Sujets)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Sujet âgé , Adénocarcinome/complications , Adénocarcinome/anatomopathologie , Adénocarcinome/épidémiologie , Tumeurs du côlon/complications , Tumeurs du côlon/anatomopathologie , Tumeurs du côlon/épidémiologie , Période postopératoire , Tumeurs du rectum/complications , Tumeurs du rectum/anatomopathologie , Tumeurs du rectum/épidémiologie , Facteurs âges , Répartition par sexe , Indice de performance de Karnofsky , Mexique/épidémiologieRésumé
The characteristics of tuberculosis (TB) patients related to a chain of recent TB transmissions were investigated. Mycobacterium tuberculosis (MTB) isolates (120) were genotyped using the restriction fragment length polymorphism-IS6110 (R), spacer oligotyping (S) and mycobacterial interspersed repetitive units-variable number of tandem repeats (M) methods. The MTB isolates were clustered and the clusters were grouped according to the similarities of their genotypes. Spearman’s rank correlation coefficients between the groups of MTB isolates with similar genotypes and those patient characteristics indicating a risk for a pulmonary TB (PTB) chain transmission were ana- lysed. The isolates showing similar genotypes were distributed as follows: SMR (5%), SM (12.5%), SR (1.67%), MR (0%), S (46.67%), M (5%) and R (0%). The remaining 35 cases were orphans. SMR exhibited a significant correlation (p < 0.05) with visits to clinics, municipalities and comorbidities (primarily diabetes mellitus). S correlated with drug consumption and M with comorbidities. SMR is needed to identify a social network in metropolitan areas for PTB transmission and S and M are able to detect risk factors as secondary components of a transmission chain of TB.
Sujets)
Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Techniques de génotypage/méthodes , Mycobacterium tuberculosis/génétique , Tuberculose pulmonaire/microbiologie , Tuberculose pulmonaire/transmission , Villes , Comorbidité , ADN bactérien/isolement et purification , Génotype , Séquences répétées dispersées/génétique , Tests de sensibilité microbienne , Mexique/épidémiologie , Épidémiologie moléculaire/méthodes , Mycobacterium tuberculosis/classification , Mycobacterium tuberculosis/isolement et purification , Polymorphisme de restriction/génétique , Facteurs de risque , Facteurs sociologiques , Statistique non paramétrique , Séquences répétées en tandem/génétique , Tuberculose pulmonaire/épidémiologie , Tuberculose pulmonaire/génétique , Population urbaineRésumé
The resistance of 139 Mycobacterium tuberculosis (MTB) isolates from the city of Monterrey, Northeast Mexico, to first and second-line anti-TB drugs was analysed. A total of 73 isolates were susceptible and 66 were resistant to anti-TB drugs. Monoresistance to streptomycin, isoniazid (INH) and ethambutol was observed in 29 cases. Resistance to INH was found in 52 cases and in 29 cases INH resistance was combined with resistance to two or three drugs. A total of 24 isolates were multidrug-resistant (MDR) resistant to at least INH and rifampicin and 11 MDR cases were resistant to five drugs. The proportion of MDR-TB among new TB cases in our target population was 0.72% (1/139 cases). The proportion of MDR-TB among previously treated cases was 25.18% (35/139 cases). The 13 polyresistant and 24 MDR isolates were assayed against the following seven second-line drugs: amikacin (AMK), kanamycin (KAN), capreomycin (CAP), clofazimine (CLF), ethionamide (ETH), ofloxacin (OFL) and cycloserine (CLS). Resistance to CLF, OFL or CLS was not observed. Resistance was detected to ETH (10.80%) and to AMK (2.70%), KAN (2.70%) and CAP (2.70%). One isolate of MDR with primary resistance was also resistant to three second-line drugs. Monterrey has a high prevalence of MDR-TB among previously treated cases and extensively drug-resistant-MTB strains may soon appear.