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1.
Rio de Janeiro; SES/RJ; 03/03/2023. 28 p.
Non-conventional in Portuguese | LILACS, SES-RJ | ID: biblio-1418987

ABSTRACT

Este guia se destina a profissionais que atuam, principalmente, nas Instituições de Acolhimento destinadas à População em Situação de Rua (PSR). Entretanto, vários conceitos e informações que serão apresentados aqui podem ser usados em outros espaços de acolhimento e de oferta de cuidados a esta população, como os de grupos informais e de organizações públicas, governamentais ou não-governamentais.


Subject(s)
Tuberculosis/transmission , Tuberculosis, Pulmonary/prevention & control , Ill-Housed Persons/classification , Tuberculosis, Multidrug-Resistant/drug therapy , Brazilian Health Surveillance Agency , Environmental Monitoring , Infection Control/standards , Personal Protective Equipment/virology
2.
Neumol. pediátr. (En línea) ; 18(1): 16-18, 2023. tab
Article in Spanish | LILACS | ID: biblio-1442725

ABSTRACT

Recientemente se publicó la actualización de la norma técnica del programa para control y eliminación de la Tuberculosis (PROCET). En lo que se refiere al tratamiento de la Tuberculosis (TB) sensible en niños, el esquema depende de la situación clínica del paciente, pero el tiempo de tratamiento es de 6 meses en todos los tipos de TB, exceptuando algunas situaciones especiales como en la meningitis o en coinfección con VIH. Posteriormente se publicaron las guías de la OMS proponiendo algunos cambios en el tratamiento de la TB sensible, el principal de ellos es una reducción de 6 a 4 meses en la TB sensible no grave en niños entre 3 meses y 16 años.


The update of the Chilean Tuberculosis Guidelines (PROCET) was recently published. Regarding the treatment of drug susceptible Tuberculosis (TB) in children, the regimen depends on the clinical situation of the patient, but the duration is 6 months in all types of TB, except for some special situations such as meningitis or co-infection with HIV. Subsequently, the WHO guidelines were published, proposing some changes in the treatment of drug susceptible TB, the main one being a reduction from 6 to 4 months in non-severe TB without evidence of drug resistance, in children between 3 months and 16 years.


Subject(s)
Humans , Child , Tuberculosis/drug therapy , Guidelines as Topic , World Health Organization , Chile , Tuberculosis, Multidrug-Resistant/drug therapy , Time-to-Treatment
3.
Braz. j. biol ; 83: e244311, 2023. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1285616

ABSTRACT

Abstract Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.


Resumo A tuberculose é uma doença transmissível com altas taxas de morbimortalidade nos países em desenvolvimento. O objetivo principal do estudo é comparar métodos convencionais, como cultura de bacilo álcool-ácido resistente (BAAR) e microscopia, com métodos de diagnóstico rápido. O objetivo secundário é comparar os achados histopatológicos e microbiológicos em pacientes com suspeita de linfadenite tubercular. Um total de 111 amostras (agosto de 2018 a setembro de 2019) de gânglios linfáticos foi processado ​​para microscopia de AFB, culturas de AFB, teste de susceptibilidade a drogas (DST), histopatologia e Xpert Mycobacterium tuberculosis (MTB)/ensaios de resistência à rifampicina (RIF). Das 111 amostras de linfonodos, 6 (5,4%) foram positivas para baciloscopia de AFB, 84 (75,6%) foram positivas para cultura de AFB, 80 (70,7%) foram positivas para o GeneXpert e 102 (91,8%) foram indicativas de tuberculose para estudos histopatológicos. A positividade da cultura do tubo indicador de crescimento de micobactérias (MGIT) foi 84 (75,6%), maior que a cultura sólida de Lowenstein-Jensen (LJ), 74 (66,6%). As culturas positivas foram submetidas a DST fenotípico. Dois casos eram multirresistentes (MDR) ao DST, enquanto três casos eram resistentes à rifampicina no GeneXpert. A sensibilidade do GeneXpert foi 62% contra o método convencional de cultura AFB. O fraco desempenho dos métodos convencionais de diagnóstico de linfadenite requer metodologia de diagnóstico precoce e precisa. O teste Xpert MTB/RIF pode ajudar no tratamento de casos de tuberculose multirresistente. No entanto, métodos rápidos e convencionais devem ser usados ​​para o isolamento completo do Mycobacterium tuberculosis.


Subject(s)
Humans , Tuberculosis, Lymph Node/diagnosis , Tuberculosis, Multidrug-Resistant , Mycobacterium tuberculosis , Rifampin/therapeutic use , Rifampin/pharmacology
4.
J. Public Health Africa (Online) ; 14(2): 1-5, 2023. tables
Article in English | AIM | ID: biblio-1418876

ABSTRACT

The global surge in Multidrug resistant (MDR) bacteria is an issue of great concern. Pseudomonas aeruginosa has been implicated in several nosocomial infections, where it has caused grave complications in immunocompromised patients. This is the first study to report the prevalence of MDR P. aeruginosa isolated from residential sewage in Dutsin-Ma, Katsina State, Nigeria. Pseudomonads count, isolation, biochemical characterization and antibiogram were carried out using standard microbiological procedures. This study examined sixty (60) samples from selected residential sewage in the study site collected at different intervals between July and September 2021. A total of 40 (66.7%) P. aeruginosa were isolated from the analyzed sewage samples. The highest (2.84x104) pseudomonad count was recorded from sewage samples collected from Kadangaru. Pseudomonas aeruginosa isolates from this sample site showed the highest (100%) resistance to cephalosporins (cefuroxime) and nitrofurantoin. Similarly, isolates from Miami area also demonstrated the highest (95%) resistance to a cephalosporin (ceftazidime). All (100%) isolates used in this study showed MDR resistance to tested antibiotics. The occurrence of MDR P. aeruginosa from a residential sewage site that may contaminate drinking water sources in the study area is of public health threat to the inhabitants. Surveillance and molecular epidemiology of antibiotics resistant bacteria are urgently needed in the study area.


