ABSTRACT
BACKGROUND: In Spain there is a high prevalence of tuberculosis (TB). The aim of this study is to describe population attended in an Isolation Unit, analysing the changes that have occurred in 10 years, the impact of immigration and factors that may condition the loss of following. PATIENTS AND METHODS: Descriptive study of all patients admitted to the Isolation Unit of Hospital Cantoblanco-La Paz from 1997 to 2006. Univariate analysis and multiple logistic regression analysis were performed. RESULTS: 832 patients were studied, 69.4% men, with a mean age of 40.8 years 37.5% immigrants. In new cases, resistance to isoniazid was documented in 6.7% and multidrug resistance in 3.1%, and in previously treated cases, in 11.2% and 8.4%, respectively. Treatment was completed by 74.1%, 17.5% were lost, which was associated with drugs consumption (OR 3.01; CL 95% 1.18-3.41), being immigrant (OR 2.14; CL 95% 1.42-3.21) and HIV infection (OR 1.96; CL 95% 1.18-3.41). In the 10 years, percentage of immigrants and patients who proceeded from the Emergency Departments increased and results improved, while HIV infection and loss of following reduced. CONCLUSIONS: Profile of patient with TB has changed in last years in association with immigration. In spite of better results, more actions are needed in order to improve the adherence and epidemiologic control of the disease. (c) 2009 Elsevier España, S.L. All rights reserved.
Subject(s)
Emigration and Immigration/statistics & numerical data , Patient Admission/statistics & numerical data , Tuberculosis/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Spain , Time Factors , Urban Health , Young AdultABSTRACT
The setting for this retrospective cohort study was a specialised tuberculosis unit in Madrid, Spain. The objective was to describe the risk factors for multidrug-resistant tuberculosis (MDR-TB). The medical records of all patients admitted to the unit were reviewed retrospectively to identify factors associated with multidrug resistance. Patients with positive culture for M. tuberculosis and with available drug-susceptibility tests were included. The variables assessed were age, gender, country of origin, homelessness, alcohol consumption, intravenous drug use, methadone substitution therapy, contact with a tuberculosis patient, sputum smear, site of disease, previous tuberculosis treatment, HIV infection, history of imprisonment, diabetes mellitus and chronic obstructive pulmonary disease. Thirty patients with MDR-TB and 666 patients with non-MDR-TB were included from the years 1997 to 2006. The only factors associated with MDR-TB in multivariate analysis were previous tuberculosis treatment (OR: 3.44; 95% CI: 1.58-7.50; p = 0.003), age group 45-64 years (OR: 3.24; 95% CI: 1.34-7.81; p = 0.009) and alcohol abuse (OR: 0.12; 95% CI: 0.03 to 0.55; p = 0.003). In our study, patients who had had previous treatment for tuberculosis, who were 45-64 years of age or who had no history of alcohol abuse were more likely to have MDR-TB.
Subject(s)
Drug Resistance, Multiple, Bacterial , Mycobacterium tuberculosis/drug effects , Risk Factors , Tuberculosis, Multidrug-Resistant/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Alcoholism , Chi-Square Distribution , Cohort Studies , Female , Hospitals, Chronic Disease , Humans , Male , Middle Aged , Multivariate Analysis , Mycobacterium tuberculosis/isolation & purification , Retrospective Studies , Spain , Tuberculosis/drug therapy , Tuberculosis/epidemiology , Tuberculosis/microbiology , Tuberculosis, Multidrug-Resistant/microbiologyABSTRACT
No disponible
Subject(s)
Humans , Heparin, Low-Molecular-Weight/therapeutic use , Drug Utilization/statistics & numerical data , Retrospective Studies , Risk Factors , Patient SelectionSubject(s)
Abscess/etiology , Diabetes Mellitus, Type 2/complications , Myositis/etiology , Staphylococcal Infections/etiology , Abscess/drug therapy , Abscess/surgery , Cloxacillin/therapeutic use , Combined Modality Therapy , Disease Susceptibility , Drainage , Female , Humans , Leg , Middle Aged , Myositis/drug therapy , Myositis/surgery , Staphylococcal Infections/drug therapy , Staphylococcal Infections/surgery , SuppurationABSTRACT
No disponible
Subject(s)
Female , Adult , Humans , Muscle, Skeletal/immunology , Muscle, Skeletal/injuries , Staphylococcus aureus/classification , Abscess/etiology , Suction/methods , Endemic Diseases/prevention & controlABSTRACT
Human immunodeficiency virus (HIV)-related liver disease is frequently diagnosed. We report a study about 100 liver biopsy samples (LB) in patients with HIV infection. The aim of the study has been to analyze the liver biopsy yield when a systemic disease (group A) or a chronic liver disease (group B) are suspected. Tuberculosis, all of them disseminated, was the most common finding in group A biopsy samples, and a 81% yield was obtained. Chronic active hepatitis was the most common finding group B, and profitability reached 90%. We conclude that LB is the elective method to diagnose systemic disease, in patients previously selected according to their clinical findings, and that final diagnoses and safe.
