Centro de Laboratório Regional Santos, Instituto Adolfo Lutz, São Paulo, SP, Brasil.
Mem Inst Oswaldo Cruz. 2012 Sep;107(6):760-6. doi: 10.1590/s0074-02762012000600009.
Monitoring the extent of and trends in multidrug-resistant tuberculosis (MDR-TB) is a priority of the Brazilian National Tuberculosis Control Programme. The current study aimed to estimate the incidence of MDR-TB, describe the profile of TB drug resistance in risk groups and examine whether screening for MDR-TB adhered to the recommended guidelines. A descriptive study that examined diagnosed cases of pulmonary TB was conducted in the city of Santos, Brazil, between 2000-2004. Of the 2,176 pulmonary TB cases studied, 671 (30.8%) met the criteria for drug sensitivity testing and, of these cases, 31.7% (213/671) were tested. Among the tested cases, 9.4% were resistant to one anti-TB drug and 15% were MDR. MDR was observed in 11.6% of 86 new TB cases and 17.3% of 127 previously treated cases. The average annual incidence of MDR-TB was 1.9 per 100,000 inhabitants-years. The extent of known MDR-TB in the city of Santos is high, though likely to be underestimated. Our study therefore indicates an inadequate adherence to the guidelines for MDR-TB screening and suggests the necessity of alternative strategies of MDR-TB surveillance.
监测耐多药结核病（MDR-TB）的范围和趋势是巴西国家结核病控制规划的重点。本研究旨在估计 MDR-TB 的发病率，描述高危人群中结核病药物耐药的特征，并检查 MDR-TB 的筛查是否符合推荐的指南。在巴西桑托斯市进行了一项描述性研究，研究时间为 2000-2004 年。在研究的 2176 例肺结核病例中，有 671 例（30.8%）符合药物敏感性检测标准，其中 31.7%（213/671）进行了检测。在检测的病例中，有 9.4%的病例对一种抗结核药物耐药，有 15%的病例为 MDR。在 86 例新结核病病例和 127 例既往治疗病例中，分别观察到 11.6%和 17.3%的 MDR。MDR-TB 的年平均发病率为每 10 万人中有 1.9 例。桑托斯市已知的 MDR-TB 范围很广，但可能被低估了。因此，我们的研究表明，对 MDR-TB 筛查的指南的遵循情况不足，并表明需要替代的 MDR-TB 监测策略。