Subject(s)
Pseudomonas , Therapeutics , Drug Resistance, Microbial , Tuberculosis, Multidrug-Resistant , Drug Resistance, Multiple , Anti-Bacterial Agents , Pseudomonas aeruginosa
5.
Rev. chil. enferm. respir ; 38(4): 264-270, dic. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1441389

ABSTRACT

En esta presentación se realiza un recorrido a través de los diferentes esquemas terapéuticos de la tuberculosis drogo-resistente. Se muestra como los investigadores utilizan los nuevos fármacos disponibles y desarrollan diferentes esquemas cada vez más acortados y de administración por vía oral exclusiva, con la intención de lograr una mayor eficacia de curación de la tuberculosis resistente, con menos efectos colaterales y menor letalidad. La búsqueda de esquemas con una duración similar a las terapias de casos sensibles de tuberculosis (esquemas primarios de 6 meses) es el objetivo principal. Las pruebas moleculares como el Xpert ayudan enormemente a seleccionar los esquemas de terapia, según el perfil de susceptibilidad de los casos (resistencia a isoniazida, rifampicina, fluorquinolonas y combinaciones). Las terapias actuales de la tuberculosis drogo-resistente se basan en nuevos fármacos como fluorquinolonas, bedaquilina y linezolid, pero otros fármacos como pretomanid y delamanid también están siendo recomendados.


This presentation takes a tour through the different therapeutic schemes of drug-resistant tuberculosis. It shows how researchers use the new drugs available and develop different increasingly shortened schedules and exclusive oral administration, with the intention of achieving greater efficacy in curing resistant tuberculosis, with fewer side effects and lower lethality. The search for regimens with a duration similar to therapies of sensitive cases of tuberculosis (primary regimens of 6 months) is the main objective. Molecular tests, such as Xpert, greatly help in selecting therapy regimens, according to the susceptibility profile of the cases (resistance to isoniazid, rifampicin, fluorquinolones and combinations). Current drug-resistant tuberculosis therapies are based on new drugs such as fluorquinolones, bedaquiline and linezolid, but other drugs such as pretomanid and delamanid are also being recommended.


Subject(s)
Humans , Tuberculosis, Multidrug-Resistant/drug therapy , Respiratory Tract Diseases , Chile , Antitubercular Agents/therapeutic use , Antitubercular Agents/pharmacology
6.
Lima; Perú. Ministerio de Salud. Dirección General de Intervenciones Estratégicas en Salud Pública. Dirección de Prevención y Control de Tuberculosis; 2 ed; Jun. 2022. 36 p. ilus.
Monography in Spanish | MINSAPERU, LILACS, LIPECS | ID: biblio-1371429

ABSTRACT

En el rotafolio encontrará conceptos básicos sobre la tuberculosis, sus síntomas, su forma de contagio y las medidas preventivas a realizar en un establecimiento de salud


Subject(s)
Signs and Symptoms , Tuberculosis , Tuberculosis, Pulmonary , Tuberculosis, Multidrug-Resistant
7.
Rev. peru. med. exp. salud publica ; 39(1): 77-82, ene.-mar. 2022. tab, graf
Article in Spanish | LILACS | ID: biblio-1389931

ABSTRACT

RESUMEN La esparteína es un alcaloide con actividad bacteriostática sobre el género Mycobacterium. El objetivo de este trabajo fue evaluar la acción antimicrobiana de la esparteína en el crecimiento de cuatro cepas ATCC de Mycobacterium tuberculosis (susceptible, resistente a isoniazida, resistente a rifampicina y multidrogorresistente) in vitro. La evaluación de la actividad bactericida del sulfato de esparteína se realizó a través de una adaptación del método de ensayo de cultivo y susceptibilidad a medicamentos antituberculosos mediante observación microscópica (MODS, por sus siglas en inglés), según el protocolo descrito en el manual técnico elaborado por el Instituto Nacional de Salud. Los resultados demuestran que a concentraciones de 25; 50 y 100 mM de sulfato de esparteína, no se desarrollan unidades formadoras de colonia en las cuatro cepas evaluadas de Mycobacterium tuberculosis. Los resultados demuestran el potencial efecto antimicrobiano in vitro de la esparteína en la tuberculosis multidrogorresistente.


ABSTRACT Sparteine is an alkaloid with bacteriostatic activity on the genus Mycobacterium. The aim of this study was to evaluate the antimicrobial activity of sparteine on the growth of 4 ATCC strains of Mycobacterium tuberculosis (susceptible, resistant to isoniazid, resistant to rifampicin and multidrug-resistant) in vitro. Validation of bactericidal activity of sparteine sulfate was carried out through an adaptation of the Microscopic-Observation Drug-Susceptibility (MODS) method according to the guidelines of the Peruvian National Health Institute. The results demonstrate that at concentrations of 25; 50 and 100 Mm of sparteine sulfate, there is no development of colony-forming units in any of the 4 evaluated strains. Our results demonstrate the potential in vitro antimicrobial effect of sparteine on multidrug-resistant tuberculosis.


