Abstract

MORCILLO, Nora; DI GIULIO, Beatriz  and  IMPERIALE, Belén. Evolución de la tuberculosis resistente en la Provincia de Buenos Aires en el período 2006 a 2014. Rev. am. med. respir. [online]. 2016, vol.16, n.3, pp.241-249. ISSN 1852-236X.

Introduction: During the last years, Argentina has been maintaining slow but progressive decreasing trends of tuberculosis (TB) incidence rates. In sanitary terms, the drug-resistant forms of the disease are complicating the global control of the disease. Objetive: The main objectives of this study were to describe the incidence of multi and extensive drug-resistant TB (M/XDR) in children and adults, to analyze its transmission within contacts and the relationship with previous treatments. Materials and methods: During 2006-2014 it was notifed to the Control Program of Buenos Aires Province 41,782 TB cases, 5.712 (13.7%) children <15 years old, 35.843 (85.8%) adults; 35,862 (85.8%) patients presented a respiratory form of the disease, 24,913 (69.5%) confrmed by bacteriology, 21,842 (87.7%) by microscopy examination. Results: They were diagnosed 636 cases of drug-resistant TB: 445 (70.0%) MDR TB, 13 (2.9%) children; 18 (2.6%) had a XDR pattern; from 109 (24.5%) individuals the bacteria showed a MDR pattern also resistant to fluoroquinolones or an injectable agent (amikacin, kanamicin or capreomicin). Besides, 64 cases suspected of being MDR were resistant to one or more drugs not accomplishing the MDR criterion. Eighty two (18.4%) patients with M/XDR had their first TB episode being 20 of them, 9 children, contacts of previous TB cases; 19 individuals were considered index cases of another 31 contacts that developed also M/XDR TB. Discussion: Transmission from index cases to contacts was demonstrated by molecular and classical epidemiology. The isolates fngerprinting and the diagnosis of TB dates were useful tools to trace the epidemiologic infection route.

Keywords : Tuberculosis; Resistance; Active transmission.

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