Pedro Heloisa da Silveira Paro, Nardi Susilene Maria Tonelli, Pereira Maria Izabel Ferreira, Oliveira Rosângela Siqueira, Suffys Philip Noel, Gomes Harrison Magdinier, Finardi Amanda Juliane, Moraes Eloise Brasil de, Baptista Ida Maria Foschiani Dias, Machado Ricardo Luiz Dantas, Castiglioni Lilian
Centro de Laboratório Regional de São José do Rio Preto, Instituto Adolfo Lutz, São José do Rio Preto, SP, Brasil.
Instituto Adolfo Lutz Central, São Paulo, SP, Brasil.
Mem Inst Oswaldo Cruz. 2015 Apr;110(2):235-48. doi: 10.1590/0074-02760140316. Epub 2015 Mar 31.
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.
耐多药结核病是一个日益严重的全球威胁。2012年，全球约有45万人患上耐多药结核病，估计有17万人死于该病。本文描述了结核病的社会人口学、临床流行病学和细菌学方面，并将这些特征与耐多药结核病的分布情况相关联。结核分枝杆菌（MT）培养和药敏试验按照BACTEC MGIT 960方法进行。结果表明，与其他个体相比，接受过结核病治疗的个体以及感染人类免疫缺陷病毒的个体的MT菌株对结核病药物的耐药性更强（p < 0.05）。约一半的个体接受了督导治疗，但大多数耐多药病例为肺结核阳性，且抗酸杆菌涂片呈阳性，这些都是结核病控制项目的复杂因素。初级医疗保健是早期疾病检测的理想层面，但三级医疗保健是患者进入该系统最常见的切入点。这些因素需要医疗保健管理人员和专业人员给予特别关注，以有效控制和监测耐多药结核病例的传播。