Subject(s)
Sparteine , Tuberculosis , In Vitro Techniques , Alkaloids , Mycobacterium tuberculosis , Tuberculosis, Multidrug-Resistant , Anti-Bacterial Agents
8.
Lima; Perú. Ministerio de Salud; 1 ed; Mar. 2022. 54 p. ilus.
Monography in Spanish | MINSAPERU, LILACS, LIPECS | ID: biblio-1362742

ABSTRACT

En el rotafolio encontrará conceptos básicos sobre la salud respiratoria y la tuberculosis, sus síntomas, su forma de contagio y las medidas preventivas a realizar en la familia y el domicilio


Subject(s)
Respiration Disorders , Tuberculosis , Tuberculosis, Multidrug-Resistant , Disease Prevention
9.
Rev. argent. microbiol ; 54(1): 43-47, mar. 2022. ilus, tab
Article in English | LILACS, UY-BNMED, BNUY | ID: biblio-1407169

ABSTRACT

Human tuberculosis is still a major world health concern. In Uruguay, contrary to the world trend, an increase in cases has been observed since 2006. Although the incidence of MDR-resistant strains is low and no cases of XDR-TB were registered, an increase in the number of patients with severe tuberculosis requiring critical care admission was observed. As a first aim, we performed the analysis of the genetic structure of strains isolated from patients with severe tuberculosis admitted to an intensive care unit. We compared these results with those corresponding to the general population observing a statistically significant increase in the Haarlem genotypes among ICU patients (53.3% vs 34.7%; p;<;0.05). In addition, we investigated the association of clinical outcomes with the genotype observing a major incidence of hepatic dysfunctions among patients infected with the Haarlem strain (p;<;0.05). The cohort presented is one of the largest studied series of critically ill patients with tuberculosis.


La tuberculosis (TB) aún representa un problema mayor de salud pública. En Uruguay, contrariamente a la tendencia mundial, se ha observado un incremento en el número de casos desde 2006. Aunque la incidencia de casos de multidrogorresistencia (MDR) es baja y no se han reportados casos de resistencia a fármacos de primera y segunda línea de tratamiento (XDR), se ha observado un incremento en el número de casos con TB grave, que requieren internación en unidad de terapia intensiva (CTI). Como primer objetivo del presente trabajo, se analizó la estructura genética de cepas de Mycobacterium tuberculosis aisladas de pacientes internados en CTI. Comparamos estos resultados con los obtenidos con cepas circulantes en la comunidad. Observamos un incremento estadísticamente significativo del genotipo Haarlem en los pacientes internados en CTI (53,3 vs. 34,7%; p;<;0,05). Además, investigamos la asociación del desenlace clínico con el genotipo, y encontramos una mayor incidencia de disfunción hepática en los pacientes infectados con la cepa Haarlem (p;<;0,05). La cohorte presentada en este trabajo corresponde a una de las series con mayor número de pacientes con tuberculosis que requirieron internación en CTI.


Subject(s)
Humans , Tuberculosis, Multidrug-Resistant/drug therapy , Extensively Drug-Resistant Tuberculosis/drug therapy , Extensively Drug-Resistant Tuberculosis/epidemiology , Mycobacterium tuberculosis/genetics , Critical Illness , Genotype , Antitubercular Agents
10.
Lima; Perú. Ministerio de Salud. Dirección General de Intervenciones Estratégicas en Salud Pública. Dirección de Prevención y Control de Tuberculosis. Dirección de Promoción de la Salud; 1 ed; Feb. 2022. 44 p. ilus.
Monography in Spanish | MINSAPERU, LILACS, LIPECS | ID: biblio-1357751

ABSTRACT

La cartilla, a través de fichas pedagógicas, te brinda información sobre los conceptos básicos de la salud respiratoria y todo lo que necesitas saber como agente comunitario para que realices la promoción de la salud a las personas afectadas con tuberculosis, a sus familias y la comunidad de su entorno inmediato


Subject(s)
Patient Escort Service , Respiration Disorders , Respiratory Tract Infections , Tuberculosis , Tuberculosis, Multidrug-Resistant , Community Health Workers , Patient-Centered Care , Disease Prevention , Health Promotion
11.
Lima; Perú. Ministerio de Salud. Dirección General de Intervenciones Estratégicas en Salud Pública. Dirección de Prevención y Control de Tuberculosis. Dirección de Promoción de la Salud; 1 ed; Feb. 2022. 128 p. ilus.
Monography in Spanish | MINSAPERU, LILACS, LIPECS | ID: biblio-1357755

ABSTRACT

La publicación, cuyos contenidos se agrupan en cinco sesiones: sesión 1, "Prácticas y entornos para mantener la salud respiratoria"; sesión 2, "Conociendo la tuberculosis"; sesión 3, "Prevenimos la tuberculosis"; sesión 4, "Importancia de la adherencia al tratamiento de la tuberculosis"; sesión 5 "¡Nos preparamos para nuestras visitas domiciliarias!" en el caso de la modalidad presencial y "¡Nos preparamos para acompañar a la Persona Afectada por Tuberculosis - PAT y su familia!" en la modalidad virtual. Asimismo, se plantea desde el enfoque del aprendizaje de adultos, elaborado para la modalidad presencial y modalidad virtual, a partir de una metodología activa participativa. Las sesiones consideran diversas dinámicas, cuya aplicación es flexible por lo que pueden adaptarse de acuerdo a las características de cada grupo


