Extensively drug-resistant tuberculosis: a case report and literature review

Extensively drug-resistant tuberculosis (XDR-TB) is an emerging health problem that threatens tuberculosis (TB) control worldwide, since suitable treatment for this disease has not yet been found. We report a case of secondary pulmonary XDR-TB in a 54-year-old, HIV-negative male from Goiânia, Brazil. The patient had long-standing pulmonary tuberculosis (nine years) with extensive bilateral lung damage and had been treated with multiple antituberculosis drugs (self-administered) before XDR-TB diagnosis. The strain of Mycobacterium tuberculosis was resistant to R- rifampicin, H-isoniazid, E-ethambutol, Eto-ethionamide, Ofx-ofloxacin, and Am-amikacin. This patient died with multiple organ failure due to sepsis secondary to bacterial pneumonia.

Multidrug-resistant tuberculosis: case reports study in a central state of Brazil

Multidrug-resistant tuberculosis (MDR-TB) is an emerging and worrisome health problem that threatens tuberculosis (TB) control worldwide. The clinical management of MDR-TB is a complex issue associated with the use of multiple drugs for a long period, usually accompanied by side effects and high costs. The objective of this work was to relate cases of MDR-TB occurring in Goiás, a central state of Brazil. We related five cases of MDR-TB, three women and two men. All were pulmonary cases. Three were in their second treatment and two in their first treatment. Surgical pulmonary resection was performed in one case. One death occurred. Lack of adherence, gastric intolerance to anti-TB drugs and poor clinical management were the main aspects related to the emergent resistance. A revision of the main clinical aspects of this disease was performed.

Equipamentos de proteção em centros de material e esterilização: disponibilidade, uso e fatores intervenientes à adesão / Equipamientos de protección en centrales de material y esterilización: disponibilidad, uso y factores que intervienen a la adhesión

O reprocessamento de artigos odontomédico-hospitalares tem relação com o risco biológico, tanto para ostrabalhadores, pela inerente exposição à matéria orgânica, quanto para os pacientes nos quais estes artigos sãoutilizados. Este estudo descritivo foi realizado em 12 hospitais de Goiânia, GO de julho/2004 a julho/2005 e seusobjetivos foram: identificar a adoção de equipamentos de proteção pelos trabalhadores de centros de material eesterilização; identificar a disponibilidade destes equipamentos nos serviços e estabelecer os fatores facilitadorese dificultadores de sua adoção. Participaram voluntariamente 64 trabalhadores. Os dados foram obtidos por meiode observação e entrevista e foram processados pelo programa Epi Info. Não houve coerência entredisponibilidade e uso dos equipamentos de proteção, bem como com a compreensão dos trabalhadores quanto àsua importância. Os fatores da não-adesão foram: de cunho individual, falta de estrutura física e recursosmateriais, e relacionados à estrutura organizacional. Estes fatores atuaram de maneira sinérgica para o que foiconsiderado “situação de risco” do trabalho em Central de Material de Esterilização (CME), tanto paratrabalhadores quanto para os clientes.

The reprocessing of objects from hospitals and dentistry is strongly associated with biological risk to the workersfor the inherent exposition to the organic matter, and to the patients in which these objects are used. Thisdescriptive study was accomplished at 12 hospitals in Goiânia-GO from July 2004 to July 2005 with the purposeof: identify the adoption of Equipments of Protection for the workers of Material and Sterilization Centers (MSC);to identify the availability of these Equipments in the services and to establish the facilitative and difficulty factorson its adoption. Participated in the study 64 volunteer workers. Data was obtained through observation andinterview and was processed by the program Epi Info. There was no coherence between availability and use ofthe Equipments of Protection, as well as the workers' understanding regarding its importance. The interveningfactors for non adhesion were: of personal reasons, lack of physical structure and material resources, and relatedto the organizational structure. These factors acted in a synergic way on what was considered “situation of risk”at the MSC work, for the workers as well for the customers.