Universidad Peruana Cayetano Heredia

High prevalence of primary multidrug resistant tuberculosis in persons with no known risk factors.

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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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