Subject(s)
Patient Escort Service , Respiration Disorders , Respiratory Tract Infections , Tuberculosis , Health Knowledge, Attitudes, Practice , Health Personnel , Tuberculosis, Multidrug-Resistant , Community Health Workers , Patient-Centered Care , Health Promotion
12.
Rev. saúde pública (Online) ; 56: 1-11, 2022. tab, graf
Article in English | LILACS, BBO | ID: biblio-1390006

ABSTRACT

ABSTRACT OBJECTIVE To understand patients' narratives about the barriers they faced in the diagnosis and treatment of multidrug-resistant tuberculosis, and their consequences in Rio de Janeiro State, Brazil. METHODS This is a qualitative cross-sectional study with non-probabilistic sampling. A theoretical saturation criterion was considered for composing the number of interviewees. Semi-structured interviews were conducted from August to December 2019 with 31 patients undergoing treatment for multidrug-resistant tuberculosis at an outpatient referral center in Rio de Janeiro. Data were transcribed and processed with the aid of the NVIVO software. Interviews were evaluated by content analysis, and their themes, cross-referenced with participants' characterization data. RESULTS Our main findings were: a) participants show a high proportion of primary drug resistance, b) patients experience delays in the diagnosis and effective treatment of multidrug-resistant tuberculosis ; c) healthcare providers fail to value or seek the diagnosis of drug-resistant tuberculosis, thus beginning the inadequate treatment for drug-susceptible tuberculosis, d) primary health units show low report rates of active case-finding and contact monitoring, and e) patients show poor knowledge about the disease. CONCLUSIONS We need to improve referral systems, and access to the diagnosis and effective treatment of multidrug-resistant tuberculosis; conduct an active investigation of contacts; intensify the training of healthcare providers, in collaboration with medical and nursing schools, in both public and private systems; and promote campaigns to educate the population on tuberculosis signs and symptoms.


Subject(s)
Humans , Tuberculosis/epidemiology , Tuberculosis, Multidrug-Resistant/diagnosis , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/epidemiology , Brazil , Cross-Sectional Studies , Health Personnel
13.
Article in English | WPRIM | ID: wpr-961133

ABSTRACT

Introduction@#Tuberculosis (TB) is one of the major diseases responsible for the public health and economic crisis in low- income countries, with the Philippines as one of the eight countries in 2020 that accounted for two thirds of the new TB cases worldwide. Its three most populous regions which are the National Capital Region, Calabarzon and the Central Luzon Region reported the highest number of TB cases in 2015. One important consideration is that health care providers’ knowledge, attitude and perception regarding TB largely affects the success of TB treatment.@*General Objective@#This study assessed the knowledge, attitude and perception among health care professionals who manage tuberculosis, using a validated questionnaire regarding drug-susceptible and drug-resistant tuberculosis in Cabanatuan City, Nueva Ecija.@*Methodology@#Cross-sectional study was used in this research. All health care professionals assigned in each identified health facility were asked to participate in the study. After obtaining informed consent, a self-administered questionnaire was given to all participants to answer. Descriptive statistics and Chi-square tests were used in data analysis.@*Results and Discussion@#A total of 113 participants were included in the study. Physicians, nurses and medical technologists were found to have good TB knowledge compared to pharmacists. Those who had training on TB DOTS were found to have good knowledge towards tuberculosis compared to those who had no training. Most participants, regardless of their profession, length of stay at TB DOTS Centers, and their training on TB DOTS, had a favorable attitude and perception towards patients infected with TB.@*Conclusion@#The lack of training may have largely contributed to the poor knowledge of HCPs which may possibly hinder the success of providing TB treatment. It is therefore of paramount consideration that prior to the HCPs’ assignment in TB DOTS centers, all HCPs must first undergo training in order to manage TB treatment properly and successfully.


Subject(s)
Health Personnel , Knowledge , Attitude , Perception , Tuberculosis, Multidrug-Resistant
14.
Rev. inf. cient ; 100(4): e3470, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289656

ABSTRACT

RESUMEN Introducción: En los últimos 10 años en Cuba y, especialmente, en provincia Guantánamo se ha observado incremento del número de pacientes tuberculosos farmacorresistentes; esta es la provincia de mayor incidencia en el país. Objetivo: Identificar las características epidemiológicas y el patrón de resistencia de la tuberculosis farmacorresistente en provincia Guantánamo. Método: Se diseñó un estudio descriptivo y transversal que incluyó la totalidad de casos (n=6) con tuberculosis farmacorresistentes diagnosticados entre diciembre de 2010 y diciembre de 2019. Se estudiaron las variables: edad, sexo, régimen terapéutico, situación económica, categorías de casos, clasificación epidemiológica de la resistencia y resistencia de la cepa aislada según el grado y perfil. Resultados: Predominó el sexo masculino (66, 6 %) y el grupo de edades de menores de 45 años (83,3 %), la mayor cantidad de resistencia estuvo propiciada por violaciones en los tratamientos anteriores (66,6 %), categorizados mayormente como crónicos y reingresos por abandono. Predominó el nivel educacional de secundaria básica terminada (66,7 %), con situación económica regular (50,0 %) y alto nivel de alcoholismo (66,7 %). La multidrogorresistencia prevaleció en cepas de pacientes con tratamiento previo (66,6 %). Conclusiones: Existe coincidencia del patrón epidemiológico y el patrón de resistencia mostrado en la investigación actual con los resultados de estudios previos nacionales e internacionales, estos resultados sugieren fallas en la aplicación local del Programa Nacional de Control y Tratamiento de la tuberculosis. Se recomienda investigar y resolver estas fallas lo que produciría un impacto inmediato en la disminución de la incidencia de tuberculosis farmacorresistentes.


