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2004, Number 4

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Rev Med Inst Mex Seguro Soc 2004; 42 (4)

Epidemiology and Initial Resistance to Antituberculous Drugs in Cases of Lung Tuberculosis

Velasco RVM, Padua GA, Esquivel MC, Sánchez CO, Martínez OV, Cicero SR

Language: Spanish
References: 29
Page: 303-308
PDF size: 131.04 Kb.


ABSTRACT

We selected a cohort of 62 new cases of pul-monary tuberculosis in 2000 from the Mexican Institute of Social Security’s (IMSS) Hospital of the Comarca Lagunera in the northern state of Coahuila, Mexico, for clinical and sociodemographic study. All were treated with isoniacid (H) rifampin (R), a pirazinamide (Z) for 6 months with a 1-year follow-up. Acid fast bacilli (AFB) in sputum samples were taken monthly. We carried out identification and drug susceptibility of Mycobacterium tuberculosis in 22 cultures. Mean age among cases was 42 ± 12.5 years, 89% had an elementary school education and low income, bacille Calmette-Guérin (BCG) vaccination was recorded in 50%, but 40.3 % had other concurrent diseases, mainly diabetes mellitus. One case had HIV-AIDS. Among the 22 cultured cases, there was initial resistance in seven (32%), including four with resistance to one drug (three to S, one to Z), and three to two drugs (one each of H + S, H + Z, and H + R). Sixty nine percent of patients were cured, deaths constituted 10%, and noncompliance, 13 %, while AFB persisted in 8 %. Diabetes was most frequently associated with treatment failure. Healing rate was less than that previously reported in Mexico, while low supervision and initial resistance reported in seven of 22 cases were similar to rates in other Mexican states. New diagnostic and treatment strategies for tuberculosis are needed, together with reinforcement of already established programs.


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