dc.contributor.author |
Otero Vegas, Larissa |
|
dc.contributor.author |
Krapp, Fiorella |
|
dc.contributor.author |
Tomatis, Cristina |
|
dc.contributor.author |
Zamudio Fuertes, Carlos Eduardo |
|
dc.contributor.author |
Matthys, Francine |
|
dc.contributor.author |
Gotuzzo Herencia, José Eduardo |
|
dc.contributor.author |
Van der Stuyft, Patrick |
|
dc.contributor.author |
Seas Ramos, Carlos Rafael |
|
dc.date.accessioned |
2022-01-18T19:34:39Z |
|
dc.date.available |
2022-01-18T19:34:39Z |
|
dc.date.issued |
2011 |
|
dc.identifier.uri |
https://hdl.handle.net/20.500.12866/11093 |
|
dc.description.abstract |
Introduction: In high multidrug resistant (MDR) tuberculosis (TB) prevalence areas, drug susceptibility testing (DST) at diagnosis is recommended for patients with risk factors for MDR. However, this approach might miss a substantial proportion of MDR-TB in the general population. We studied primary MDR in patients considered to be at low risk of MDR-TB in Lima, Peru. METHODS: We enrolled new sputum smear-positive TB patients who did not report any MDR-TB risk factor: known exposure to a TB patient whose treatment failed or who died or who was known to have MDR-TB; immunosuppressive co-morbidities, ex prison inmates; prison and health care workers; and alcohol or drug abuse. A structured questionnaire was applied to all enrolled participants to confirm the absence of these factors and thus minimize underreporting. Sputum from all participants was cultured on Löwenstein-Jensen media and DST for first line drugs was performed using the 7H10 agar method. RESULTS: Of 875 participants with complete data, 23.2% (203) had risk factors for MDR-TB elicited after enrolment. Among the group with no reported risk factors who had a positive culture, we found a 6.3% (95%CI 4.4-8.3) (37/584) rate of MDR-TB. In this group no epidemiological characteristics were associated with MDR-TB. Thus, in this group, multidrug resistance occurred in patients with no identifiable risk factors. CONCLUSIONS: We found a high rate of primary MDR-TB in a general population with no identifiable risk factors for MDR-TB. This suggests that in a high endemic area targeting patients for MDR-TB based on the presence of risk factors is an insufficient intervention. |
en_US |
dc.language.iso |
eng |
|
dc.publisher |
Public Library of Science |
|
dc.relation.ispartofseries |
PLoS ONE |
|
dc.rights |
info:eu-repo/semantics/restrictedAccess |
|
dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es |
|
dc.subject |
Humans |
en_US |
dc.subject |
Peru |
en_US |
dc.subject |
Risk Factors |
en_US |
dc.subject |
controlled study |
en_US |
dc.subject |
major clinical study |
en_US |
dc.subject |
endemic disease |
en_US |
dc.subject |
Prevalence |
en_US |
dc.subject |
comorbidity |
en_US |
dc.subject |
rifampicin |
en_US |
dc.subject |
methodology |
en_US |
dc.subject |
health care personnel |
en_US |
dc.subject |
infection rate |
en_US |
dc.subject |
sputum culture |
en_US |
dc.subject |
high risk population |
en_US |
dc.subject |
infection risk |
en_US |
dc.subject |
ethambutol |
en_US |
dc.subject |
isoniazid |
en_US |
dc.subject |
Tuberculosis, Multidrug-Resistant |
en_US |
dc.subject |
Endemic Diseases |
en_US |
dc.subject |
antibiotic resistance |
en_US |
dc.subject |
Mass Screening |
en_US |
dc.subject |
structured questionnaire |
en_US |
dc.subject |
alcohol abuse |
en_US |
dc.subject |
drug abuse |
en_US |
dc.subject |
prisoner |
en_US |
dc.title |
High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors. |
en_US |
dc.type |
info:eu-repo/semantics/article |
|
dc.identifier.doi |
https://doi.org/10.1371/journal.pone.0026276 |
|
dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#3.01.00 |
|
dc.relation.issn |
1932-6203 |
|