Resistencia de Mycobacterium tuberculosis en Zaragoza (1993–1997) y factores asociados
Resistance of Mycobacterium tuberculosis Zaragoza, Spain (1993–1997) and related factors.
Luis Torresa,
, Piedad Arazob, Juan Blas Pérezcc, María del Pilar Amadord, María Antonia Lezcanoa, María José Revilloa, Juan Bautista García-Moyaa
Autor para correspondencia
med023023@nacom.es
Correspondencia: Servicio de Microbiología. Hospital Universitario Miguel Servet.P.o Isabel la Católica, 1–3. 50009 Zaragoza
Correspondencia: Servicio de Microbiología. Hospital Universitario Miguel Servet.P.o Isabel la Católica, 1–3. 50009 Zaragoza
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Huesca." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Enfermedades Infecciosas. Hospital Universitario Miguel Servet. Zaragoza." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Interna. Hospital Provincial.Huesca." "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Farmacia. Hospital General San Jorge. Huesca." "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Servicio de Microbiología. Hospital Universitario Miguel Servet.P.o Isabel la Católica, 1–3. 50009 Zaragoza" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Resistance of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> Zaragoza, Spain (1993–1997) and related factors." ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-05-05" "fechaAceptado" => "2000-09-21" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec222547" "palabras" => array:4 [ 0 => "Tuberculosis" 1 => "VIH" 2 => "Resistencia microbiana a los medicamentos" 3 => "<span class="elsevierStyleItalic">Mycobacterium tuberculosis</span>" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Conocer la frecuencia de resistencias de <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> Zaragozay estudiar los factores asociados.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal de la sensibilidad de <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> el Hospital Universitario Miguel Servet (Zaragoza) entre 1993 y 1997; el método utilizado fue el de las proporciones. Se realizó un análisis estadístico con pruebas convencionales utilizando un nivel de significación de p < 0,05.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 428 pacientes con cultivo positivo frente a <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span>: 136 (31,8%) VIH positivos, 121 (28,3%) VIH negativos y en 171 (39,9%) no constaba la serología. Las resistencias al menos a un fármaco se observaron en 47 pacientes (10,9%). En 22 fueron primarias (5,9%) y en 25 pacientes fueron adquiridas (42,4%). La resistencia primaria observada en los VIH positivos fue del 9,2%, mientras que en los VIH negativos fue del 7,5%; la resistencia adquirida también fue mayor en los pacientes infectados por el VIH, 51,8% frente al 42,8% de los seronegativos. Cuando se comparó la aparición de resistencias entre ambos colectivos, no se observaron diferencias estadísticamente significativas. En 20 pacientes aparecieron resistencias múltiples (4,7%), y 10 (2,3%) lo eran al menos a isoniacida y rifampicina. Los factores asociados con la aparición de resistencia adquirida fueron: hábito enólico (<span class="elsevierStyleItalic">odds ratio</span>[OR] = 2,65; intervalo de confianza [IC] del 95%, 1,24–5,65), usuarios de drogas por vía parenteral (OR = 2,33; IC del 95%, 1,05–5,17), episodios previos de tuberculosis (OR = 109,40; IC del 95%, 15,02–796,43) y ser transeúnte (OR = 3,75; IC del 95%, 1,26–11,17); cuando estudiamos la resistencia primaria, no encontramos diferencias significativas entre los diferentes factores de riesgo.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El porcentaje de resistencias a <span class="elsevierStyleItalic">M. tuberculosis</span> observado en Zaragoza es similar a otros descritos en diferentes regiones de España. No se han observado diferencias significativas entre seropositivos y seronegativos para el VIH. Los factores asociados significativamente con la aparición de resistencia adquirida fueron: hábito enólico, adicción a drogas por vía parenteral, episodios previos de tuberculosis y ser transeúnte.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To know the frequency of resistance of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> a general hospital and the related factors.