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2020-06-02
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DRUG-RESISTANT TUBERCULOSIS IN SIX HOSPITALS IN RIO DE JANEIRO, BRAZIL
Brito, R. C. et al. | Date Issued: 2010
Author
Brito, R. C.
Mello, F. C. Q.
Andrade, M. K.
Oliveira, H.
Costa, W.
Matos, H. J.
Lourenço, M. C.
Rolla, V. C.
Fonseca, L.
Ruffino Netto, A.
Kritski, A. L.
Affilliation
Secretaria de Estado de Saúde e Defesa Civil do Rio de Janeiro. Programa de Controle da Tuberculose. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Faculdade de Medicina Programa Acadêmico de Tuberculose. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Faculdade de Medicina Programa Acadêmico de Tuberculose. Rio de Janeiro, RJ, Brasil / Secretaria Municipal de Saúde da Prefeitura do Rio de Janeiro. Hospital Raphael de Paula Souza. Rio de Janeiro, RJ, Brasil.
Secretaria de Estado de Saúde e Defesa Civil do Rio de Janeiro. Hospital Estadual Santa Maria. Rio de Janeiro, RJ, Brasil.
Secretaria de Estado de Saúde e Defesa Civil do Rio de Janeiro. Instituto Estadual de Doenças do Tórax Ary Parreiras. Rio de Janeiro, RJ, Brasil.
Ministério da Saúde. Hospital dos Servidores do Estado. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Faculdade de Medicina Programa Acadêmico de Tuberculose. Rio de Janeiro, RJ, Brasil / Secretaria Municipal de Saúde da Prefeitura do Rio de Janeiro. Hospital Raphael de Paula Souza. Rio de Janeiro, RJ, Brasil.
Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Ribeirão Preto, SP, Brasil.
Universidade Federal do Rio de Janeiro. Faculdade de Medicina Programa Acadêmico de Tuberculose. Rio de Janeiro, RJ, Brasil / Secretaria Municipal de Saúde da Prefeitura do Rio de Janeiro. Hospital Raphael de Paula Souza. Rio de Janeiro, RJ, Brasil.
Abstract
SETTING: Tuberculosis (TB) drug resistance survey in six hospitals in Rio de Janeiro, Brazil. OBJECTIVE: To estimate resistance to at least one drug (DR) and multidrug resistance (MDR) and identify associated factors. DESIGN: One-year cross-sectional survey. Hospitals were included as a convenience sample. RESULTS: Of 595 patients investigated, 156 (26.2%) had previously undergone anti-tuberculosis treatment, 433 (72.8%) were not previously treated and information on the remaining 6 was not available. Overall, DR and MDR rates were high, at respectively 102 (17.1%, 95%CI 14.3–20.5) and 44 (7.4%, 95%CI 5.5–9.9) cases. Among individuals not previously treated, 17 had MDR (3.9%, 95%CI 2.4–6.3) and diagnosis in a TB reference hospital was independently associated with MDR (prevalence ratio [PR] 3.3, 95%CI 1.2–8.7) after multivariate analysis. Among previously treated individuals, 27 had MDR (17.3%, 95%CI 11.7–24.2). MDR-TB was independently associated with diagnosis in a TB reference hospital (PR 3.6, 95%CI 1.5–8.7), male sex (PR 2.3, 95%CI 1.2–4.4) and dyspnoea (PR 0.3, 95%CI 0.1–0.7). CONCLUSION: We found high levels of DR- and MDRTB. Our study design did not permit us to determine the contribution of community versus nosocomial transmission. Further studies are needed to establish this. Nevertheless, hospitals should be recognised as a potential source of transmission of resistant TB strains and urgent measures to avoid nosocomial TB transmission should be taken.
Keywords
M. tuberculosis
Drug resistance
MDR-TB
Epidemiology
Hospitals
 
Publisher
International Union Against Tuberculosis and Lung Disease
Citation
BRITO, R. C. et al. Drug-resistant tuberculosis in six hospitals in Rio de Janeiro, Brazil. International Journal of Tuberculosis and Lung Disease, v. 14, n. 1, p. 24-33, 2010.
ISSN
1027-3719