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2003, Number 2

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Rev Inst Nal Enf Resp Mex 2003; 16 (2)

Clinical evolution of multidrug-resistant tuberculosis in Tijuana, Baja California.

Laniado-Laborín R, Cabrales-Vargas N

Language: Spanish
References: 17
Page: 74-78
PDF size: 55.17 Kb.


ABSTRACT

Introduction: The rates of multidrug resistant tuberculosis have increased in many developing areas of the world. According to the World Health Organization guidelines for developing countries, relapses and failures are usually treated with an empirical course of first line drugs. Because of the increased probability of acquired resistance in those patients, this could lead to failure and increased drug resistance. Objective: To determine the outcome of patients with multidrug-resistant TB (MDR-TB) referred to the Tuberculosis Clinic, and identify factors contributing to the genesis and treatment failure in MDR-TB cases. Patients and methods: Case-control study; we included 15 cases with MDR-TB and 30 controls with disease caused by susceptible Mycobacterium tuberculosis (DS-TB). Results: One patient (6.6%), with MDR-TB was cured vs 28 controls (93.3%; p=0.000). Fourteen cases (93.3%) had received irregular and/or incomplete treatment vs one control (3.3%; p=0.000). Cases had received 2.3±0.4 courses of treatment with first-line drugs before their first sputum culture versus 0.09±0.06 treatments in controls (p=0.000). A history of irregular and/or incomplete treatment was correlated with MDR (r=0.63; p=0.000); the odds ratio for MDR-TB in those cases was 28:1. Conclusion: It is necessary to reinforce the directly observed therapy program; structural and organizational changes are needed to allow a rapid diagnosis and treatment of MDR-TB.


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