ABSTRACT Introduction: An increase in the number of drug-resistant tuberculosis patients has been observed in the last 10 years in Cuba and, especially, in Guantánamo province. This is the province with the highest incidence in the country. Objective: To identify the epidemiological characteristics and the resistance pattern of drug-resistant tuberculosis in Guantánamo province. Method: A descriptive, cross-sectional study was designed that included all cases (n=6) with drug-resistant tuberculosis, diagnosed between December 2010 and December 2019. The variables studied were: age, gender, therapeutic regimen, economic situation, categories of cases, epidemiological classification of resistance, and resistance of the isolated strain according to the grade and profile. Results: Males predominated (66.6%), and also the age group under 45 years (83.3%), the greatest resistance was caused by not abiding the previous treatments (66.6%), categorized mostly as chronic, and readmitted due to treatment abandonment. Highschool degree (66.7%) predominated, with a moderate economic situation (50.0%) and high levels of alcoholism (66.7%). Multi-drug resistance prevailed in the strains in patients with previous treatment (66.6%). Conclusions: There is a coincidence of the epidemiological pattern and the resistance pattern shown in the current research with the results of previous national and international studies; these results suggest flaws in the local application of the Programa Nacional de Control y Tratamiento de la tuberculosis. It is recommended to investigate and resolve these flaws, which would have an immediate impact on reducing the incidence of drug-resistant tuberculosis.


RESUMO Introdução: Nos últimos 10 anos, em Cuba e, principalmente, na província de Guantánamo, observou-se um aumento no número de pacientes com tuberculose resistente aos medicamentos; esta é a província com maior incidência no país. Objetivo: Identificar as características epidemiológicas e o padrão de resistência da tuberculose resistente a medicamentos na província de Guantánamo. Método: Foi elaborado um estudo descritivo e transversal que incluiu todos os casos (n=6) com tuberculose resistente a medicamentos diagnosticados entre dezembro de 2010 e dezembro de 2019. Foram estudadas as variáveis: idade, sexo, regime terapêutico, situação econômica, categorias de casos, classificação epidemiológica de resistência e resistência da cepa isolada de acordo com o grau e perfil. Resultados: Houve predomínio do sexo masculino (66,6%) e na faixa etária abaixo de 45 anos (83,3%), a maior quantidade de resistência foi causada por violações nos tratamentos anteriores (66,6%), categorizados principalmente como crônicos e reinternações por abandono. Predominou situação econômica regular (50,0%) e alto nível de alcoolismo (66,7%). A multirresistência prevaleceu em cepas de pacientes com tratamento anterior (66,6%). Conclusões: Há coincidência do padrão epidemiológico e do padrão de resistência mostrado na pesquisa atual com os resultados de estudos nacionais e internacionais anteriores, esses resultados sugerem falhas na aplicação local do Programa Nacional de Controle e Tratamento da Tuberculose. Recomenda-se investigar e resolver essas falhas, que teriam um impacto imediato na redução da incidência de tuberculose resistente aos medicamentos.


Subject(s)
Humans , Male , Middle Aged , Tuberculosis, Multidrug-Resistant/diagnosis , Tuberculosis, Multidrug-Resistant/epidemiology , Rifampin , Streptomycin , Epidemiology, Descriptive , Cross-Sectional Studies , Isoniazid
15.
Rev. cuba. salud pública ; 47(2): e2101, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1341492

ABSTRACT

Introducción: En el departamento del Atlántico los estudios de resistencia del Mycobacterium tuberculosis se han limitado a drogas de segunda línea. Objetivo: Determinar prevalencia de resistencia a amikacina, kanamicina, capreomicina y ofloxacina en casos de tuberculosis resistente a isoniacida, rifampicina o a ambas drogas, en el periodo 2013 a 2016 en el departamento del Atlántico. Métodos: Estudio transversal de 194 aislamientos resistentes a isoniacida, rifampicina o ambas, por metodología Genotype MTBDR plus versión 2, enviados al Instituto Nacional de Salud en el periodo 2013 al 2016 para ser confirmados y procesados para drogas de segunda línea. La proporción de resistencia, se hizo según variables sociodemográficas, clínica y de vigilancia en salud pública. Resultados: Las comorbilidades frecuentes encontradas fueron desnutrición con el 18,56 por ciento, seguido de infección concomitante VIH-tuberculosis con el 13,40 por ciento. La ofloxacina en casos no tratados obtuvo la mayor resistencia global con el 1,50 por ciento (IC 95 por ciento 0,18-5,33). En los que fueron previamente tratados la resistencia global a capreomicina fue del 8,10 por ciento (IC 95 por ciento 2,7-17,8). En los resistentes a rifampicina, un caso fue extensivamente resistente y dos casos resistentes en los multidrogorresistente. Conclusiones: Se encontró baja resistencia a fluoroquinolonas y fármacos inyectables en pacientes no tratados resistentes a isoniacida, rifampicina o ambas, que muestra que todavía no constituye un problema mayor en el departamento del Atlántico. Se debe complementar su seguimiento con buen manejo tanto físico como psicológico y un equipo de salud fortalecido que actúe prontamente y ayude a la adherencia del paciente a los tratamientos(AU)


