爆发，在49例可用于限制性片段长度多态性分析的初始耐多药结核病病例中，该菌株导致了24例发病。其中，21例在1997年或之后被诊断出来。医院暴露使感染与M菌株相关的耐多药结核病的风险增加了约2.5倍。1997年后HIV阴性患者中初始耐多药结核病的出现显然是艾滋病相关疫情爆发的后续影响。由于在这十年结束时，研究人群中与M菌株相关疾病的患病率并未趋于平稳，这种疾病有可能进一步蔓延。
