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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 |
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