Introduction: In Atlántico department, resistance studies of Mycobacterium tuberculosis have been limited to second-line drugs. Objective: Determine prevalence of resistance to amikacin, kanamycin, capreomycin and ofloxacin in cases of tuberculosis resistant to isoniazid, rifampicin or both, in the period 2013 to 2016 in Atlántico department. Methods: Cross-sectional study of 194 isolations resistant to isoniazid, rifampicin or both, by Genotype MTBDR plus version 2 methodology, that were sent to the National Institute of Health from 2013 to 2016 to be confirmed and processed for second-line drugs. The resistance ratio was made according to sociodemographic, clinical and public health surveillance variables. Results: The common comorbilities found were malnutrition with 18.56 percent, followed by concomitant HIV-tuberculosis infection with 13.40 percent. Ofloxacin in non-treated cases achieved the highest overall resistance with 1.50 percent (95 percent CI 0.18-5.33). In those previously treated, global resistance to capreomycin was 8.10 percent (95 percent CI 2.7-17.8). In the ones resistant to rifampicin, one case was extensively resistant and two cases were resistant in multi-drugs resistant. Conclusions: Low resistance to fluoroquinolones and injectable drugs was found in non-treated patients who were resistant to isoniazid, rifampicin or both, showing that it is not yet a major problem in Atlántico department. Its follow-up should be complemented with good physical and psychological management and a strengthened health team that acts promptly and helps the patient adherence to treatments(AU)


Subject(s)
Humans , Rifampin/therapeutic use , Tuberculosis, Multidrug-Resistant , Fluoroquinolones/antagonists & inhibitors , Isoniazid/therapeutic use , Cross-Sectional Studies
16.
Rev. cuba. med. trop ; 73(1): e590, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1280329

ABSTRACT

Introducción: La tuberculosis persiste como un importante problema de salud mundial. En el 2016 se estimaron 600 000 casos de resistente a rifampicina, y entre estos 490 000 casos multidrogorresistentes. Objetivo: Describir el comportamiento de la resistencia de los aislados de M. tuberculosis de pacientes con tuberculosis pulmonar notificados en Cuba entre los años 2015-2017. Métodos: Se determinó la susceptibilidad a isoniacida y rifampicina mediante el método de la nitratasa. A los aislados resistentes a rifampicina/multidrogorresistentes se les determinó mediante el método proporcional la susceptibilidad a ofloxacina, kanamicina, amikacina y capreomicina. Resultados: El 93,2 por ciento de los aislados fueron sensibles a isoniacida y rifampicina. En 39 se identificó resistencia a isoniacida y 23 fueron resistente a rifampicina. Se identificaron 10 multidrogorresistentes. No se detectó resistencia a fármacos de segunda línea. Conclusiones: Los resultados alertan sobre la necesidad de investigar las causas que han conllevado al incremento de la tuberculosis resistente en Cuba(AU)


Introduction: Tuberculosis continues to be an important health problem worldwide. In the year 2016, as many as 600 000 cases of rifampicin resistance were estimated, among which 490 000 were multi-drug resistant. Objective: Describe the behavior of resistance to M. tuberculosis isolates in patients with pulmonary tuberculosis reported in Cuba in the period 2015-2017. Methods: Susceptibility to isoniazid and rifampicin was determined by the nitratase method. Susceptibility of rifampicin resistant / multi-drug resistant isolates to ofloxacin, kanamycin, amikacin and capreomycin was determined by the proportional method. Results: Of the isolates analyzed, 93.2 percent were sensitive to isoniazid and rifampicin. Isoniazid resistance was identified in 39 and 23 were rifampicin resistant. Ten multi-drug resistant isolates were identified. Resistance to second line drugs was not detected. Conclusions: Results warn about the need to study the factors leading to the increase in resistant tuberculosis in Cuba(AU)


Subject(s)
Humans , Tuberculosis, Multidrug-Resistant/prevention & control , Drug Resistance, Multiple, Bacterial/drug effects
17.
Rev. chil. enferm. respir ; 37(1): 74-81, mar. 2021. ilus, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388134

ABSTRACT

Resumen El éxito de los tratamientos acortados de la tuberculosis se debe a la asociación de fármacos bactericidas y esterilizantes, principalmente Rifampicina e Isoniazida. Cuando la Rifampicina no puede ser utilizada por resistencia, los tratamientos son más prolongados y el éxito en la curación se reduce. La resistencia a Rifampicina frecuentemente se acompaña de resistencia a Isoniazida (Multidrogoresistencia o MDR). La OMS informa que en 2019 se diagnosticaron sólo el 44% de los casos estimados de tuberculosis con resistencia a Rifampicina (se proyectaba 465.000 casos) y se trató sólo al 38% de los casos estimados, quedando una gran proporción de casos sin diagnosticar y sin tratar. En Chile la vigilancia de la susceptibilidad a fármacos de primera línea en cepas de Mycobacterium tuberculosis se efectúa mediante biología molecular desde 2014, observándose un progresivo incremento de casos resistentes a Rifampicina desde 1% (23 casos) para ese año hasta 2,2% (65 casos) en 2019. La mayoría de casos de resistencia a Rifampicina corresponden a resistencia inicial. En casos con resistencia a Rifampicina realizamos estudio de susceptibilidad a fármacos de segunda línea en el laboratorio de referencia nacional. La terapia de TB-MDR tradicional tiene baja eficacia, con abandonos frecuentes por su largo tiempo de terapia y toxicidad. Nuevos tratamientos sin inyectables y el uso de Clofazimina, Fluorquinolonas, Linezolid y Bedaquilina tienen una mejor tasa de curación. Recientemente, el Programa de Control de la Tuberculosis de Chile dispone de esta terapia más eficaz y de menor duración por vía oral con estos fármacos.


