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1996-02-27
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Document 0069
DOCN M9630069
TI [Resistance of Mycobacterium tuberculosis in Mexican patients. I.
Clinical features and risk factors]
DT 9603
AU Sifuentes-Osornio J; Ponce-de-Leon LA; Camacho-Mezquita FE;
Bobadilla-del-Valle JM; Infante-Suarez ML; Ramirez-Fernandez N;
Hernandez-Gomez L; Nelson AM; Departamento de Infectologia, Instituto
Nacional de la; Nutricion Salvador Zubiran.
SO Rev Invest Clin. 1995 Jul-Aug;47(4):273-81. Unique Identifier : AIDSLINE
MED/96030316
AB OBJECTIVE. To determine the clinical manifestations associated with
resistant M. tuberculosis infection and the antimicrobial resistance in
isolates from Mexican patients. STUDY DESIGN. Epidemiological
surveillance. PATIENTS. Tuberculosis confirmed cases. METHODS. Primary
resistance: no history of treatment prior to diagnosis. The following
critical concentrations (micrograms/mL) were used for susceptibility:
isoniazid 0.2 and 1; rifampin 1 and 5; ethambutol 5 and 10; streptomycin
2 and 10; ethionamide 5; kanamycin 6; and para-aminosalicylic acid (PAS)
2 and 10. RESULTS. Eighty-four patients with a mean age of 44.7 years
were included; 54 men (64%) and 30 women (36%); most patients were from
the Mexico City metropolitan area. In 34 patients there was clinical
information available, 26 presented fever and weight loss and 8
respiratory symptoms. Fifty-nine patients (70%) were infected by
pan-susceptible M. tuberculosis, and 25 (30%) by a resistant isolate; 17
(68%) of them were resistant to at least two drugs, 16 (64%) to
isoniazid and rifampin. The proportion of resistance was: isoniazid 24%,
rifampin 19%, streptomycin 12%, ethambutol 10%, PAS 9%, etionamide 7%,
and kanamycin 6%. Of 47 patients without previous treatment, eight had a
resistant microorganism (17%): 9% resistant to isoniazid, 6% to
rifampin, 2% to streptomycin, 6% to PAS and 6% multiresistant. Of 37
patients with history of previous treatment for tuberculosis, 17 (46%)
had a resistant isolate; 44% were resistant to isoniazid, 35% to
rifampin, 24% to streptomycin, 19% to ethambutol, 12% to PAS and 35%
multiresistant. Of the 84 patients, four were physicians infected by a
resistant isolate, and seven HIV-infected patients, one with a
multiresistant isolate, and another with isoniazid resistance.
CONCLUSIONS. Antimicrobial resistance among M. tuberculosis is
alarmingly high in Mexico City; these results emphasize the importance
of case detection and early isolation of patients.
DE Adolescence Adult Aged Aged, 80 and over Antitubercular
Agents/*PHARMACOLOGY Child Comorbidity Drug Resistance, Microbial
Drug Resistance, Multiple English Abstract Female Human HIV
Infections/EPIDEMIOLOGY Male Microbial Sensitivity Tests Middle Age
Mycobacterium tuberculosis/*DRUG EFFECTS/ISOLATION & PURIF Population
Surveillance Retrospective Studies Risk Factors Support, Non-U.S.
Gov't Support, U.S. Gov't, Non-P.H.S. Support, U.S. Gov't, P.H.S.
Tuberculosis/EPIDEMIOLOGY/*MICROBIOLOGY Urban Population JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).