ABSTRACT
ABSTRACT The incidence and clinical characteristics of NTM diseases in Brazil remain relatively unknown. The present study describes the diagnosis of NTM isolates, the clinical presentation and treatment outcomes. We analyzed NTM isolates in patients of a tertiary hospital in the Southeast region of Brazil, from January 2008 to July 2019. The ATS/IDSA criteria for diagnosis and treatment of these patients was applied. Mycobacterium kansasii were identified in 13/113 (11.5%) patients. In 59/113 (52.2%) patients who met the ATS criteria for disease, 29/59 (49.1%) received treatment, and 22/29 (75.8%) were cured. The major species identified was M. kansasii. The most frequent symptoms among the treated patients were dyspnea and cough, and the proportion of cured patients was high.
ABSTRACT
Abstract DNA genotyping of Mycobacterium tuberculosis has been widely applied in the understanding of disease transmission in many countries. The purpose of this study was to genotype the strains of M. tuberculosis isolated in patients with new tuberculosis (TB) cases in Minas Gerais, as well as to compare the similarity, discriminatory power, and agreement of the clusters between the IS6110 Restriction Fragment Length Polymorfism (RFLP) and 12 loci Variable Number Tandem Repeat - Mycobacterial Interspersed Repetitive Units (MIRU-VNTR) techniques. It was observed that 32% (66/204) of the isolated strains in the RFLP-IS6110 and 50.9% (104/204) of the isolated strains in the MIRU-VNTR presented a similarity of equal to or above 85%. The RFLP-IS6110 and MIRU-VNTR proved to contain a high discriminatory power. The similarity index resulting from the RFLP showed no recent transmission. Good agreement was observed between the techniques when clusters were detected; however, the best epidemiological relationship was found when using the RFLP-IS6110.
Subject(s)
Humans , Tuberculosis/microbiology , Polymorphism, Restriction Fragment Length , Bacterial Typing Techniques/methods , Minisatellite Repeats , Amplified Fragment Length Polymorphism Analysis/methods , Mycobacterium tuberculosis/isolation & purification , Brazil , Mycobacterium tuberculosis/classification , Mycobacterium tuberculosis/geneticsABSTRACT
OBJECTIVE: To analyze the profile of tuberculosis cases reported between 2002 and 2009 in the state of Minas Gerais, Brazil, according to sociodemographic, clinical, and laboratory characteristics, as well as to comorbidities and mortality. METHODS: This was a descriptive, epidemiological study based on data obtained from the Brazilian Case Registry Database and the Brazilian Mortality Database for the 2002-2009 period. RESULTS: There were 47,285 reported cases of tuberculosis, corresponding to a mean incidence of 22.3/100,000 population. The individuals diagnosed with tuberculosis were predominantly in the 20- to 49-year age bracket and male (62.4% and 67.0%, respectively). Individuals with a low level of education accounted for 18.5% of the cases. New cases, cases of recurrence, and cases of retreatment accounted for 83.7%, 5.7%, 5.7%, respectively. The rates of cure and treatment noncompliance were 66.2% and 11.2%, respectively; multidrug-resistant tuberculosis was identified in 0.2% of the cases; and the mortality rate was 12.9%. The directly observed treatment, short-course (DOTS) strategy was applied in 21.8% of the cases. Sputum smear microscopy and culture were performed in only 73.9% and 12.9% of the cases, respectively. Chest X-rays were performed in 90.5% of the cases. Pulmonary tuberculosis was the predominant form (in 83.9%). Comorbidity with alcoholism, HIV infection, and diabetes mellitus were identified in 17.2%, 8.3%, and 3.8%, respectively. CONCLUSIONS: During the study period, the numbers of new cases, cases of treatment noncompliance, and deaths were high, comorbidities were common, and there was a failure to perform adequately basic tests for the diagnosis of tuberculosis. Multidisciplinary approaches, expanded use of the DOTS strategy, better knowledge of the distribution of tuberculosis, and improvements in the databases are needed ...
OBJETIVO: Analisar o perfil de casos de tuberculose no estado de Minas Gerais entre 2002 e 2009, segundo características sociodemográficas, clínicas e laboratoriais, assim como presença de comorbidades e mortalidade. MÉTODOS: Estudo epidemiológico descritivo com levantamento de dados dos casos notificados no Sistema de Informação de Agravos de Notificação e Sistema de Informação de Mortalidade entre 2002 e 2009. RESULTADOS: Foram notificados 47.285 casos de tuberculose nos anos estudados, com média de incidência 22,3/100.000 habitantes. Os indivíduos com tuberculose eram predominantemente da faixa etária de 20-49 anos (62,4%), do sexo masculino (67,0%) e tinham baixa escolaridade (18,5%). Casos novos, de recidiva e de retratamento representaram, respectivamente, 83,7%, 5,7% e 5,7% do total de casos. As proporções de cura, abandono do tratamento e tuberculose multirresistente foram, respectivamente, 73,1%, 11,2% e 0,2%, enquanto o coeficiente de mortalidade foi 12,9%. O tratamento diretamente observado (TDO) foi administrado em 21,8% dos casos. A baciloscopia e a cultura de escarro somente foram realizadas em 73.9% e 12,9% dos casos, respectivamente. A radiografia de tórax foi realizada em 90,5% dos casos. A forma pulmonar prevaleceu (83,9%). A comorbidade com alcoolismo, infecção pelo HIV e diabetes mellitus foi identificada em 17,2%, 8,3% e 3,8% dos casos, respectivamente. CONCLUSÕES: No período estudado, o número de casos novos, de abandono e de óbitos foi elevado, as comorbidades foram relevantes, e os exames básicos não foram realizados adequadamente para o diagnóstico da tuberculose. São necessários o trabalho multiprofissional, ampliação da estratégia TDO, maior conhecimento da distribuição ...