The high success rate of shortened Tuberculosis (TB) treatments has been achieved by the association of bactericidal and sterilizing drugs. The main drugs are Rifampicin and Isoniazide. When Rifampicin cannot be used by resistance, the treatment is prolonged and success in healing is significantly reduced. Resistance to Rifampicin is often accompanied by resistance to Isoniazide (Multidrug resistance or MDR). WHO reports that only 44% of estimated TB cases with resistance to Rifampicin were diagnosed in 2019 (465,000 cases projected) and only 38% of estimated cases were treated, with a large proportion of cases remaining undiagnosed and untreated. In Chile, monitoring of susceptibility to first-line drugs is conducted in strains of Mycobacterium tuberculosis by molecular biology since 2014, observing a progressive increase in cases with Rifampicin resistance from 1% for that year (23 cases) to 2.2% in 2019 (65 cases). Most cases of resistance to Rifampicin correspond to cases of initial resistance. In cases with resistance to Rifampicin we carry out susceptibility study to second-line drugs in a national reference laboratory. MDR-TB therapy has low efficacy, with frequent abandonments for its long therapy time and toxicity. New non-injectable treatments and use of Clofazimine, Fluorquinolones, Linezolid and Bedaquiline are achieving a better cure rate. Recently, Chile's TB Control Program has this most effective and shorter-lasting oral therapy with these drugs.


Subject(s)
Humans , Rifampin/pharmacology , Tuberculosis, Multidrug-Resistant/drug therapy , Tuberculosis, Multidrug-Resistant/epidemiology , Antibiotics, Antitubercular/pharmacology , Chile/epidemiology
18.
Rev. cuba. med. mil ; 50(1): e899, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1289511

ABSTRACT

La tuberculosis es el principal asesino infeccioso del mundo, sin embargo, no constituye una prioridad política. Con el conocimiento que se tiene de la tuberculosis, se está en capacidad de controlarla y erradicarla, pues se cuenta con métodos probados de diagnóstico y esquemas terapéuticos efectivos. Pero existen factores que perpetúan el problema, como la inequidad social, la pandemia del VIH/ sida, el incremento de las poblaciones de riesgo, la inexistencia de una vacuna protectora, las deficiencias en los programas de control y la drogo resistencia. El desarrollo de la tuberculosis resistente a múltiples drogas revela debilitamiento de los servicios asistenciales, se considera un indicador de negligencia en salud pública. En la actualidad solo se logra curación en el 52 por ciento de los pacientes, con regímenes de 21-24 meses y un costo por paciente de 50 000 a 100 000 dólares estadounidenses. El incremento de la resistencia y la capacidad que tiene la tuberculosis para aprovechar y acentuar las desigualdades socioeconómicas en una población, aumenta la desestabilización de un área o país, lo cual ha llevado a que esta enfermedad sea incluida en la lista de posibles armas biológicas. En este trabajo se analizan los factores que hacen de la tuberculosis una enfermedad social, las acciones necesarias para su control, así como su papel como arma bioterrorista(AU)


Tuberculosis remains as the world's leading infectious killer, but it is not a political priority. With the knowledge of Tuberculosis, it is able to control and eradicate it, as there are proven methods of diagnosis and effective therapeutic schemes. But there are factors that perpetuate the problem, such as social inequality, the HIV/AIDS pandemic, the increase in risk populations, the absence of a protective vaccine, deficiencies in Tuberculosis control programs and drug resistance. The development of multi-drug resistant and extremely resistant Tuberculosis reveals a weakening of care services, so Tuberculosis from being a preventable and curable disease, is becoming a virtually incurable disease is considered an indicator of public health negligence. At present, healing is only achieved in 52 percent of patients with 21-24-month regimens and a cost per patient of 50,000 to 100,000 US dollars. The increase in multi-resistance and the ability of Tuberculosis to take advantage of and accentuate socioeconomic inequalities in a population, increasing the destabilization of an area or country has led to this disease being included in the list of possible biological weapons. Taking into account the importance of this disease, the factors that can influence its control and its role as a bioterrorist weapon, it was decided to analyze the elements that make Tuberculosis a social disease and a health emergency are analyzed(AU)


Subject(s)
Humans , Aptitude , Socioeconomic Factors , Drug Resistance , Acquired Immunodeficiency Syndrome , Tuberculosis, Multidrug-Resistant , Biological Warfare Agents , Pandemics , Elements , Malpractice
19.
Braz. j. infect. dis ; 25(1): 101544, jan., 2021. tab
Article in English | LILACS | ID: biblio-1249299

ABSTRACT

ABSTRACT Multidrug-resistant tuberculosis (MDR-TB) represents a significant impact in transmission, outcome, and health costs. The World Health Organization recommends implementation of rapid diagnostic methods for multidrug-resistance detection. This study was performed to evaluate the frequency of pre- and extensively drug resistant tuberculosis (pre-XDR-TB and XDR-TB) among MDR-TB patients, the pattern of resistance mutations for fluoroquinolones and the clinical outcome. Adult patients followed at a Brazilian regional reference center for TB, from January 2013 to June 2019 were included. Stored Mycobacterium tuberculosis (Mtb) cultures were recovered, the DNA was extracted, and the susceptibility test was performed using the line probe assay for second line antimycobacterial drugs, Genotype MTBDRsl version 2.0 (Hain Lifescience, CmbH, Germany). Among 33 MDR-TB included patients, we diagnosed XDR-TB or pre-XDR in five (15%) cases. Of these, mutations related to fluoroquinolones resistance were observed in four Mtb isolates, including one who had no phenotypic resistance profile. In two other patients with phenotypic resistance to ofloxacin, genotypic resistance was not found. Case fatality rate was 60% in pre/XDR-TB group, compared to 3.6% in the remaining of patients. This study observed few cases of pre-XDR and XDR-TB among a MDR-TB cohort. Phenotypic and genotypic assays presented good agreement. Clinical outcome was more favorable for patients with susceptibility to fluoroquinolones and injectable drugs.