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Transversal study of the sensitivity of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> the Hospital Miguel Servet (Zaragoza, Spain) between 1993–1997; the proportions method was used to study the susceptibility. Statistical analysis of conventional tests and significance level at p < 0.05 were performed.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Four hundred and twenty height patients with culture positive to Mycobacterium tuberculosiswere studied; 136 (31.8%) were HIV+, 121 (28.3%) were HIV– and in 171 (39.9%) this situation was unknown. In 47 patients (10.9%) the strains isolated were resistant at least to one drug. Primary resistance was 5.9% (22 patients) and acquired resistance was 42.4% (25 patients). Primary resistance in HIV+ patients was 9.2% and in HIV– patients was 7.5%; acquired resistance in HIV+ patients was greater than in HIV– patients (51.8% vs 42.8%). When we compared the resistances between both HIV+ and HIV– patients we did not find significant differences. Twenty isolates (4.7%) were resistant to more than one drug and 10 (2.3%) were resistant to at least isoniazid and rifampin. The risk factors for acquired resistance were alcohol (odds ratio[OR] = 2.65; 95% CI, 1.24–5.65), drugs users (OR = 2.33; 95% CI, 1.05–5.17), previous episodes of tuberculosis (OR = 109.40; 95% CI, 15.02–796.43) and homeless (OR = 3.75; 95% CI, 1.26–11.17); we did not find significant differences between the different risk factors according to primary resistance.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">On one study, the resistance of <span class="elsevierStyleItalic">M. tuberculosisis</span> similar to other described in Spain. We haven't found significant differences between both seropositive and seronegative patients. The risk factors for acquired resistance were alcoholism, drug users, previous episodes of tuberculosis and homeless. 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| 2022 Enero | 0 | 2 | 2 |
| 2021 Diciembre | 0 | 3 | 3 |
| 2021 Octubre | 0 | 1 | 1 |
| 2021 Septiembre | 0 | 1 | 1 |
| 2021 Agosto | 0 | 1 | 1 |
| 2021 Julio | 0 | 2 | 2 |
| 2021 Mayo | 0 | 1 | 1 |
| 2021 Abril | 0 | 1 | 1 |
| 2021 Marzo | 0 | 1 | 1 |
| 2021 Febrero | 0 | 2 | 2 |
| 2020 Diciembre | 0 | 1 | 1 |
| 2020 Septiembre | 0 | 1 | 1 |
| 2020 Agosto | 0 | 1 | 1 |
| 2020 Julio | 0 | 1 | 1 |
| 2020 Junio | 0 | 1 | 1 |
| 2020 Abril | 0 | 1 | 1 |
| 2020 Marzo | 0 | 3 | 3 |
| 2020 Enero | 0 | 3 | 3 |
| 2019 Diciembre | 0 | 1 | 1 |
| 2019 Noviembre | 0 | 2 | 2 |
| 2019 Agosto | 0 | 1 | 1 |
| 2019 Julio | 0 | 1 | 1 |
| 2019 Junio | 0 | 10 | 10 |
| 2019 Mayo | 0 | 17 | 17 |
| 2017 Octubre | 3 | 5 | 8 |
| 2017 Septiembre | 2 | 3 | 5 |
| 2017 Agosto | 1 | 3 | 4 |
| 2017 Julio | 6 | 0 | 6 |
| 2017 Junio | 14 | 7 | 21 |
| 2017 Mayo | 7 | 3 | 10 |
| 2017 Abril | 3 | 1 | 4 |
| 2017 Marzo | 5 | 59 | 64 |
| 2017 Febrero | 10 | 0 | 10 |
| 2017 Enero | 4 | 0 | 4 |
| 2016 Diciembre | 14 | 4 | 18 |
| 2016 Noviembre | 31 | 2 | 33 |
| 2016 Octubre | 26 | 8 | 34 |
| 2016 Septiembre | 20 | 3 | 23 |
| 2016 Agosto | 17 | 2 | 19 |
| 2016 Julio | 14 | 1 | 15 |
| 2016 Junio | 18 | 0 | 18 |
| 2016 Mayo | 14 | 2 | 16 |
| 2016 Abril | 9 | 0 | 9 |
| 2016 Marzo | 11 | 1 | 12 |
| 2016 Febrero | 8 | 1 | 9 |
| 2016 Enero | 14 | 0 | 14 |
| 2015 Diciembre | 11 | 0 | 11 |
| 2015 Noviembre | 7 | 0 | 7 |
| 2015 Octubre | 18 | 0 | 18 |
| 2015 Septiembre | 16 | 0 | 16 |
| 2015 Agosto | 10 | 0 | 10 |
| 2015 Julio | 10 | 0 | 10 |
| 2015 Junio | 3 | 0 | 3 |
| 2015 Mayo | 11 | 0 | 11 |
| 2015 Abril | 11 | 0 | 11 |
| 2015 Marzo | 12 | 0 | 12 |
| 2015 Febrero | 6 | 0 | 6 |
| 2015 Enero | 29 | 0 | 29 |
| 2014 Diciembre | 17 | 0 | 17 |
| 2014 Noviembre | 3 | 0 | 3 |
| 2014 Octubre | 10 | 0 | 10 |
| 2014 Septiembre | 6 | 0 | 6 |
| 2014 Agosto | 11 | 0 | 11 |
| 2014 Julio | 7 | 0 | 7 |
| 2014 Junio | 2 | 0 | 2 |
| 2014 Mayo | 6 | 0 | 6 |
| 2014 Abril | 5 | 0 | 5 |
| 2014 Febrero | 1 | 0 | 1 |
| 2014 Enero | 3 | 0 | 3 |
| 2013 Diciembre | 1 | 0 | 1 |
| 2013 Noviembre | 6 | 0 | 6 |
| 2013 Octubre | 4 | 0 | 4 |
| 2013 Septiembre | 5 | 0 | 5 |
| 2013 Agosto | 4 | 0 | 4 |
| 2013 Julio | 1 | 0 | 1 |
| 2000 Noviembre | 790 | 0 | 790 |
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