Subject(s)
Humans , Adult , Pharmaceutical Preparations , Mycobacterium tuberculosis/genetics , Brazil , Microbial Sensitivity Tests , Tuberculosis, Multidrug-Resistant , Drug Resistance, Multiple, Bacterial/genetics , Antitubercular Agents/therapeutic use , Antitubercular Agents/pharmacology
20.
Av. enferm ; 39(1): 21-29, 01 de enero de 2021.
Article in Portuguese | LILACS, BDENF, COLNAL | ID: biblio-1151180

ABSTRACT

Objetivo: analisar a percepção de pessoas com tuberculose sobre o itinerário terapêutico da tuberculose resistente e em retratamento. Materiais e método: pesquisa descritiva, com abordagem qualitativa, realizada com pessoas com tuber-culose resistente ou em retratamento por abandono ou recidiva. Os dados foram coletados por meio de entrevistas semiestruturadas, que, depois de transcritas, foram submetidas à análise de conteúdo e, posteriormente, analisadas à luz do referencial teórico sobre itinerário terapêutico. Resultados:na percepção das pessoas com tuberculose resistente ou em retratamento, evidenciou-se o pouco entendimento sobre a doença e a recidiva, principalmente quanto à causa. No itinerário terapêutico em busca dos serviços para atender às necessidades de saúde apontaram a centralização do atendimento no serviço hospitalar. A adesão esteve remetida ao abandono do tratamen-to anterior, à necessidade de voltar à rotina e ao medo de transmissão para os familiares. As ações de auto-cuidado se relacionaram à adesão ao tratamento, ao uso de equipamentos de proteção individual e à adoção de hábitos de vida mais saudáveis. Conclusões: os itinerários tera-pêuticos de pessoas com tuberculose aconteceram em diferentes níveis da atenção à saúde, especialmente nos centros especializados. Em cada serviço, analisaramse diferentes experiências quanto ao entendimento sobre a doença, ao tratamento e aos diferentes sentimentos durante o percurso do tratamento. Diante disso, os profissio-nais necessitam fazer uso de estratégias que considerem a complexidade do uso de múltiplos medicamentos, a necessidade de monitoramento da adesão e da atenção às comorbidades.


Objetivo: analizar la percepción de las personas con tuberculosis sobre el itinerario terapéutico de la tuberculosis resistente y en retratamiento. Materiales y método: investigación descriptiva, con enfoque cualitativo, realizada con personas con tuberculosis resistente o en retratamiento por abandono o recaída. Los datos fueron recolectados por medio de entrevistas semiestructuradas, que luego de ser transcritas fueron sometidas a análisis de contenido y posteriormente analizadas a la luz del marco teórico sobre itinerario terapéutico. Resultados: en la percepción de las personas con tuberculosis resistente o en retratamiento había poco conocimiento sobre la enfermedad y la recaída, especialmente en cuanto a la causa. En el itinerario terapéutico en busca de servicios para satisfacer las necesidades de salud, apuntaron a la centralización de la atención en el servicio hospitalario. La adherencia se relacionó con el abandono del tratamiento previo, la necesidad de volver a la rutina y el miedo a la transmisión a los familiares. Las acciones de autocuidado se relacionaron con la adherencia al tratamiento, el uso de equipos de protección personal y la adopción de hábitos de vida más saludables. Conclusiones: los itinerarios terapéuticos de las personas con tuberculosis tuvieron lugar en diferentes niveles de atención de salud, especialmente en centros especializados. En cada servicio se analizaron diferentes experiencias en cuanto a la comprensión de la enfermedad, el tratamiento y las diferentes sensaciones en la trayectoria del tratamiento. Por lo tanto, los profesionales deben hacer uso de estrategias que consideren la complejidad del uso de múltiples medicamentos, la necesidad de monitorear la adherencia y la atención a las comorbilidades


Objective: To study the perception of people with tuberculosis about the therapeutic itinerary of resistant tuberculosis and its retreatment. Materials and method:Descriptive research, with a qualitative approach, carried out with people with resistant tuberculosis or subject to retreatment due to abandonment or relapse. Data were collected through semi-structured interviews, which after being tran-scribed were submitted to content analysis, and, subsequently, analyzed in the light of the theoretical frame-work on therapeutic itinerary. Results: The perception of people with resistant tuberculosis or under retreatment shows little understand-ing about the disease and its relapse, especially regarding the cause of the disease. In the therapeutic itinerary in search of services to meet health needs, they pointed to the centralization of care in the hospital service. Adherence was related to the abandonment of previous treatment, the need to return to a routine, and fear of transmission to family members. Self-care actions were related to adher-ence to treatment, the use of personal protective equipment and the adoption of healthier lifestyle habits. Conclusions: Therapeutic itineraries of people with tuberculosis took place at different levels of health care, particularly in specialized centers. In each service, different experiences were examined regarding the under-standing of the disease, its treatment, and the different feelings involved during the treatment. Therefore, professionals should deploy strategies that consider the complexity of using multiple medications and the need to monitor adherence and existing comorbidities.


Subject(s)
Humans , Tuberculosis , Tuberculosis, Multidrug-Resistant , Retreatment , Delivery of Health Care
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